142nd APHA Annual Meeting and Exposition

Annual Meeting Recordings are now available for purchase

Building on Safety, Feasibility and Acceptability of Community Based Distribution of DMPA and Implications for Youth

142nd APHA Annual Meeting and Exposition (November 15 - November 19, 2014): http://www.apha.org/events-and-meetings/annual
Tuesday, November 18, 2014 : 10:30 AM - 10:45 AM

Jessica Izquierdo, MPH , Youth Programs, ChildFund International, Washington DC, DC
Background: Improving the health conditions of Zambians is essential, especially in rural areas and among youth where access to health services is low. In 2009, ChildFund Zambia collaborated with FHI 360 on a pilot project to introduce injectable contraceptives into its existing Family Planning Integrated Health Program. The project’s study measured the impact of adding DMPA provision by CBD programs and assessed CBD agent’s ability to safely and effectively provide DMPA to clients.

 Methods: CBDs received training on DMPA including classroom demonstrations on providing injections, needle safety and needle stick injury infection prevention and treatment. CBDs were also provided with checklists for screening clients to determine medical eligibility to receive DMPA and referral forms for clients who report side effects and need treatment at local health posts. To increase RH information and awareness-raising throughout the community a cadre of youth peer educators were further supported as leaders for change.

Results: Approximately 35% of the women reported their first DMPA injection as their first use of a FP method. CBD agents safely provided injectable contraceptives; alleviating the workload of health facility staff and enhancing youth leadership through peer education. Client Continuation rates for Injectables (63%) were much higher than pills. Cost per CYP for combined FP methodology of pills and DMPA ranged from about US$11-$61. ChildFund’s CBD model for FP, and specifically DMPA, has been hailed as an effective service delivery program by the Zambian government and USAID and provides a great opportunity to focus on youth, thereby preventing high-risk pregnancies.

Learning Areas:

Advocacy for health and health education
Other professions or practice related to public health
Program planning
Provision of health care to the public
Public health or related research
Social and behavioral sciences

Learning Objectives:
Demonstrate effectiveness of community-based distribution of injectables Compare cost effectiveness of community-based distribution of FP as to that administered in facilities Analyze challenges of supervisory systems in community based distribution FP Discuss role of youth in generating demand for CBD of FP Discuss preventing and delaying pregnancy vis a vis CBD of injectables Explain future programming around CBDs in Zambia and journey to accreditation

Keyword(s): Family Planning, Community Health Programs

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have been working in public health programming and emergency response for the past decade, providing technical support to national offices across Asia, Africa and Latin America. In my current role I serve as primary advisor for adolescent sexual reproductive health programs, lead organization-wide gender-based violence (GBV) mainstreaming efforts, and promotes multi sector integration across youth programs globally.
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.