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Peer-reviewedCC BY 4.0PLOS One

Introduction of contraceptive implants as a family planning strategy in Honduras and Chiapas: Results from the Salud Mesoamerica Initiative (SMI)

  • Adrián Santoro1
  • Natalia Basualdo2
  • Federico Rolón3
  • Lucía Bartolomeu4
  • Camila Volij5
  • Matt Simon
  • Brittany Hagedorn
  • Diego Ríos-Zertuche
  • Santiago Esteban
  • Adolfo Rubinstein
5 affiliations
  1. 1Center for Implementation and Innovation in Health Policies, Institute for Clinical Effectiveness and Health Policy, Buenos Aires, Argentina
  2. 2Primary Health Care, Global Development Division, Gates Foundation, Seattle, Washington, United States of America
  3. 3Institute for Disease Modeling, Global Health Division, Gates Foundation, Seattle, Washington, United States of America
  4. 4Health, Nutrition and Population Division, Inter-American Development Bank, Washington, District of Columbia, United States of America
  5. 5Social Protection and Health Division, Inter-American Development Bank, Washington, District of Columbia, United States of America
Open at sourceDOICite

Abstract

Expanding access to a broad range of contraceptive methods is critical for reducing unintended pregnancies and improving reproductive health. This study evaluates the introduction of subdermal contraceptive implants in the selected areas of Honduras and Chiapas, Mexico, in the context of the Salud Mesoamérica Initiative, a results-based financing program focused on disadvantaged populations. Data were obtained from household surveys conducted between 2012 and 2022 among women aged 15–49 years in selected intervention and comparison municipalities in Chiapas, Mexico, and Honduras, using a two-stage sampling design. Indicators included contraceptive prevalence rates, reasons for method switching, and adoption by sociodemographic characteristics. Findings show a substantial increase in implant use in both settings over time. In the selected areas of Honduras, implant uptake increased gradually, reaching 7.9% in the 2022 SMI household survey, while in the selected areas of Chiapas use rose to 7.2%. Younger women aged 20–29 years and those with full literacy exhibited the highest adoption rates. In the selected areas of Chiapas and Honduras, implants most often replaced non-modern and short-acting hormonal methods, suggesting successful integration into the existing method mix. Variations in adoption across sociodemographic subgroups highlight persistent inequities. The results underscore the potential of subdermal implants to expand access to long-acting reversible contraception in resource-limited settings. To sustain and enhance this progress, strategies must address sociocultural and structural barriers, ensuring equitable access across all population groups and mitigating service disruptions. These findings may inform future strategies to expand informed contraceptive choice in similar resource-limited settings; their effects on reproductive health outcomes require further evaluation.

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Cite

BibTeXRIS
BibTeX
@article{santoro2026introduction,
  title = {{Introduction of contraceptive implants as a family planning strategy in Honduras and Chiapas: Results from the Salud Mesoamerica Initiative (SMI)}},
  author = {Adrián Santoro and Natalia Basualdo and Federico Rolón and Lucía Bartolomeu and Camila Volij and Matt Simon and Brittany Hagedorn and Diego Ríos-Zertuche and Santiago Esteban and Adolfo Rubinstein},
  journal = {PLOS One},
  year = {2026},
  month = nov,
  doi = {10.1371/journal.pone.0362270},
  url = {https://doi.org/10.1371/journal.pone.0362270},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - Introduction of contraceptive implants as a family planning strategy in Honduras and Chiapas: Results from the Salud Mesoamerica Initiative (SMI)
AU  - Adrián Santoro
AU  - Natalia Basualdo
AU  - Federico Rolón
AU  - Lucía Bartolomeu
AU  - Camila Volij
AU  - Matt Simon
AU  - Brittany Hagedorn
AU  - Diego Ríos-Zertuche
AU  - Santiago Esteban
AU  - Adolfo Rubinstein
PY  - 2026
DA  - 2026/11/06
JO  - PLOS One
DO  - 10.1371/journal.pone.0362270
UR  - https://doi.org/10.1371/journal.pone.0362270
AB  - Expanding access to a broad range of contraceptive methods is critical for reducing unintended pregnancies and improving reproductive health. This study evaluates the introduction of subdermal contraceptive implants in the selected areas of Honduras and Chiapas, Mexico, in the context of the Salud Mesoamérica Initiative, a results-based financing program focused on disadvantaged populations. Data were obtained from household surveys conducted between 2012 and 2022 among women aged 15–49 years in selected intervention and comparison municipalities in Chiapas, Mexico, and Honduras, using a two-stage sampling design. Indicators included contraceptive prevalence rates, reasons for method switching, and adoption by sociodemographic characteristics. Findings show a substantial increase in implant use in both settings over time. In the selected areas of Honduras, implant uptake increased gradually, reaching 7.9% in the 2022 SMI household survey, while in the selected areas of Chiapas use rose to 7.2%. Younger women aged 20–29 years and those with full literacy exhibited the highest adoption rates. In the selected areas of Chiapas and Honduras, implants most often replaced non-modern and short-acting hormonal methods, suggesting successful integration into the existing method mix. Variations in adoption across sociodemographic subgroups highlight persistent inequities. The results underscore the potential of subdermal implants to expand access to long-acting reversible contraception in resource-limited settings. To sustain and enhance this progress, strategies must address sociocultural and structural barriers, ensuring equitable access across all population groups and mitigating service disruptions. These findings may inform future strategies to expand informed contraceptive choice in similar resource-limited settings; their effects on reproductive health outcomes require further evaluation.
SN  - 1932-6203
ER  -