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Scaling Up Community Provision of Injectables through the Public Sector in Uganda
Author(s) -
Krueger Kirsten,
Akol Angela,
Wamala Patricia,
Brunie Aurélie
Publication year - 2011
Publication title -
studies in family planning
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.529
H-Index - 68
eISSN - 1728-4465
pISSN - 0039-3665
DOI - 10.1111/j.1728-4465.2011.00271.x
Subject(s) - service delivery framework , public sector , medicine , family planning , public health , community health workers , developing country , community health , data collection , business , service provider , population , service (business) , environmental health , nursing , economic growth , health services , political science , research methodology , sociology , marketing , economics , law , social science
This case study presents service monitoring data and programmatic lessons from scaling up Uganda's community‐based distribution of depot medroxyprogesterone acetate (DMPA, marketed as Depo‐Provera) to the public sector in two districts. We describe the process and identify implementation opportunities and challenges, including modifications to the service model. Analysis of monitoring data indicates that the number of women initiating DMPA with a community health worker (CHW) was 56 percent higher than the number of new DMPA acceptors served by clinics. Including continuing DMPA users, about three of every four DMPA clients chose CHWs as their service delivery point. CHW provision appears to be the preferred method of delivery for new DMPA users in this study, and may appeal even more to continuing clients. Lessons from scaling up in Uganda's public sector include recognizing the needs for ongoing assessment of support, a process to gain community “ownership,” and spontaneous innovations to supplement CHW supervision.