NGO experiences in scaling up community-based distribution of Depo Provera in Uganda

In 2004 Save the Children-US, in collaboration with Family Health International, and the Uganda Ministry of Health demonstrated that the introduction of community-based distribution (CBD) of Depo Provera (DMPA) into a pre-existing CBD program in Uganda was safe, feasible and acceptable. The initial project was piloted in one district where Save the Children's CBD program was already present. Based on recommendations from the success of the pilot project, Save worked to scale up CBD of DMPA services into two more districts. Scale up activities included not only technical training, but also efforts to ensure continuous access to contraceptive logistics, ongoing supervision, monitoring and evaluation. In addition, advocacy activities begun during the pilot facilitated uptake not only within the two scale up districts, but also served to create an enabling environment where CBD of DMPA could be successfully scaled up by other service delivery organizations within Uganda. Save contributed to these advocacy activities by assisting to convene and participate in a national core team responsible for coordinating introduction of CBD of DMPA in Uganda, and by hosting educational tours of its program sites. Save also worked with FHI to collaboratively develop advocacy briefs and an Implementation Handbook for use by other service delivery partners looking to scale up these services. Save is considering scaling up CBD of DMPA services to its CBD programs in other countries.