2011
DOI: 10.1111/j.1728-4465.2011.00271.x
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Scaling Up Community Provision of Injectables through the Public Sector in Uganda

Abstract: This case study presents service monitoring data and programmatic lessons from scaling up Uganda's community-based distribution of depot medroxyprogesterone acetate (DMPA, marketed as Depo-Provera) to the public sector in two districts. We describe the process and identify implementation opportunities and challenges, including modifications to the service model. Analysis of monitoring data indicates that the number of women initiating DMPA with a community health worker (CHW) was 56 percent higher than the num… Show more

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Cited by 14 publications
(30 citation statements)
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“…They can also effectively refer patients for long-acting and permanent forms of family planning (115). Similar evidence is now emerging from Africa for injectable contraceptives (66,76,96,117). Community-based distribution programs, including a recently implemented program in Afghanistan, have increased by three-or fourfold (from 5-10% to 20-40%) usage of family-planning methods in areas where initial coverage is very low (53,110).…”
Section: Improvement Of Women's Healthmentioning
confidence: 75%
“…They can also effectively refer patients for long-acting and permanent forms of family planning (115). Similar evidence is now emerging from Africa for injectable contraceptives (66,76,96,117). Community-based distribution programs, including a recently implemented program in Afghanistan, have increased by three-or fourfold (from 5-10% to 20-40%) usage of family-planning methods in areas where initial coverage is very low (53,110).…”
Section: Improvement Of Women's Healthmentioning
confidence: 75%
“…In the first 12 months of this expansion, 1,364 women accepted injectables from 44 trained community health workers; of these women, 30% were first-time users of the method. 12 NGOs in Kanungu and Mubende districts also added community-based distribution to their programming at that time, but data on client uptake were not obtained by FHI 360. Throughout these phases, FHI 360 worked with Ugandan partners to advocate for community-based distribution of injectables.…”
Section: Nigeriamentioning
confidence: 99%
“…The embedding of the innovation within existing systems was commonly described as a core principle, even when investment in developing systems capacity to support the integration of the innovation may be required [17,44,45]. Particularly in cases of CBD of DMPA [46], the development of adequate managerial capacity has proven to be essential for quality and efficiency, for instance in order to ensure injections are being given safely, the supply chain is maintained, and strict confidentiality is preserved. Similarly, structural features of the delivery system can maximize ‘fit’ and therefore increase the likelihood of scale up.…”
Section: Discussionmentioning
confidence: 99%
“…In Zimbabwe (Rhodesia), having women (rather than men) deliver injections in non-clinic settings such as well-baby clinics and markets allowed women to use DMPA without the knowledge of others. Systematic assessment of delivery system capacity and harmonization as feasible, particularly where financial and technical capacity is limited, is essential [46]. …”
Section: Discussionmentioning
confidence: 99%