Evolution of a Large-Scale Community-Based Contraceptive Distribution Program in Kinshasa, DRC Based on Process Evaluation

Hernandez, Julie; Akilimali, Pierre; Muanda, Mbadu; Glover, Annie; Bertrand, Jane T.

doi:10.9745/ghsp-d-18-00205

Cited by 10 publications

(14 citation statements)

References 19 publications

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“…Investments in quality, combined with free care, can therefore improve equity. For short-acting method users, community-level provision may improve their access and use of contraception, although results from such pilots in DRC have thus far been mixed [26,27]. It is, however, important to note that 20-24-year-olds were more likely to receive contraceptive information from health workers or CHWs than 15-19-yearolds.…”

Section: Plos Medicinementioning

confidence: 99%

Contraceptive use among adolescent and young women in North and South Kivu, Democratic Republic of the Congo: A cross-sectional population-based survey

Casey

Gallagher

Kakesa³

et al. 2020

PLoS Med

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Background Adolescent girls in humanitarian settings are especially vulnerable as their support systems are often disrupted. More than 20 years of violence in the Democratic Republic of the Congo (DRC) has weakened the health system, resulting in poor sexual and reproductive health (SRH) outcomes for women. Little evidence on adolescent contraceptive use in humanitarian settings is available. CARE, International Rescue Committee (IRC), and Save the Children, in collaboration with the Reproductive Health Access, Information and Services in Emergencies (RAISE) Initiative, Columbia University, have supported the Ministry of Health (MOH) since 2011 to provide good quality contraceptive services in public health facilities in conflict-affected North and South Kivu. In this study, we analyzed contraceptive use among sexually active young women aged 15-24 in the health zones served by the partners' programs. Methods and findings The partners conducted cross-sectional population-based surveys in program areas of North and South Kivu using two-stage cluster sampling in six health zones in July-August 2016 and 2017. Twenty-five clusters were selected in each health zone, 22 households in each cluster, and one woman of reproductive age (15-49 years) was randomly selected in each household. This manuscript presents results from a secondary data analysis for 1,022 women aged 15-24 who reported ever having sex: 326 adolescents (15-19 years) and 696 young women (20-24 years), 31.7% (95% confidence interval [CI] 29.5-34.1), of whom were displaced at least once in the previous five years. Contraceptive knowledge was high, with over 90% of both groups able to name at least one modern contraceptive method.

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Section: Plos Medicinementioning

confidence: 99%

Contraceptive use among adolescent and young women in North and South Kivu, Democratic Republic of the Congo: A cross-sectional population-based survey

Casey

Gallagher

Kakesa³

et al. 2020

PLoS Med

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“…In this issue of GHSP, Hernandez and colleagues present a notable description of how their process evaluation of a large community-based distribution (CBD) program in the capital city of the Democratic Republic of the Congo (DRC), Kinshasa, led to major improvements in that program 1 . We compliment the authors for forthrightly detailing the weaknesses they observed in the original design of the AcQual program and the reasonable changes they subsequently have made.…”

mentioning

confidence: 96%

Time to Evolve Beyond Prototypical Community-Based Distribution (CBD) of Contraception?

2018

Glob Health Sci Pract

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“…To overcome such challenges, increasing the number of the education sessions, arranging a group talk in a break and reassured the community names and personal information would be kept con dential by the promoters (40). Also, weak Interaction with clinical Services, having weak support and supervision of Community-Based Distributors and Recurring Stock-Outs of contraceptive (32). In line with these studies, our study deploys the following mechanism to minimize the challenges in the provision of the interventions.…”

Section: Discussionmentioning

confidence: 94%

“…Moreover, in the Kinshasa study, they recruited community-based distributors (CBDs) to have a group discussion, individual counseling, distribution of contraceptive (condom, pills, and CycleBeads) and arranging referral (32). Besides, a study done in Bahir district of India reports that an increment of FP following provision of training to the rural provider and community leaders, group meeting, and disseminating message using street theatre and wall painting for a total provision of the intervention 21-27 months.…”

Section: Discussionmentioning

confidence: 99%

Use of Community-based Interventions to Promote Family Planning Use Among Pastoralist Women in Ethiopia: Cluster Randomized Controlled Trial

Alemayehu

Medhanyie

Reed

et al. 2020

Preprint

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Background- Afar region is one of the pastoralists dominated regions in Ethiopia. The region is characterized by a low contraceptive prevalence rate (CPR) with 5.4%. Lack of awareness, husband objection, and religious influence was the reasons attributed to low CPR in the region. As objective we assessed the effect of a community-based interventions for promoting FP use among pastoralist communities of Afar region state, Ethiopia.MethodsThe design was parallel, cluster randomized controlled trial (CRT) recruiting married women. It had three arms: 1) women’s education on FP, 2) male involvement in FP education and 3) control with one to one ratio. A total of 33 kebeles (lowest administrative structure) were randomized and allocated. Women’s FP education and male involvement in FP education were the interventions. It was implemented using 1) health education on FP to married women and men by faema leaders (a traditional community-based structure that serves as a social support group) 2) Video-assisted message on FP, and 3) Assisting the faema leader using health workers. The intervention was given for a total of 9 months. FP use and intentions were measured as outcome variables based on woman’s perspectives. Cluster level summaries considering a cluster effect analysis was performed. The result was presented with adjusted risks and 95% CI. A p-value < 0.05 was used to declare statistically significant.ResultsThere was a positive change in the proportion of married women who use FP in the women’s FP education arm, absolute risk (AR) of 0.13(95% CI,0.08,0.17) and male involvement arm with AR of 0.29 (95% CI, 0.23,0.34) as compared to the control arm. In the control arm, the proportion of FP use was 4.3%, whereas it was 17.5% with women who receive FP education and 34% in the male involvement arm. Furthermore, the proportion of married women who had high intention to use FP was high in arms of women’s FP education and male involvement with AR = 3.4(95% CI: 2.48,4.91) and AR = 2.1 (95% CI: 1.5,2.95), respectively as compared with the control arm.ConclusionThe community-based interventions brings a significant change in increasing FP users and intention to use FP.Trial registration : NCT03450564

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Evolution of a Large-Scale Community-Based Contraceptive Distribution Program in Kinshasa, DRC Based on Process Evaluation

Cited by 10 publications

References 19 publications

Contraceptive use among adolescent and young women in North and South Kivu, Democratic Republic of the Congo: A cross-sectional population-based survey

Contraceptive use among adolescent and young women in North and South Kivu, Democratic Republic of the Congo: A cross-sectional population-based survey

Time to Evolve Beyond Prototypical Community-Based Distribution (CBD) of Contraception?

Use of Community-based Interventions to Promote Family Planning Use Among Pastoralist Women in Ethiopia: Cluster Randomized Controlled Trial

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