The Lancet Public Health Highlights Impact of Zika Contraception Access Network (Z-CAN) for Women in Puerto Rico

In 2016 during the Zika virus outbreak, Puerto Rico had the highest number of Zika infections in the United States, a high rate of unintended pregnancy and limited access to contraception, including long-acting reversible contraception (LARC), like intrauterine devices and contraceptive implants. At the time, action was needed to help women who desired to delay or avoid pregnancy during the Zika outbreak.

Today, we are very proud to announce that The Lancet Public Health published an article examining the initial results of the Zika Contraception Access Network (Z-CAN), one of the strategies established to prevent Zika-related birth defects in Puerto Rico. The article reports that Z-CAN provided services to more than 21,000 women on the island between May 2016 and mid-August 2017 and demonstrated the feasibility of implementing a program to increase access to the full range of reversible contraception within a complex public health response.

Among the findings highlighted in the article are:

  • Z-CAN was a short-term response for rapid implementation of reversible contraceptive services in a complex emergency setting in Puerto Rico. This model could be replicated or adapted as part of future emergency response efforts.
  • The program served more than 21,000 women from May 2016 to mid-August 2017. (The CDC Foundation estimates Z-CAN in total served more than 27,000 women before ending in September 2017.)
  • Z-CAN increased physician and staff capacity in contraception knowledge, counseling and initiation as well as management of contraceptive methods, including insertion and removal of LARCs.
  • Over two-thirds of women (67.5 percent) chose and received a LARC method; 24.9 percent chose either oral contraceptive pills, the transdermal patch, the vaginal ring, or depo medroxyprogesterone acetate injection; 2.9 percent chose condoms alone; and 4.5 percent did not receive a contraceptive method.

We are very pleased with the impact of Z-CAN and extremely grateful to all the donors and partners who quickly stepped forward to support the program during the Zika outbreak in Puerto Rico. Strong partnerships from the government, philanthropic, health and corporate sectors were essential to the success of Z-CAN and helped to protect more women in Puerto Rico.


Judy Monroe, MD, is president and CEO of the CDC Foundation.