Community-Based Distribution of Contraceptives in Zaire

Bertrand, Jane T.; McBride, Mark E.; Mangani, Nlandu; Baughman, Nancy C.; Kinuani, Mombela

doi:10.2307/2133241

Cited by 10 publications

(7 citation statements)

References 3 publications

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“…This view implies a homogeneity of norms, values, and status among community members that places CBDs and their clients on equal footing in their everyday interactions (Cornish & Ghosh, 2007). Indeed, this view is supported by numerous quantitative studies, which find that CBD performance is consistent enough across various demographic characteristics—such as age, gender, and marital status—to conclude that willingness to perform and proper training are the most important determinants of distributor behavior rather than specific traits that correspond to particular target populations (Bertrand, Mcbride, Mangani, Baughman, & Kinuani, 1993; Bertrand, Pineda, Santiso, & Hearn, 1980; Kipp & Flaherty, 2003). …”

mentioning

confidence: 97%

Local Hierarchies and Distributor (Non) Compliance: A Case Study of Community-Based Distribution in Rural North India

Abbott

Luke

2011

Health Care for Women International

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Community-based distribution of family planning services is particularly appropriate for South Asia, which has hard-to-reach rural populations. In Uttar Pradesh (UP), India, local status hierarchies of gender, caste, and generation shape the nature of relationships that community-based distributors (CBDs) create with their clients. In this case study of an “ideal” distributor, we uncover the conflicting expectations that many CBDs experience: to comply with project objectives without violating local social norms that limit interactions across status boundaries. Our CBD responded to these dual pressures with varying strategies, often perpetuating social distance and restricting information and services for men, adolescents, and other marginalized populations.

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confidence: 97%

Local Hierarchies and Distributor (Non) Compliance: A Case Study of Community-Based Distribution in Rural North India

Abbott

Luke

2011

Health Care for Women International

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“…4 In Zaire, an impact evaluation of a pilot community project initiated in the 1980s used a quasi-experimental design and found the program to be an acceptable distribution system; it could not, however, establish if the increase in contraceptive prevalence was due to the program or to expanded clinicbased services. 5 A program's effectiveness depends on how a number of organizational components-such as training, recruitment and supervision of workers, remuneration, the extent of community involvement, 6 sustainability, cost-effectiveness and the link to formal services 7 -are addressed. Because different strategies can work for different communities, operations research has received increasing recognition as an important part of evaluating these projects.…”

mentioning

confidence: 99%

Increasing Access to Family Planning Services in Rural Mali Through Community-Based Distribution

Katz¹,

West²,

Doumbia³

et al. 1998

International Family Planning Perspectives

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Background: Family Planning (FP) is a key developmental focus for the government of Nepal. Use of modern contraceptives has stagnated at 43.2% since 2011. Unmet need for family planning (FP) in Nepal remains high at 27%. Despite relatively high unmet need, a factor contributing to this levelling of contraceptive use is the limited range of methods available to most clients at most sites. To address the FP need among married women of reproductive age (WRA), we tested integration of FP into agricultural programs. Aim: To assess the effectiveness of a FP program integrated into an agriculture (e.g., non-health) sector program. Methods: A descriptive cross-sectional (post interventional) study was conducted November 2015 to February 2016 among 525 WRA participating in an agriculture program. Results: The contraceptives commonly used by women in the study location were Depo Provera and Minilap. After Technical Integration Coverage and Access (TICA) interventions, almost all of the respondents (99.6%) had heard about FP of which 67.8% correctly understood FP as a method to prevent unwanted pregnancy. About 50% of the respondents were found currently using FP. The percentage of WRA aware of long-acting and permanent FP methods increased from 49.0% to 62.0% and 39.0% to 52.0% respectively. Decisions on using a FP method were predominantly made by the husband (68.0%). However, 68.4% women reported that they were accompanied by their husband. The proportion of men willing to use FP increased from 5.2% to 15.5% after TICA activities implementation. The main reason identified for not currently using FP devices was that the husband and wife were not living together (88.8%). Most of the women (98.0%) reported that FP utilization improved their quality of life. Conclusion: TICA activities were very successful in both increasing FP knowledge level as well as utilizing FP services among the targeted beneficiaries. The use of FP increased

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“…Previous studies have noted similar differentials in contraceptive use between urban and rural residents in sub-Saharan Africa [ 1 , 6 ]. In addition, while several quasi-experimental studies have found positive associations between contraceptive use and community-based distribution programs [ 7 , 9 , 26 , 27 ], the size of these associations varies widely due in part to differences in study design and setting.…”

Section: Discussionmentioning

confidence: 99%

“…In the 1970s, widespread use of CBD occurred in Asia and Latin America, but the first programs did not reach Africa until the early 1980s [ 9 ]. The popularity of CBD programs in Africa grew steadily throughout the next two decades–from seven countries operating programs in 1984 to 20 countries between 1994 and 1998 [ 10 ].…”

Section: Introductionmentioning

confidence: 99%

Can family planning outreach bridge the urban-rural divide in Zambia?

White

Speizer

2007

BMC Health Serv Res

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Background: Zambia experienced declining aggregate fertility and increasing aggregate contraceptive use from 1990 to 2000. Yet, in rural Zambia, progress in family planning has lagged far behind the advances made in Zambia's urban areas. The contraceptive prevalence rate in Lusaka and other urban areas outstripped the rate in rural Zambia by nearly 25 percentage points (41.2 percent versus 16.6 percent) in 2001. The total fertility rate varied between urban and rural areas by 2.5 children (4.3 versus 6.9 children). This paper considers the urban-rural differentials in Zambia and assesses family planning outreach as a tool to narrow this divide.

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Community-Based Distribution of Contraceptives in Zaire

Cited by 10 publications

References 3 publications

Local Hierarchies and Distributor (Non) Compliance: A Case Study of Community-Based Distribution in Rural North India

Local Hierarchies and Distributor (Non) Compliance: A Case Study of Community-Based Distribution in Rural North India

Increasing Access to Family Planning Services in Rural Mali Through Community-Based Distribution

Can family planning outreach bridge the urban-rural divide in Zambia?

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