178951 Community based distribution of injectable contraceptives in Tigray, Ethiopia

Monday, October 27, 2008

Ndola Prata, MD, MSc , The Bixby Center for Population, Health and Sustainability, School of Public Health, University of California, Berkeley, Berkeley, CA
Amanuel Gessessew, MD , Department of Obstetrics and Gynecology, Mekelle University, Tigray, Ethiopia
Deborah Karasek, MPH , Advancing New Standards in Reproductive Health; Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Francisco, Oakland, CA
Malcolm Potts, MB, PhD, FRCOG , School of Public Health, University of California, Berkeley, Berkeley, CA
According to the Ethiopian 2005 Demographic and Health Survey (DHS) 78 percent of married women say that they either want to delay the birth of their next child or to have no additional children. As only 14 percent of women are using a modern method of contraception, the unmet need for family planning is one of the highest in the world. Ethiopia has a limited distribution network of public or private providers in rural areas, but community-based distributors are only allowed to deliver oral contraceptives and condoms and are not permitted administer intramuscular injections of DMPA (Depot Medroxyprogesterone Acetate). Low contraceptive prevalence in rural areas is partially due to limited access to health facilities that provide injectable contraception, the preferred method by rural Ethiopian women.

This presentation will discuss preliminary results from research to examine the safety and feasibility of the community based distribution of DMPA in the state of Tigray, Ethiopia. Working in conjunction with the state health bureau, the study trained Community Based Reproductive Health Agents (CBRHAs) to deliver DMPA alongside pills and condoms in villages. The research compares morbidities, client satisfaction, and use continuation outcomes of 500 control clients who receive DMPA from Health Extension Workers to outcomes of 500 women who receive DMPA from trained CBRHAs. The presentation will cover implications of this research for policy change surrounding community based distribution of DMPA in other low resource settings.

The potential to reduce the unmet need for family planning in rural Ethiopia through community based distribution of DMPA will be discussed.

Learning Objectives:
1. Discuss the evidence for community based distribution of injectable contraceptives in Ethiopia. 2. Analyze the safety and feasibility of community based reproductive health agents offering injectable contraceptives.

Keywords: Family Planning, Community-Based Care

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I work as a graduate student researcher on the study described in the abstract.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

See more of: Contraceptive Use Worldwide
See more of: Population, Family Planning, and Reproductive Health