157 J Fam Plann Reprod Health Care 2012;38:157–166. doi:10.1136/jfprhc-2011-100116 Article Abstract Background and methodology The Standard Days Method ® (SDM) is a fertility awareness-based method of family planning that helps users to identify the fertile days of the reproductive cycle (Days 8–19). To prevent pregnancy users avoid unprotected sexual intercourse during these days. A cross-sectional community- based study was conducted from December 2007 to June 2008 in four operational areas of Pathfinder International Ethiopia. A total of 184 SDM users were included in the study. Quantitative and qualitative methods of data collection were used. The aim of the study was to examine the experience of introducing the SDM at community level in Ethiopia. Results Of the 184 participants, 80.4% were still using the SDM at the time of the survey, with 35% having used it for between 6 and 12 months, while 42% had used it for more than a year. The majority (83%) knew that a woman is most likely to conceive halfway through her menstrual cycle, and nearly 91% correctly said that the SDM does not confer protection from sexually transmitted infections/AIDS. A substantial majority (75%) had correctly identified what each colour- coded bead represents in the CycleBeads ® , and an aggregate of 90.5% of women practised all the elements of correct use. Discussion and conclusions This study demonstrates the importance of the SDM in increasing the availability and accessibility of family planning, and the potential to improve family planning method choice and method mix by expanding use of the SDM. Introduction Ethiopia is the second most populous country in Africa 1 with high maternal mortality ratio (673 per 100 000 live births). Though there has been a decline in fertility from 6.4 births per woman in 1990 to 5.4 births in 2005, this rate is nevertheless still very high. The 2005 Ethiopian Demographic and Health Survey (EDHS) suggests that while 88% of currently married women and 93% of currently married men were aware of at least one method of contraception, only 15% of married women were using a contraceptive method. The contracep- tive prevalence was more than four times higher in urban (47%) than in rural (11%) areas. Modern contraceptive methods were more widely practised than tradi- tional methods, with 14% of currently married women using a modern method, and 1% using a traditional method. The most popular modern method was the injectable followed by oral contraceptive pills. The unmet need for family planning was calculated to be 34%, with 20% for spacing and 14% for limiting. 2 Knowledge about fertility and repro- ductive physiology is very low in Ethiopia. Only 11% of women and 8% of men could identify the middle of the menstrual cycle as the time women are most likely to become pregnant. 2 The low level of knowledge about the fertile period is an important factor accounting for unplanned pregnancies. 2 A way of averting unplanned pregnancies result- ing from poor knowledge about repro- ductive physiology and fertility can be 1 Regional Monitoring and Evaluation Advisor, HIV/AIDS Care and Support Program, Tigray Region, Ethiopia 2 Professor, School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia Correspondence to Biruhtesfa Bekele, HIV/AIDS Care and Support Program, Tigray Region, Ethiopia; birbek@yahoo.com Received 30 November 2009 Accepted 6 June 2011 Published Online First 20 August 2011 The Standard Days Method ® : an addition to the arsenal of family planning method choice in Ethiopia Biruhtesfa Bekele, 1 Mesganaw Fantahun 2 Key message points ▶ The Standard Days Method ® (SDM) has great potential for increasing the availability and accessibility of family planning in Ethiopia. ▶ The vast majority of women understood the elements for the correct use of the SDM method, and were willing to continue using this method. ▶ The SDM is an important addition to the method mix of family planning method choice in Ethiopia. copyright. on October 19, 2021 by guest. Protected by http://jfprhc.bmj.com/ J Fam Plann Reprod Health Care: first published as 10.1136/jfprhc-2011-100116 on 20 August 2011. Downloaded from