Safety and Acceptability of Community-Based Distribution of Injectable Contraceptives: A Pilot Project in Mozambique

Jacinto, Ana; Mobaracaly, Mahomed Riaz; Ustáb, Momade Bay; Bique, Cassimo; Blazer, Cassandra; Weidert, Karen; Prata, Ndola

doi:10.9745/ghsp-d-16-00133

Cited by 14 publications

(31 citation statements)

References 19 publications

(21 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…CHWs (men and women) were accepted by their communities and effectively delivered a complex intervention without adverse events, despite their low education level and lack of previous training either to measure BP, proteinuria, or pulse oximetry [15] , or to administer medications in pregnancy. This has important implications for additional task-sharing to strengthen access to primary and maternity health care, as they already administer of oral misoprostol to prevent postpartum haemorrhage and injectable contraception in the community [23] . CHWs must cover large areas (of 5–8 km) around health facilities, are sustained by external partners and restrictions on spending limit governmental ability to regularise their employment.…”

Section: Discussionmentioning

confidence: 99%

Community-level interventions for pre-eclampsia (CLIP) in Mozambique: A cluster randomised controlled trial

Sevene

Sharma

Munguambe

et al. 2020

Pregnancy Hypertension

Self Cite

View full text Add to dashboard Cite

Highlights Task-sharing activities to detect and manage pregnancy hypertension can be achieved by CHWs. Community engagement activities can achieve a community-driven transport plan. Intervention effects may have been masked by incomplete implementation or weak in-facility care. Contact intensity analyses support the WHO eight contact antenatal care model. Condition-focused community-based interventions without facility strengthening are inadequate.

show abstract

Section: Discussionmentioning

confidence: 99%

Community-level interventions for pre-eclampsia (CLIP) in Mozambique: A cluster randomised controlled trial

Sevene

Sharma

Munguambe

et al. 2020

Pregnancy Hypertension

Self Cite

View full text Add to dashboard Cite

show abstract

“…A wide variety of study designs have been used to examine CHW performances in SSA based on the present evidence base. Of the 13 eligible studies, 4 were non-randomized community trials (non-RCTs) [ 19 – 22 ], 3 descriptive cross-sectional studies [ 4 , 15 , 18 ], 2 descriptive longitudinal studies [ 23 , 24 ], 1 pilot intervention [ 14 ], 1 randomized control trial [ 17 ] and 2 case study [ 10 , 25 ]. Most of the studies had a study period of 12–13 months [ 15 , 21 , 23 , 25 ] and 1 had a study period of 3 years [ 20 ].…”

Section: Resultsmentioning

confidence: 99%

Provision of injectable contraceptives by community health workers in sub-Saharan Africa: a systematic review of safety, acceptability and effectiveness

et al. 2022

View full text Add to dashboard Cite

Background Injectable contraceptives are the most popular method of contraception in sub-Saharan Africa (SSA), but their availability in clinical settings has been severely limited, despite the scarcity of health care providers and limited access to health facilities. WHO and USAID have endorsed the community-based distribution of injectable contraceptives as a promising option for improving access to family planning services and expanding the method mix for women who want to limit the number of births. Studies have shown that community health workers (CHWs) can provide women with injectable contraceptives that meet acceptable quality standards. The goal of this study is to identify, evaluate and synthesize evidence supporting the use of community-based administration of injectable contraceptives in SSA. Methods This review's guidance was based on a previously developed protocol. Nine international electronic databases and the websites of organizations known to support community-based reproductive health initiatives in SSA were searched systemically. Experts in this area were also contacted for the identification of unpublished literature and ongoing studies. The reference lists of eligible studies were reviewed. The Effective Public Practice Project tool was used to assess the quality and risk of bias in eligible studies. Data were extracted and analysed using a custom data extraction form and a narrative synthesis. Results The search strategy identified a total of 1358 studies with 12 studies meeting the inclusion criteria. One unpublished study was provided by an expert making a total of 13 studies. The results showed that irrespective of the study designs, well-trained CHWs can competently administer injectable contraceptives safely and community-based delivery of injectable contraceptives is acceptable in SSA. Also, the use of community health workers in the provision of depot-medroxyprogesterone acetate expanded access to inhabitants of hard-to-reach areas and led to an overall uptake of injectable contraceptives as well as family planning. Studies that compared CHWs to clinic-based providers revealed equivalent or higher levels of performance in favour of CHWs. Conclusions The CHWs can competently provide injectable contraceptives within SSA communities if appropriately trained and supervised. Hence, SSA policymakers should give this initiative due consideration as a way of improving access to family planning services.

show abstract

“…The success of CHWs among the less educated, poor or rural populations is not a speci city of Rwanda; it was reported by many researchers using different approaches and scales across the world [3,9,[19][20][21][22][23][24].…”

Section: Discussionmentioning

confidence: 99%

Socio-economic factors associated with the choice of community health workers as contraceptive providers in Rwanda

Muhoza

Ruturwa

Kabano

2022

Preprint

View full text Add to dashboard Cite

Background: In 2008, Rwanda decided to enhance its community health program in order to further scale up the health system effectiveness. One of the components of the program is the community-based family planning. Between 2010 and 2015, the proportion of women using contraception from the community health workers (CHWs) increased threefold. This study aims at identify the socio-economic factors associated with the choice of CHWs as contraceptive providers in Rwanda in the period 2010-2015. Methods: The study uses a pooled dataset from the 2010 and 2015 Rwanda Demographic and Health Surveys. It is restricted to women in union aged 15-49 years. The dependent variable is the source of modern method used at the time of survey. Independent variables include demographic characteristics, socioeconomic factors, and regional variable. Descriptive statistics and multinomial logistic regression are used to assess the association. Results: The results indicate that the choice of CHWs is negatively associated with socioeconomic factors (education, economic status, residence, etc) and varies with provinces. The propensities of referring to CHWs are significantly higher among women with no or low education (odds ratio [OR]: 3.76 and 3.80), women from poor or middle households (OR: 1.20, 1.27) or among those living in rural areas (OR: 1.04) than among women with high education, residing in rich households or in urban areas. The Northern Province has recorded the highest adhesion to CHWs (OR: 2.47), followed by the Eastern (OR: 1.88) and Southern (OR: 1.69). Conclusions: The community health program gained higher approval and adoption among the lower socioeconomic segments of the population. The combined effects of high contraceptive uptake from CHWs among the poor populations and rural residents and that of their predominant share in the total population enable to assume further decline of fertility in Rwanda.

show abstract

Safety and Acceptability of Community-Based Distribution of Injectable Contraceptives: A Pilot Project in Mozambique

Cited by 14 publications

References 19 publications

Community-level interventions for pre-eclampsia (CLIP) in Mozambique: A cluster randomised controlled trial

Community-level interventions for pre-eclampsia (CLIP) in Mozambique: A cluster randomised controlled trial

Provision of injectable contraceptives by community health workers in sub-Saharan Africa: a systematic review of safety, acceptability and effectiveness

Socio-economic factors associated with the choice of community health workers as contraceptive providers in Rwanda

Contact Info

Product

Resources

About