BACKGROUND: Long-acting reversible contraception (LARC) is underused in many countries in sub-Saharan Africa. Many previous attempts to increase uptake of this important class of contraception have not been successful. STUDY DESIGN: This program in Zambia employed 18 dedicated providers of LARC, placed them in high volume public sector facilities and collected routine, anonymous information over a 14-month period. We tallied uptake of LARC, analyzed user characteristics to see what populations were reached by the program and compared this to nationally representative data. We also estimated costs per couple-year of protection of the program. RESULTS: In a 14-month period, 33,609 clients chose either a subdermal implant (66%) or an intrauterine device (34%). The program reached a younger and lower parity population compared to nationally representative surveys of Zambian women using contraception. The estimated program costs, including the value of donated commodities, averaged $13.0 per couple-year of protection. CONCLUSION: By having the necessary time, skills and materials - as well as a mandate to both generate informed demand and provide quality services - dedicated providers of LARC can expand contraceptive choice. This new approach shows what can be achieved in a short period and in a region of the world where uptake of LARC is limited.
BACKGROUND: Long-acting reversible contraception (LARC) is underused in many countries in sub-Saharan Africa. Many previous attempts to increase uptake of this important class of contraception have not been successful. STUDY DESIGN: This program in Zambia employed 18 dedicated providers of LARC, placed them in high volume public sector facilities and collected routine, anonymous information over a 14-month period. We tallied uptake of LARC, analyzed user characteristics to see what populations were reached by the program and compared this to nationally representative data. We also estimated costs per couple-year of protection of the program. RESULTS: In a 14-month period, 33,609 clients chose either a subdermal implant (66%) or an intrauterine device (34%). The program reached a younger and lower parity population compared to nationally representative surveys of Zambian women using contraception. The estimated program costs, including the value of donated commodities, averaged $13.0 per couple-year of protection. CONCLUSION: By having the necessary time, skills and materials - as well as a mandate to both generate informed demand and provide quality services - dedicated providers of LARC can expand contraceptive choice. This new approach shows what can be achieved in a short period and in a region of the world where uptake of LARC is limited.
Authors: Nancy L Hancock; Bellington Vwalika; Elizabeth Siyama Sitali; Clara Mbwili-Muleya; Benjamin H Chi; Gretchen S Stuart Journal: Contraception Date: 2015-07-02 Impact factor: 3.375
Authors: Naw H Khu; Bellington Vwalika; Etienne Karita; William Kilembe; Roger A Bayingana; Deborah Sitrin; Heidi Roeber-Rice; Emily Learner; Amanda C Tichacek; Lisa B Haddad; Kristin M Wall; Elwyn N Chomba; Susan A Allen Journal: Contraception Date: 2012-11-12 Impact factor: 3.375
Authors: Kristin M Wall; Bellington Vwalika; Lisa Haddad; Naw H Khu; Cheswa Vwalika; William Kilembe; Elwyn Chomba; Rob Stephenson; David Kleinbaum; Azhar Nizam; Ilene Brill; Amanda Tichacek; Susan Allen Journal: J Acquir Immune Defic Syndr Date: 2013-05-01 Impact factor: 3.731
Authors: Kristin M Wall; William Kilembe; Mubiana Inambao; Alexandra Hoagland; Tyronza Sharkey; Kalonde Malama; Bellington Vwalika; Rachel Parker; Supriya Sarkar; Ken Hunter; Gordon Streeb; Christine Mazarire; Amanda Tichacek; Susan Allen Journal: AIDS Date: 2020-09-01 Impact factor: 4.177