Acceptability of contraceptive use in NTD-endemic regions
Acceptability of contraceptive use in NTD-endemic regions
Assess the acceptability of contraceptive use when medically indicated during treatment for leishmaniasis and Chagas or participation in clinical trials
updated 12 Dec 2025
Women of childbearing age are often excluded from clinical trials for neglected tropical diseases due to the potential risks of treatment during pregnancy. Treatments for leishmaniasis and Chagas disease can carry teratogenic risks, necessitating contraceptive use during treatment and for a defined period following treatment completion. However, access to and acceptability of contraception vary widely due to cultural, religious, and socioeconomic factors. Associated exclusion from access to treatment or clinical trials limits access to life-saving therapies and contributes to gender inequities in healthcare.
In collaboration with local and international partners, DNDi is conducting a multi-country study in endemic regions of Kenya, Brazil, and Colombia to assess the acceptability of medically indicated contraceptive use among women of childbearing age. The study aims to generate evidence that will inform recommendations for improving women’s access to treatments with potential reproductive toxicity for leishmaniasis and Chagas disease.
Using a mixed-methods, community-based participatory research approach, the study includes quantitative surveys with women of childbearing potential, in-depth interviews and focus group discussions with women, men, healthcare providers, and community advisory boards to guide study design.
Institutional ethics oversight and implementation support for the study are provided by Amref Health Africa (Kenya), Universidad del Norte (Colombia), and Federal University of Recôncavo da Bahia (Brazil). Local Community Advisory Boards in each country provide input and guidance to ensure study activities are respectful, relevant, and aligned to community needs.
Project updates
2025
Study preparation, including stakeholder mapping, protocol development, ethics approvals, and community engagement, has been completed in all three countries. Community Advisory Boards were established and actively contributed to the co-development and validation of research tools. Research teams received training on mixed-methods approaches, informed consent, and the community-based participatory research framework, while community members were engaged through disease awareness activities. Quantitative data collection was completed in Kenya and Colombia and initiated in Brazil and qualitative interviews and focus group discussions were conducted in Kenya and initiated in Colombia. Preliminary analyses of quantitative data were finalized, and qualitative data analysis is in progress.
Community Advisory Board meetings were held in each country to review progress and discuss findings, and dissemination efforts through community meetings and international conference presentations have begun. Quantitative data reveal widespread acceptance of contraception in the study area of Colombia among women surveyed in family planning settings ad when medically prescribed. This acceptance decreases significantly in clinical trial settings. The qualitative phase currently underway will attempt to explain the main and varied causes of this reduced acceptability.
- Amref Health Africa, Kenya
- Federal University of Recôncavo da Bahia , Brazil
- University of the North (Uninorte), Colombia
- Amref Health Africa
- ,Kenya
- Federal University of Recôncavo da Bahia
- ,Brazil
- University of the North (Uninorte)
- ,Colombia
- Amref Health Africa, Kenya
- University of the North (Uninorte), Colombia
- Federal University of Recôncavo da Bahia , Brazil
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