Scaling Up Contraceptive Use in LMICs: A Systematic Review of Social and Behavioral Change Interventions

Abstract

Background: Despite global family planning initiatives, many women in low- and middle-income countries (LMICs) continue to encounter barriers to contraceptive access, contributing to persistently high unmet need. Social and behavior change (SBC) interventions, such as mass media campaigns, peer education, community engagement, and male involvement; have been increasingly employed to enhance knowledge, shift attitudes, and support sustained contraceptive use.

Methodology: This systematic review followed PRISMA 2020 guidelines. PubMed, Google Scholar, Scopus, Web of Science, and ScienceDirect were searched for studies published between 2014 and 2024. Eligible studies included randomized controlled trials (RCTs), quasi-experimental, and cohort designs with measurable contraceptive outcomes and robust statistical analyses.

Results: Twenty studies met the inclusion criteria, encompassing mHealth and telehealth technologies, community-based programs, and counseling services. SBC interventions were associated with significant improvements in contraceptive uptake and acceptability. Effective elements included tailored educational materials, digital platforms, male partner engagement, and peer support networks. Several interventions also enhanced psychosocial outcomes and improved access to family planning services.

Conclusion: SBC interventions significantly increase contraceptive use in LMICs, with greater impact when incorporating community participation, culturally tailored messaging, and supportive financial measures. Future research should address gaps in the long-term effectiveness of digital approaches and assess scalability across diverse settings. Policymakers should prioritize evidence-based SBC strategies to ensure equitable access to family planning services.