Academic journal article Bulletin of the World Health Organization

Provision of Injectable Contraceptives in Ethiopia through Community-Based Reproductive Health Agents

Academic journal article Bulletin of the World Health Organization

Provision of Injectable Contraceptives in Ethiopia through Community-Based Reproductive Health Agents

Article excerpt

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 [chi square] 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 CBRI-IAs 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.

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Fourniture de contraceptifs injectables en Ethiopie par le biais des agents communautaires de sante reproductive

Objectif Determiner si le personnel soignant communautaire d'une region rurale d'ethiopie peut fournir des contraceptifs injectables aux femmes avec des niveaux de securite, d'efficacite et d'acceptabilite similaires a ceux des agents de vulgarisation sanitaire (AVS).

Methodes II s'agissait d'un essai d'intervention communautaire prospectif non randomise, concu pour tester la fourniture de contraceptifs injectables par les agents communautaires de sante reproductive (ACSR). Les taux d'efficacite, de securite, d'acceptabilite et de continuite etaient les resultats recherches. Les resultats observes Iors de I'administration de contraceptifs injectables par les AVS dans les postes sanitaires et Iors de leur administration par les ACSR ont ete compares au moyen de tests [chi square] pour I'association entre les variables nominales et les tests-t d'echantillons independants, afin de determiner les differences entre les moyennes du groupe.

Resultats Un total de 1 062 femmes ont participe a I'etude. Par rapport aux patientes des postes sanitaires, les patientes des ACSR etaient, en moyenne, un peu plus agees, moins susceptibles d'etre mariees et moins instruites, et elles avaient beaucoup plus d'enfants en vie. Les femmes s'adressant aux ACSR etaient aussi nettement plus susceptibles d'utiliser des contraceptifs injectables pour la premiere fois; les patientes des postes sanitaires etaient plus susceptibles de les avoir deja utilises dans le passe. En outre, les patientes des ACSR etaient moins susceptibles de cesser d'utiliser les contraceptifs injectables apres trois cycles d'injection que les parientes des postes sanitaires.

Conclusion L'administration de contraceptifs injectables par les ACSR s'est revelee aussi sure et acceptable pour cet echantillon de femmes ethiopiennes que radministration dans les postes sanitaires par les AVS. Ces resultats s'ajoutent a la quantite croissante de preuves encourageant le developpement, I'introduction et I'augmentation du nombre de programmes de formation d'agents de sante communautaires, comme les ACSR, pour administrer sans danger des contraceptifs injectables. …

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