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Trained community-based distributors successfully
provide injectable contraceptives, Madagascar.
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| Article Type: | Brief article |
| Subject: |
Contraceptive drugs, Injectable
(Distribution) Community health aides (Practice) |
| Pub Date: | 05/01/2012 |
| Publication: | Name: Reproductive Health Matters Publisher: Elsevier Science Publishers Audience: General Format: Magazine/Journal Subject: Family and marriage; Health; Women's issues/gender studies Copyright: COPYRIGHT 2012 Reproductive Health Matters ISSN: 0968-8080 |
| Issue: | Date: May, 2012 Source Volume: 20 Source Issue: 39 |
| Topic: | Event Code: 690 Goods & services distribution; 200 Management dynamics Advertising Code: 59 Channels of Distribution Computer Subject: Company distribution practices |
| Product: | Product Code: 2834128 Injectable Contraceptives NAICS Code: 325412 Pharmaceutical Preparation Manufacturing SIC Code: 2834 Pharmaceutical preparations |
| Geographic: | Geographic Scope: Madagascar Geographic Name: Madagascar Geographic Code: 6MADA Madagascar |
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| Accession Number: | 296571596 |
| Full Text: |
Madagascar's Ministry of Health and Family Planning sought
evidence regarding the safety, effectiveness and acceptability of
community-based distribution (CBD) of injectable contraceptives. 62
experienced CBD agents from 13 very poor communities with low service
provision and low contraceptive usage were trained in provision of
injectables in 2006. Management mechanisms for injectables were added to
the existing CBD systems for record keeping, commodity management and
supervision. After seven months of service provision, service records
were reviewed and CBD workers and their supervisors and service users
were interviewed. CBD workers demonstrated competence in injection
technique, counselling and management of re-injection schedules, with
nearly half the agents scoring the maximum possible points.
Community-based distribution of injectables appeared to increase
contraceptive use, with 1,662 women accepting injectables from a CBD
worker. Of these, 41% were new family planning users. Ali CBD agents
wished to continue providing this service, and most supervisors
indicated the programme should continue. Nearly all women interviewed
intended to return to the CBD worker for re-injection and would
recommend this service to a friend. Two gaps needing improvement were
counselling on possible side effects and use of a checklist to rule out
pregnancy for non-menstruating women, which called for enhanced training
and supervision. This intervention shows the feasibility, effectiveness
and acceptability of CBD services for injectable contraceptives. It is
an example of effective task shifting as a means of extending services
to underserved populations. (1) [ILLUSTRATION OMITTED] (1.) Hoke T, Wheeler SB, Lynd K, et al. Community-based provision of injectable contraceptives in Madagascar: 'task shifting' to expand access to injectable contraceptives. Health Policy and Planning 2011;1-8. Doi:10.1093/ heapol/cz003. Doi: 10.1016/S0968-8080(12)39628-6 |
| Gale Copyright: | Copyright 2012 Gale, Cengage Learning. All rights reserved. |