Objective: To show that low-cost attitudinal, structural and procedural changes aimed at improving responsiveness to patients have the potential to increase uptake of family planning (FP) even among populations considered reluctant to do so by health personnel.
Methods: Intervention study with before-after comparison of contraceptive acceptance, couple-years of protection (CYP) and an 'index of contraceptive uptake' (IUC) in rural health centres in Niger. The intervention consists of a package of instructions to actively propose family planning, integrated within curative and under-fives consultations, coupled with measures to increase the health centres' responsiveness to their clients.
Results: Implementation of the intervention package was followed by marked increases in family planning uptake.
Conclusion: Health services in Niger present an untapped potential for improving family planning through low-cost supply-side measures.