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

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.