increasing uptake of long acting reversible family planning methods in zambia meeting the family...
TRANSCRIPT
![Page 1: Increasing Uptake of Long Acting Reversible Family Planning Methods in Zambia Meeting the Family Planning Demand to Achieve MDGs Kigali, March 2010](https://reader035.vdocuments.mx/reader035/viewer/2022062805/5697bfae1a28abf838c9cd16/html5/thumbnails/1.jpg)
Increasing Uptake of Long Acting Reversible Family Planning Methods in Zambia
Meeting the Family Planning Demand to Achieve MDGs
Kigali, March 2010
![Page 2: Increasing Uptake of Long Acting Reversible Family Planning Methods in Zambia Meeting the Family Planning Demand to Achieve MDGs Kigali, March 2010](https://reader035.vdocuments.mx/reader035/viewer/2022062805/5697bfae1a28abf838c9cd16/html5/thumbnails/2.jpg)
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Zambia context
• High and rising fertility: TFR increased from 5.9 to 6.2 • Generalized HIV epidemic• High unmet need for FP• Shortage of qualified medical personnel• Limited contraceptive choice due to
– HIV burden– Limited MCH provider time, RH commitment/competency– Space, equipment & commodity gaps– Policies regarding provider cadres & FP service provision
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LARM Clients ServedN
um
be
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f C
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Results
• In the first 16 months, the program served 40,977 women with a long-term method of their choice (34% chose the IUD)
• 1,690 clients served with other methods• 4 out of 10 clients served were not previously using
any FP method• 9% rural• Very low discontinuation rates (2.9% among implant
clients & 1% IUD clients)• Lowest cost per CYP among 14 country programs
supported by the same grant ($13)
![Page 5: Increasing Uptake of Long Acting Reversible Family Planning Methods in Zambia Meeting the Family Planning Demand to Achieve MDGs Kigali, March 2010](https://reader035.vdocuments.mx/reader035/viewer/2022062805/5697bfae1a28abf838c9cd16/html5/thumbnails/5.jpg)
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Methodology
• Seconding competent, dedicated LARM providers to 20 high volume sites in 4 provinces
• Integrating demand creation with service delivery• Piloting post-partum IUD services• Providing significant post-training support &
monitoring for LARM-trained providers• Equipment to aide service delivery in low resource
setting (headlamps, buckets w/ taps, insertion sets)
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Provider Rynn Ngoma conducts a “sensitization talk” with rural women in Eastern province using SFH’s LTM flipchart--developed based on in-depth interviews w/ satisfied LARM users
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PPIUD Clients ServedN
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Lessons
• Seconding providers who serve as dedicated LARM champions can be a cost-effective strategy to increase LARM uptake
• Post-partum IUD is a viable contraceptive option in the Zambian context
• In a low LARM use context, providers require significant supervised practical experience & support to move from “LARM trained” to “LARM competent”
• Provider attitude and commitment are at least as important as clinical skills
![Page 9: Increasing Uptake of Long Acting Reversible Family Planning Methods in Zambia Meeting the Family Planning Demand to Achieve MDGs Kigali, March 2010](https://reader035.vdocuments.mx/reader035/viewer/2022062805/5697bfae1a28abf838c9cd16/html5/thumbnails/9.jpg)
Next Steps• Raise funds for service
delivery beyond June 2010• Expand coverage• Integrate e.g. neonatal
circumcision• Partner with MOH to
sustain national-level commitment to and uptake of LARM
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