|
Research |
|||
Community-Based Workers Can Administer Safe, High-Quality Contraceptive Injections |
|
||
|
Community-based reproductive health workers in a rural African setting can provide contraceptive injections as safely and effectively as local clinic-based workers, according to results of a USAID-supported study in Uganda. Community-based workers in Nakasongola district, Uganda, were trained in counseling skills, health screening for injectable users, techniques for safe injections, and proper waste disposal. They then spent two weeks observing and practicing injections of depot medroxyprogesterone acetate (DMPA) in supervised medical settings, after which they began providing injections on their own. Job aids provided during the training included a checklist for client screening and an illustrated counseling tool. Scientists from Family Health International, the Uganda Ministry of Health, and Save the Children/USA interviewed 777 clients 13 weeks after their first contraceptive injection. The care received by the community-based workers was compared with the care received by nurses and midwives in local health centers. Care was evaluated according to whether a second injection was obtained, continuation rates and reasons for discontinuation, client satisfaction, and recall of key counseling messages, among other measures. Results of the study showed no significant difference in continuation rates or client satisfaction between the two groups. Clients of the community-based workers had a slightly higher rate of problems at the injection site than clients of clinic-based workers, but this difference was not significant and decreased over time (presumably because of improved injection technique with practice). Interviewers noted that clients in both groups had difficulty retaining key counseling messages such as common side effects and method-related health problems for which medical attention should be sought. The authors of the study conclude that the practice of contraceptive injections by community-based reproductive health workers should be scaled up throughout Africa and elsewhere. Special emphasis should be placed on promoting quality and access through training, the use of job aids, and solid logistical support systems. To read more about this topic, click here. Source |
|||
 |
|||
