The effectiveness of Community Based Distribution of Injectable Contraceptives using Community Health Extension Workers in Gombe State, Northern Nigeria

Rabiatu A. Abdul-hadi, Moyosola M. Abass, Bolatito O. Aiyenigba, Lolade O. Oseni, Solomon Odafe, Otto N. Chabikuli, Mohammed D. Ibrahim, Christoph Hamelmann, Oladapo A. Ladipo

Abstract

This study reports on findings of a pilot of community-based distribution (CBD) of injectable contraceptives in two local government areas (LGAs) of Gombe State, Nigeria. From August 2009 to January 2010, the project enrolled, trained and equipped community health extension workers (CHEWs) to distribute condoms, oral and injectable contraceptives in communities. The project mobilized communities and stakeholders to promote Family Planning (FP) services in the selected communities. Using anonymised unlinked routine service data, the mean couple years of protection (CYP) achieved through CBD was compared to that achieved in FP clinics. The CBD mean CYP for injectables- depo medroxy-progesterone acetate (DMPA) and norethisterone enantate was higher (27.72 & 18.16 respectively) than the facility CYP (7.21 & 5.08 respectively)

(p<0.05) with no injection related complications. The CBD’s mean CYP for all methods was also found to be four times higher (11.65) than that generated in health facilities (2.86) (p<0.05). This suggests that the CBD of injectable contraceptives is feasible and effective, even in a setting like northern Nigeria that has sensitivities about FP.  (Afr J Reprod Health 2013; 17[2]: 80-88).

Résumé

Cette étude porte sur les résultats d’un projet pilote de distribution à base communautaire (DBC) des contraceptifs injectables dans deux Administrations Locales (AL) de l’Etat de Gombe, Nigeria. D’aout 2009 au janvier 2010,  a inscrit, a formé et a équipé des membres de personnel de santé communautaire (MPSC) pour distribuer des préservatifs, des contraceptifs oraux et des injectables dans les communautés.  Le projet a mobilisé les communautés et les parties prenantes pour promouvoir la planification familiale (PF) dans les communautés choisies.  , les L’utilisation des données de service de routine anonyme et non corrélées, la  moyenne de couple d’années de protection (CAP) obtenue par la CDB a été comparée à celle obtenue dans les cliniques de PF.  La DBC de CAP pour les produits injectables Depomedroxy-acétate de progestérone (DMPA) et  l'énanthate de noréthistérone était plus élevé (27,72 et 18,16 respectivement) que l'installation (7,21 et 5,08 respectivement) CYP (p <0,05), sans des  complications liées à l’injection.  On a trouvé que la CAP moyenne de la DB pour toutes les méthodes a également était quatre fois plus élevée (11,65) que celles générées dans les établissements de santé (2,86) (p <0,05). Ceci suggère que la DBC des contraceptifs injectables est réalisable et efficace, même dans un milieu tel que le nord du Nigeria qui a des sensibilités de la PF. (Afr J Reprod Health 2013; 17[2]: 80-88).

 

Keywords: Community-based provision, contraceptives, injectable, PHC

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