Family Planning Integration and Depo-Provera Projects

To assess safety, acceptability, feasibility, costs and CYP of DMPA To review national scale-up strategies To highlight key stakeholders and advocacy for policy change

Family Planning Integration Project

Family Planning Integration Project (FPIP) began June 2006
FP users increased from 25% at baseline to 68% Community knowledge of available FP methods rose 92%-97% Spousal communication about FP increased from 31% to 66% Birth spacing rose from 29% to 48%

FPIP II began in April of 2010, expanding upon Phase I DMPA pilot study introduced in 2009 in collaboration with FHI360

Introduction of DMPA
With approval from the GoZ and in collaboration with FHI 360 Safety of CBD agents provision of DMPA injections Acceptability and client satisfaction Changes in workload with CBD agent delivery of DMPA Impact of adding DMPA provision by CBD agents Incremental cost per coupleyears of protection (CYP)

Community-based Distributors of DMPA

Theory- and practice-based training Checklists to determine medical eligibility Links with health clinics On-the-job training and mentorship Waste management, procurement, reporting

Client reported problem at injection site

No: 98% Yes: 2% 1 2

Acceptability and Client Satisfaction

94 percent of CBD clients (February and April 2010) received a second DMPA injection 93 percent wanted to get another DMPA injection 98 percent were satisfied with the way CBD agent gave them their injection 98 percent would recommend receiving a DMPA injection from their CBD agent to a friend

Feasibility and Costs

More than 50% of DHOs reported a decrease in DMPA and FP clients at clinics About 35% of the women reported their first DMPA injection as their first use of a FP method Client Continuation rates for Injectables 63% Cost per CYP for combined FP methodology of pills and DMPA ranged from about US$11-$61

Advancing the Road Map for National Scale-up Plan

Key Stops on the Road to Success

Zambian Ministry of Health Ministry of Community Development, Mother & Child Health Family Planning Technical Working Group

Study Tour to Sustain Momentum

Worked to orient new leadership to the project Improved country-level ownership Provided regional learning for professional bodies, donors, implementers and ministries Motivated plans for moving ahead with CHW-provision of DMPA in Zambia

Thank You!