Task-shifting the provision of DMPA-SC in the DR Congo: Perspectives from two different groups of providers

Abstract

ObjectivesTo document the experience of three groups of Family Planning service providers participating in task-shifting for the provision of subcutaneous depot-medroxyprogesterone acetate (DMPA-SC) at the community level in the DRC.Study designThis article compares results from interviews with DMPA-SC providers in two separate pilot studies: 1) 53 medical and nursing school students teaching women how to self-inject (2016–2017); and 2) 34 lay community health workers providing DMPA-SC in rural areas of Lualaba (2017). All providers gave information on socio-demographic characteristics, recruitment,) training, supervision, experience and satisfaction with the provision of DMPA-SC. The paper examines variations in responses from the different provider cadres.ResultsDespite substantive variations in provider profiles in terms of age, educational and marital status, reported levels of satisfaction with offering DMPA-SC in the community were consistently high. Over 90% of all providers declared being comfortable or very comfortable interacting with FP clients, and more than three quarters of them were very comfortable performing an injection. Over 90% of Lualaba providers and over 80% of student providers gave correct responses to DMPA-SC protocol questions regarding referral of clients to facilities and side-effects management. The vast majority declared being (very) satisfied with their experience providing DMPA-SC.ConclusionsProviders with and without a clinical background, when properly trained and supervised, can provide DMPA-SC at the community level in both urban and rural settings of the DRC. Support strategies from the Family Planning environment (continuous contraceptive supplies and adequate referral system to fixed facilities) are key to engaging community health workers and sustainably leveraging task-shifting opportunities.Implication statementThis study provides additional evidence on the acceptability and feasibility of task-shifting in relation to DMCP-SC and supports further scale-up efforts.

Did COVID‐19 Impact Contraceptive Uptake? Evidence from Senegal

“… 2018 ; Hernandez et al. 2018 ). Self‐care options such as self‐injection of Sayana Press have also been shown to be acceptable in other settings (Cover et al.…”

Acceptability of the distribution of DMPA-SC by community health workers among acceptors in the rural province of Lualaba in the Democratic Republic of the Congo: a pilot study

“…Results from the companion article Task-shifting the provision of DMPA-SC in the DR Congo: perspectives from different groups of providers showed that CHWs were not satisfied with the compensation received [ 14 ]. Under this pilot, CHWs operated on a volunteer basis.…”

“…A total of 34 CHWs participated in the pilot. The average age of participating CHWs was 42.2 years, 52.9% ( n =18) were female, almost three quarters were married ( n =25), and all but one CHW had children (mean number: 5.8 children) [14] .…”

DMPA-SC: an emerging option to increase women's contraceptive choices

“…Hernandez and colleagues interviewed two cadres of community-level providers: medical and nursing students who administered DMPA-SC in a community setting or who taught women how to self-inject and CHWs who provided DMPA-SC in rural areas. Over 90% of these providers reported being comfortable or very comfortable interacting with clients, and more than three quarters of them were very comfortable performing an injection [8]. In the same study, Mwembo and colleagues assessed the acceptability and feasibility of DMPA-SC among 252 women on the initial injection date and 3 months later.…”