NorplantŪ contraceptive implants, available in Ethiopia since 1994, have the potential to satisfy clients' demand for a convenient, long-lasting contraceptive. Piloted at five facilities, NorplantŪ services have expanded, perhaps too rapidly. In a 1997 Reproductive Health Needs Assessment, there were some problems noted, including periodic stockouts, inadequate training, and lack of adequate mechanisms for follow-up. An evaluation was recommended to determine the extent of these problems and to suggest solutions. The project had two phases: Primary data were collected through a nationwide modified Situation Analysis at a representative sample of 21 health care facilities, including observations of provider-client interactions (110), client exit interviews (113), record reviews (317), inventories of health facilities (21), and provider interviews (69). Phase Two comprised a team of international and national experts and stakeholders who returned to the field to follow-up trends and problems, and to make recommendations for remediation. The evaluation highlighted both successes and problems. Removal on demand was available, however, few women received removals on the same date requested. Likewise, insertions were also unnecessarily delayed until a woman's next menses. Sixty-two percent of providers offered NorplantŪ services, but only 60% had attended NorplantŪ training. There were more stockouts with NorplantŪ compared to other methods: 57% of sites in the preceding six months as compared to 10% for oral contraceptives and 29% for the IUD. At a dissemination meeting, stakeholders proposed improved mechanisms for maintaining stocks of NorplantŪ, for ensuring that all staff receive training, and improving the timeliness of removals and insertions.
Learning Objectives: At the conclusion of the session, the participant will be able to: 1. Describe the strengths and weaknesses of the NorplantŪ program in Ethiopia 2. Understand the process the stakeholders used to establish priorities for problem-solving 3. Identify solutions to the problems identified in the NorplantŪ evaluation
Keywords: Service Delivery, Contraceptives
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.