The effectiveness of Community Based Distribution of Injectable Contraceptives using Community Health Extension Workers in Gombe State, Northern Nigeria

Abstract

This study reports on findings of a pilot of community-based distribution (CBD) of injectable contraceptives in two local government areas (LGAs) of Gombe State, Nigeria. From August 2009 to January 2010, the project enrolled, trained and equipped community health extension workers (CHEWs) to distribute condoms, oral and injectable contraceptives in communities. The project mobilized communities and stakeholders to  promote Family Planning (FP) services in the selected communities. Using anonymised unlinked routine service data, the mean couple years of  protection (CYP) achieved through CBD was compared to that achieved in FP clinics. The CBD mean CYP for injectables- depo medroxy-progesterone acetate (DMPA) and norethisterone enantate was higher (27.72 & 18.16  respectively) than the facility CYP (7.21 & 5.08 respectively) (p<0.05) with no injection related complications. The CBD’s mean CYP for all methods  was also found to be four times higher (11.65) than that generated in health facilities (2.86) (p<0.05). This suggests that the CBD of injectable  contraceptives is feasible and effective, even in a setting like northern Nigeria that has sensitivities about FP. (Afr J Reprod Health 2013; 17[2]:  80-88).

Keywords: Community-based provision, contraceptives, injectable, PHC