A contraceptive needs assessment conducted in Zambia in 1995 revealed several problems, including a limited method mix, high reliance on oral contraceptive pills, client and provider misinformation and biases, and constraints in the logistics systems. This study tested the feasibility of enhancing choice through the expansion of the method mix and improving quality of service delivery in the Copperbelt Province of northern Zambia. Using the WHO Strategic Approach to Contraceptive Introduction, the intervention package included training of health care personnel, introduction of contraceptive methods, improved management systems, and community outreach strategies. The intervention was evaluated with a quasi-experimental research design with 11 experimental and 10 control sites using a pre- and post-intervention situation analysis. The intervention resulted in an expansion in the choice of methods as well as an increase in new acceptors. In addition, there were improvements in quality of care, more frequent use of IEC materials, the introduction of new methods such as emergency contraception and the female condom, more frequent supervisory visits, and improved information exchange between clients and providers. In addition, providers were four times more likely to discuss STI/HIV risks with family planning clients post-intervention. These findings highlight the importance of introducing new methods within a quality of care framework and a context of broad method choice. The success of this pilot project led to an innovative plan for scaling up, using the in-house skills and expertise of the intervention site personnel.
Learning Objectives: At the conclusion of the session, the participant will be able to: 1. Articulate the WHO Strategic Approach to Contraceptive Introduction 2. Evaluate the effectiveness of this contraceptive introduction strategy in the Copperbelt of Zambia 3. Describe the scaling-up strategy being adopted.
Keywords: Quality of Care, Contraception
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.