Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

Abstract #106919

Bulbul Sood, MPH, CEDPA India, C-1 Hauz Khas, New Delhi, 110016, India, 9111-51656781, bsood@vsnl.net and Bhagyashree Dengle, Plan India, C-1 Hauz Khas, New Delhi, 110016, India.

Despite decades of family planning initiatives, unmet need remains high in India, in part due to limited spacing options. Large scale, sustainable expansion of options such as DMPA and the Standard Days Method (SDM) is critical to addressing unmet need. CEDPA worked with CASP, an NGO working in Delhi slums, to develop sustainable, community-based services. Community health workers, previously paid by CASP, stocked and marketed contraceptives and other medical supplies, effectively shifting costs from the NGO to the community. A strategy of cost reduction, cost recovery, revenue generation and continuous quality improvement was implemented while the volume of services increased through incorporation of the SDM, DMPA and emergency contraception. This paper will describe the integration process and assess this effort through analysis of service statistics and financial data, interviews with 230 new users, and results of a baseline and endline census of 14,826 homes. Method adoption began slowly, increasing over time in response to IE&C efforts. SDM and DMPA appealed to diverse groups and attracted many first-time users – about 30% of SDM accepters were new users. After two years, 55% of women had heard of the SDM and 72% DMPA, and contraceptive prevalence increased from 46.6% to 58%. CASP reported that their services were 75% sustainable. Successful introduction depended on consensus building, demand generation, and adequate training and supervision. Lessons learned include the importance of addressing provider bias and continuous supply of quality products. Incorporating several new options reached couples dissatisfied with available choices, and countered opposition to new technologies.

Learning Objectives: By the end of the session, participants will be able to

(
• identify best practices for sustainable integration and expansion of new family planning options; and (
• identify indicators to assess integration results

Keywords: Family Planning, New Technology

Presenting author's disclosure statement:

I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commercial supporters.

Recorded presentation