Community based programmes a strategy for improving access and quality
This presentation is the property of its rightful owner.
Sponsored Links
1 / 14

Community-based Programmes: a Strategy for Improving Access and Quality PowerPoint PPT Presentation


  • 65 Views
  • Uploaded on
  • Presentation posted in: General

Community-based Programmes: a Strategy for Improving Access and Quality. Ian Askew FRONTIERS in Reproductive Health Population Council. What Have We Learned From 20 Years of CBD in West Africa?. CBD Can Generate Interest in Child Spacing and FP Use.

Download Presentation

Community-based Programmes: a Strategy for Improving Access and Quality

An Image/Link below is provided (as is) to download presentation

Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author.While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server.


- - - - - - - - - - - - - - - - - - - - - - - - - - E N D - - - - - - - - - - - - - - - - - - - - - - - - - -

Presentation Transcript


Community based programmes a strategy for improving access and quality

Community-based Programmes: a Strategy for Improving Access and Quality

Ian Askew

FRONTIERS in Reproductive Health

Population Council


What have we learned from 20 years of cbd in west africa

What Have We Learned From 20 Years of CBD in West Africa?


Cbd can generate interest in child spacing and fp use

CBD Can Generate Interest in Child Spacing and FP Use

  • CBD agents and key individuals stimulate community and couple discussions

  • Building social acceptance allows couples to practice without stigma

  • Most successful with same sex interactions


Cbd can increase use of fp

CBD Can Increase Use of FP

  • Immediate increase as agents legitimise FP and increase access

  • More methods provided increases overall CPR

  • Increase in use may take time due to building new social norms

  • CBD can augment clinic-based quality improvements


What types of cbd have been tried

Public and Private Sector:

Government programmes

NGO, church-based, employment-based

Agent status:

Part-time – voluntary or allowance

Full-time – salaried employees

Male, female

Home visits, depot/post

No single model – each developed to fit the situation

What Types of “CBD” Have Been Tried?


Performance of cbd programs can vary by model

Performance of CBD Programs Can Vary by Model


Cost effectiveness can vary by type of program

Cost-effectiveness Can Vary by Type of Program


Why is cbd a repositioning strategy for fp

Fertility preferences still high

Interest in using FP to space or limit births still low

Changing these social norms requires education and discussion at individual, family and community level

Clinic-based services cannot easily stimulate or facilitate such social interactions

Why Is CBDa Repositioning Strategy for FP?


Why is cbd a repositioning strategy for fp1

Providing contraceptives through clinics limits their physical, financial and social access

Clinics cannot effectively reach men with FP messages and condoms

CBD facilitates continuation of use

CBD can offer FP integrated within a range of basic health information and services (malaria, ORT, iron tablets, STI information, etc.)

Why Is CBDa Repositioning Strategy for FP?


Challenges can cbd provide more fp services

Currently offering information, condoms, pills, spermicides, NFP, and referral for clinical methods

But:

Can injectables be offered?

Can emergency contraception be offered?

Can IUCD be offered?

Dual protection messages can be communicated – but to what effect?

Challenges – Can CBD Provide More FP Services?


Challenges hiv safe motherhood and child survival services

Feasibility of providing basic HIV/STI information proven, but:

Can verbal risk screening and referral be added?

Can STI treatment for males be added?

Can CBD link with VCT, ART and home-based care?

Information about pregnancy and child nutrition?

Birth planning and support for assisted deliveries?

Challenges – HIV, Safe Motherhood and Child Survival Services?


Major challenge ensuring sustainability

 Transition from pilot project to routine programme critical – but how?

Diversification of programme role and income sources (NGOs: Ghana; Zimbabwe)

Planned phasing: (MOH: Ghana)

Pilot model, then experiment to test effectiveness (Navrongo)

Sustain, and demonstrate replication (Nkwanta)

Gradual nationwide expansion (CHPS)

Revitalise existing government community programmes (Senegal)

Major Challenge– Ensuring Sustainability


Critical elements in sustaining community based programmes

Commitment to a large-scale, routine CBD programme

Belief in cost-effectiveness of strategy

Willingness to engage community-level cadre as standard staffing component

Pilot test model first to identify how it works

Plan for going to scale from the beginning:

Immediately sustain successful pilot model in project sites (and expand to district level)

Document successful configuration and pilot its replication in limited additional districts

Develop systems to enable expansion nationwide

Critical Elements in Sustaining Community-based Programmes


Programmatic recommendations

National leadership….with district ownership

Reinvigorate (and reconfigure) existing community-level cadres rather than develop new cadre

Do not use volunteers in isolation from an employed cadre

Offer a range of related and integrated services

Include possibility of cost- and profit-sharing for commodities

Move from project-funding to line-item budgeting as soon as possible

Programmatic Recommendations


  • Login