Building momentum for innovation: Community-based distribution of injectables

Community-based distribution (CBD) of contraceptives is common throughout much of the developing world. CBD of injectables has been used for decades in family planning programs in Asia and Latin America. Despite the large unmet need for family planning in Africa and the popularity of injectables as a contraceptive method, CBD of injectables hasn't been introduced on a large scale for several reasons including lack of infrastructure and concerns over safety and feasibility. First, this presentation will describe CBD of DMPA in terms of its potential to improve access to family planning, at scale, in the African context. Then, this presentation will describe the planning and execution of a strategy for improving legitimacy and increasing adoption of this service delivery mechanism across geographic settings, using principles and techniques informed by modern scale-up theory and practice. The presentation will describe use of primary research to improve the legitimacy of an innovation in its local context, tool development as a collaborative and facilitative steps in the adaptation process, use of a scale-up framework to guide planning and implementation within an individual country context, the role of multi-lateral agencies in providing global technical leadership, and a 3T (target, tailor and tip) approach to generating interest and support for diffusion for CBD of injectables across countries. Remaining challenges for CBD of DMPA will be described along with options for facilitating greater adoption of this approach to increasing access in the future.