building on safety, feasibility and acceptability of community-based distribution of dmpa and...
TRANSCRIPT
Family Planning Integration and Depo-Provera Projects
• To assess safety, acceptability, feasibility, costs and CYP of DMPA
• To review national scale-up strategies
• To highlight key stakeholders and advocacy for policy change
Family Planning Integration Project
• FP users increased from 25% at baseline to 68% • Community knowledge of available FP methods rose 92%-97%• Spousal communication about FP increased from 31% to 66%• Birth spacing rose from 29% to 48%
Family Planning Integration Project (FPIP) began June 2006
FPIP II began in April of 2010, expanding upon Phase I
DMPA pilot study introduced in 2009 in collaboration with FHI360
Introduction of DMPA
• Safety of CBD agents’ provision of DMPA injections
• Acceptability and client satisfaction
• Changes in workload with CBD agent delivery of DMPA
• Impact of adding DMPA provision by CBD agents
• Incremental cost per couple-years of protection (CYP)
With approval from the GoZ and in collaboration with FHI 360
• Theory- and practice-based training
• Checklists to determine medical eligibility
• Links with health clinics• On-the-job training and
mentorship• Waste management,
procurement, reporting
Community-based Distributors of DMPA
Acceptability and Client Satisfaction• 94 percent of CBD clients (February and April 2010)
received a second DMPA injection • 93 percent wanted to get another DMPA injection • 98 percent were satisfied with the way CBD agent gave
them their injection • 98 percent would recommend receiving a DMPA injection
from their CBD agent to a friend
Feasibility and Costs
• More than 50% of DHOs reported a decrease in DMPA and FP clients at clinics
• About 35% of the women reported their first DMPA injection as their first use of a FP method
• Client Continuation rates for Injectables 63%• Cost per CYP for combined FP methodology of pills and
DMPA ranged from about US$11-$61
Key Stops on the Road to Success• Zambian Ministry of Health• Ministry of Community
Development, Mother & Child Health
• Family Planning Technical Working Group
Study Tour to Sustain Momentum• Worked to orient new leadership to the project• Improved country-level ownership • Provided regional learning for professional bodies, donors, implementers and ministries • Motivated plans for moving ahead with CHW-provision of DMPA in Zambia