The 130th Annual Meeting of APHA

Abstract #50338

Rofina Asuru, RN¹, James Phillips, PhD², Isaac Akumah, BA¹, John E. Williams, MD³, and James Akazili, MA¹. (1) Navrongo Health Research Centre, P.O. Box 114, Navrongo, UER, Ghana, 233-742-22310, rasuru@navrongo.mimcom.net, (2) Policy Research Division, Population Council, 1 Dag Hammarskjold Plaza, New York, NY 10017, (3) Senior Medical Officer, Navrongo Health Research Centre, Box 114, Navrongo, Upper East Region, Ghana

It is widely assumed that making family planning services available in community locations will lead to increased use of contraception and reduced fertility. This paper presents findings from a four celled factorial trial of the Navrongo Health Research Centre in Kassena-Nankana District that challenges this generalization. A cell of the experiment where nurses have been deployed to community locations and equipped to provide doorstep services has had no impact on contraceptive use or fertility. Moreover, an operations experiment in which male village volunteers were equipped to distribute oral pills has had no impact on contraceptive use. However, where attention has been addressed to mobilizing community leaders and deploying men as volunteer social activists for family planning, small but significant fertility effects have been realized. Moreover, where nurse outreach is combined with male mobilization, the demographic impact of the Navrongo experiment has been pronounced. Findings suggest that resolving the social constraints to accessibility and perceived social costs of family planning are more important determinants of the adoption and use of contraception than improving geographic accessibility. Where demand for family planning is nascent and fragile, the importance of developing socially appropriate service strategies is particularly acute.

Learning Objectives:

• Discuss the history of CBD in family planning programs throughout Africa.
• Contrast the involvement of male CBD workers and community nurses dispatched to rural areas in a community-based family planning program in rural northern Ghana.
• Assess the effect of male involvement as mobilized community leaders and village volunteers on changes in attitudes toward family planning and contraceptive behavior in a rural West African setting.

Keywords: Family Planning, Community Collaboration

Presenting author's disclosure statement:
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.