Task Shifting Provision of Contraceptive Implants to Community Health Extension Workers: Results of Operations Research in Northern Nigeria

Abstract

With training and supportive supervision, male and female Community Health Extension Workers (CHEWs) in Nigeria safely and effectively provided contraceptive implants, and virtually all clients said they were satisfied. Most CHEWs achieved competency after 5 client insertions. However, the CHEWs provided only an average of 4 insertions per health facility per month. Realizing the true potential of providing implants calls for a context with dedicated providers and robust outreach.

Strengthening implant provision and acceptance in South Africa with the ‘Any woman, any place, any time’ approach: An essential step towards reducing unintended pregnancies

“…Furthermore, in several settings in Africa and Asia, LARC services rely heavily on community health workers (CHWs). [23][24][25] They lead community-based distribution of the implant, visit users' homes and provide support for women experiencing side-effects. A study in rural Northern Nigeria, where CHWs were tasked with inserting implants, showed the importance of frequent supervisory visits for CHWs.…”

“…A study in rural Northern Nigeria, where CHWs were tasked with inserting implants, showed the importance of frequent supervisory visits for CHWs. [24] In the absence of such support, CHWs reverted to dispensing shorter-acting methods. [26] CHWs in SA, especially at 'primary healthcare re-engineering' sites, [27] and HIV lay counsellors -already adept at 'task shifting' -could play an important role in implant services through demand creation, conducting pre-insertion counselling around LARCs and providing follow-up support.…”

Assessing the Competency and Acceptability of Community Health Worker Provision of Standard Days Method® in Family Planning Services in Gisagara District, Rwanda

“…; Stanback, Mbonye, and Bekiita ), emergency contraception (Chin‐Quee, Stanback, and Graham ; Khan, Hossain, and Rahman ), implants (Charyeva et al. ), and Fertility Awareness Methods such as the Lactational Amenorrhea Method (IRH ; Sebastian et al. ) and SDM (Johri, Panwar, and Lundgren ; Toth ; IRH ).…”

“…and Samadi 2010;Hoke et al 2011;Arrowsmith et al 2012), reductions in fertility rates (Phillips, Bawah, and Binka 2006), maternal mortality (Perry, Zulliger, and Rogers 2014), and the ability to attract new and different types of family planning users (Prata et al 2011). Clients benefit from cost and time savings by receiving services in their community (Simba et al 2011;Shelus et al 2015), and generally report high levels of satisfaction with their health worker (Stanback, Mbonye, and Bekiita 2007;Lebetkin et al 2014;Hoke et al 2011;Charyeva et al 2015;Prata et al 2011). CHWs and other community agents have been shown to be capable of offering a variety of methods including pills (Gallo et al 2013;Perry, Zulliger, and Rogers 2014) injectables (Huber, Saeedi.…”

Effectiveness of Alcohol, Smoking, and Substance Involvement Screening Test-Linked Brief Intervention on Harmful and Hazardous Alcohol Use in Nigerian Semirural Communities: A Non-Randomized Intervention Study

“…Dedicated low-cost health care workers such as community health extension workers (CHEW) are available and more in contact with people at the grass roots especially with regards to immunization programmes in Nigeria. They have been involved in task-shifting models to address gaps in reproductive health care in primary care settings in Nigeria (23) as well as for depression in primary health care settings (24). However, this model has not been examined with regards to substance use and particularly in rural settings.…”