title: Protocol for a systematic review on the effect of demand generation interventions on uptake and use of modern contraceptives in LMIC.
abstract: BACKGROUND
  Despite a global increase in contraception use, its prevalence remains low in low- and middle-income countries. One strategy to improve uptake and use of contraception, as an essential complement to policies and supply-side interventions, is demand generation. Demand generation interventions have reportedly produced positive effects on uptake and use of family planning services, but the evidence base remains poorly documented. To reduce this knowledge gap, we will conduct a systematic review on the impact of demand generation interventions on the use of modern contraception. The objectives of the review will be as follows: (1) to synthesize evidence on the impacts and costs of family planning demand generation interventions and on their effectiveness in improving modern contraceptive use and (2) to identify the indicators used to assess effectiveness, cost-effectiveness, and impacts of demand generation interventions.
  
  
  METHODS
  We will systematically review the public health and health promotion literature in several databases (e.g., CINAHL, Medline, EMBASE) as well as gray literature. We will select articles from 1970 to 2015, in French and in English. The review will include studies that assess the impact of family planning programs or interventions on changes in contraception use. The studied interventions will be those with a demand generation component, even if a supply component is implemented. Two members of the team will independently search, screen, extract data, and assess the quality of the studies selected. Different tools will be used to assess the quality of the studies depending on the study design. If appropriate, a meta-analysis will be conducted. The analysis will involve comparing odd ratios (OR) DISCUSSION: The systematic review results will be disseminated to United Nations Population Fund program countries and will contribute to the development of a guidance document and programmatic tools for planning, implementing, and evaluating demand generation interventions in family planning. Improving the effectiveness of family planning programs is critical for empowering women and adolescent girls, improving human capital, reducing dependency ratios, reducing maternal and child mortality, and achieving demographic dividends in low- and middle-income countries.
  
  
  BACKGROUND
  This protocol is registered in PROSPERO (CRD 42015017549).
authors.affiliation: Maternal and Reproductive Health Unit, Public Health Department, Institute of Tropical Medicine, 155 Nationalestraat, 2000, Antwerp, Belgium. Belaid.loubna@gmail.com.
authors.forename: Loubna
authors.initials: L
authors.lastname: Belaid
authors.affiliation: UMR 216 IRD-Université Paris Descartes, 4 Avenue de l'Observatoire, 75 006, Paris, France. alexandre.dumont@ird.fr.
authors.forename: Alexandre
authors.initials: A
authors.lastname: Dumont
authors.affiliation: Département d'obstétrique et gynécologie et département de Médecine de famille et médecine d'urgence, Faculté de médecine et des sciences de la santé, Centre de recherche du CHUS: Axe Santé: populations, organisation, pratiques, Université de Sherbrooke, Sherbrooke, Canada. Nils.Chaillet@usherbrooke.ca.
authors.forename: Nils
authors.initials: N
authors.lastname: Chaillet
authors.affiliation: Maternal and Reproductive Health Unit, Public Health Department, Institute of Tropical Medicine, 155 Nationalestraat, 2000, Antwerp, Belgium. vdbrouwere@itg.be.
authors.forename: Vincent
authors.initials: V
authors.lastname: De Brouwere
authors.affiliation: Centre de recherche du CHUM, Axe Évaluation, Systèmes de soins et services, Université de Montréal, 850, rue Saint Denis-Tour S, Local S03-814, Montréal, QC, H2X 0A9, Canada. amel.zertal.chum@ssss.gouv.qc.ca.
authors.forename: Amel
authors.initials: A
authors.lastname: Zertal
authors.affiliation: Commodity Security Branch, Technical Division, United Nations Population Fund, 605 3rd Avenue, New York, NY, 10158, USA. hounton@unfpa.org.
authors.forename: Sennen
authors.initials: S
authors.lastname: Hounton
authors.affiliation: Institut de recherche en santé publique de l'Université de Montréal (IRSPUM), 7101 Avenue du Parc, bureau 3187-03, Montréal, Québec, H3N1X9, Canada. Valery.ridde@umontreal.ca.|ESPUM (école de santé publique de l'Université de Montréal), Montréal, Canada. Valery.ridde@umontreal.ca.
authors.forename: Valéry
authors.initials: V
authors.lastname: Ridde
mesh_terms: D003268:Contraception Behavior; D003270:Contraceptive Agents / Q000600:supply & distribution / Q000627:therapeutic use*; D003362:Cost-Benefit Analysis; D003906:Developing Countries; D005193:Family Planning Services / Q000706:statistics & numerical data* / Q000600:supply & distribution; D006266:Health Education / Q000191:economics; D006801:Humans; D010342:Patient Acceptance of Health Care; D015397:Program Evaluation; D012107:Research Design; D000078202:Systematic Reviews as Topic; D014480:United Nations
chemical_list: D003270:Contraceptive Agents