Document Detail


Provision of DMPA by community health workers: what the evidence shows.
MedLine Citation:
PMID:  21570545     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
BACKGROUND: To reduce a large unmet need for family planning in many developing countries, governments are increasingly looking to community health workers (CHWs) as an effective service delivery option for health care and as a feasible option to increase access to family planning services. This article synthesizes evidence on the feasibility, safety and effectiveness of community-based delivery of the injectable contraceptive depot-medroxyprogesterone acetate (DMPA).
STUDY DESIGN: Manual and electronic search and systematic review of published and unpublished documents on delivery of contraceptive injectables by CHWs.
RESULTS: Of 600 identified documents, 19 had adequate information on injectables, almost exclusively intramuscular DMPA, provided by CHWs. The data showed that appropriately trained CHW demonstrate competency in screening clients, providing DMPA injections safely and counseling on side effects, although counseling appears equally suboptimal in both clinic and community settings. Clients and CHWs report high rates of satisfaction with community-based provision of DMPA. Provision of DMPA in community-based programs using CHWs expanded access to underserved clients and led to increased uptake of family planning services.
CONCLUSIONS: We conclude that DMPA can be provided safely by appropriately trained and supervised CHWs. The benefits of community-based provision of DMPA by CHWs outweigh any potential risks, and past experiences support increasing investments in and expansion of these programs.
Authors:
Shawn Malarcher; Olav Meirik; Elena Lebetkin; Iqbal Shah; Jeff Spieler; John Stanback
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Publication Detail:
Type:  Journal Article     Date:  2010-10-06
Journal Detail:
Title:  Contraception     Volume:  83     ISSN:  1879-0518     ISO Abbreviation:  Contraception     Publication Date:  2011 Jun 
Date Detail:
Created Date:  2011-05-16     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0234361     Medline TA:  Contraception     Country:  United States    
Other Details:
Languages:  eng     Pagination:  495-503     Citation Subset:  IM    
Copyright Information:
Published by Elsevier Inc.
Affiliation:
Office of Population and Reproductive Health, Bureau for Global Health, USAID, Washington, DC 20523-3600, USA.
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