OBJECTIVE: To determine whether community-based health workers in a rural region of Ethiopia can provide injectable contraceptives to women with similar levels of safety, effectiveness and acceptability as health extension workers (HEWs). METHODS: This was a prospective non-randomized community intervention trial designed to test the provision of injectable contraceptives by community-based reproductive health agents (CBRHAs). Effectiveness, safety, acceptability and continuation rates were the outcomes of interest. The outcomes observed when injectable contraceptives were administered by HEWs in health posts and when they were administered by CBRHAs were compared by means of χ(2) tests for association among categorical variables and t-tests for independent samples to determine differences between group means. FINDINGS: A total of 1062 women participated in the study. Compared with health post clients, the clients of CBRHAs were, on average, slightly older, less likely to be married and less educated, and they had significantly more living children. Women seeking services from CBRHAs were also significantly more likely to be using injectable contraceptives for the first time; health post clients were more likely to have used them in the past. In addition, clients of CBRHAs were less likely to discontinue using injectable contraceptives over three injection cycles than health post clients. CONCLUSION: Receiving injectable contraceptives from CBRHAs proved as safe and acceptable to this sample of Ethiopian women as receiving them in health posts from HEWs. These findings add to the growing body of evidence supporting the development, introduction and scale up of programmes to train community-based health workers such as CBRHAs to safely administer injectable contraceptives.
OBJECTIVE: To determine whether community-based health workers in a rural region of Ethiopia can provide injectable contraceptives to women with similar levels of safety, effectiveness and acceptability as health extension workers (HEWs). METHODS: This was a prospective non-randomized community intervention trial designed to test the provision of injectable contraceptives by community-based reproductive health agents (CBRHAs). Effectiveness, safety, acceptability and continuation rates were the outcomes of interest. The outcomes observed when injectable contraceptives were administered by HEWs in health posts and when they were administered by CBRHAs were compared by means of χ(2) tests for association among categorical variables and t-tests for independent samples to determine differences between group means. FINDINGS: A total of 1062 women participated in the study. Compared with health post clients, the clients of CBRHAs were, on average, slightly older, less likely to be married and less educated, and they had significantly more living children. Women seeking services from CBRHAs were also significantly more likely to be using injectable contraceptives for the first time; health post clients were more likely to have used them in the past. In addition, clients of CBRHAs were less likely to discontinue using injectable contraceptives over three injection cycles than health post clients. CONCLUSION: Receiving injectable contraceptives from CBRHAs proved as safe and acceptable to this sample of Ethiopian women as receiving them in health posts from HEWs. These findings add to the growing body of evidence supporting the development, introduction and scale up of programmes to train community-based health workers such as CBRHAs to safely administer injectable contraceptives.
Authors: Kelly R Culwell; Marcel Vekemans; Upeka de Silva; Manuelle Hurwitz; Barbara B Crane Journal: Int J Gynaecol Obstet Date: 2010-05-07 Impact factor: 3.561
Authors: Shawn Malarcher; Olav Meirik; Elena Lebetkin; Iqbal Shah; Jeff Spieler; John Stanback Journal: Contraception Date: 2010-10-06 Impact factor: 3.375
Authors: Lincoln Chen; Timothy Evans; Sudhir Anand; Jo Ivey Boufford; Hilary Brown; Mushtaque Chowdhury; Marcos Cueto; Lola Dare; Gilles Dussault; Gijs Elzinga; Elizabeth Fee; Demissie Habte; Piya Hanvoravongchai; Marian Jacobs; Christoph Kurowski; Sarah Michael; Ariel Pablos-Mendez; Nelson Sewankambo; Giorgio Solimano; Barbara Stilwell; Alex de Waal; Suwit Wibulpolprasert Journal: Lancet Date: 2004 Nov 27-Dec 3 Impact factor: 79.321
Authors: Brent D Fulton; Richard M Scheffler; Susan P Sparkes; Erica Yoonkyung Auh; Marko Vujicic; Agnes Soucat Journal: Hum Resour Health Date: 2011-01-11
Authors: Ronald Anguzu; Raymond Tweheyo; Juliet N Sekandi; Vivian Zalwango; Christine Muhumuza; Suzan Tusiime; David Serwadda Journal: BMC Res Notes Date: 2014-03-17
Authors: Leslie Curry; Lauren Taylor; Sarah Wood Pallas; Emily Cherlin; Rafael Pérez-Escamilla; Elizabeth H Bradley Journal: Reprod Health Date: 2013-08-02 Impact factor: 3.223
Authors: Dawn Chin-Quee; Cathy Mugeni; Denis Nkunda; Marie Rose Uwizeye; Laurie L Stockton; Jennifer Wesson Journal: Reprod Health Date: 2016-01-06 Impact factor: 3.223