K4Health Shines a Spotlight on Community-Based Family Planning

Community-Based Family Planning

Leigh Wynne, MPH

FHI 360 | Technical Advisor, Research Utilization

Kirsten Krueger, MSW

FHI 360 | Technical Advisor, Research Utilization

Carter Crew

FHI 360 | Intern, Research Utilization
A community health worker with the Nawandala Village Health Team (VHT) gives the Sayana Press injection at her own home in Kiringa B Village, Uganda.

A community health worker with the Nawandala Village Health Team (VHT) gives the Sayana Press injection at her own home in Kiringa B Village, Uganda. © 2016 Laura Wando, WellShare International Uganda, Courtesy of Photoshare

Envision a health system in which quality family planning information and services are accessible to everyone in their local communities. Community-based family planning (CBFP) lessens the burden of having to travel to health facilities while providing valuable and comprehensive care. In countries where CBFP is being implemented, contraceptive methods are being provided to women, men, and couples typically using a combination of three high-impact practices: provision by community health workers, mobile outreach, and drug shops.

Across the 69 Family Planning 2020 (FP2020) countries, 134 million women who are married or in a relationship need family planning assistance. While services may be available in the public and private sector, those who could benefit from them often face barriers such as lack of transportation, limited financial resources, no family planning knowledge, and cultural traditions that promote early marriages and large families. Community-based family planning can reduce inequities in access to services, increase contraceptive knowledge and use, and dispel family planning myths and misconceptions.

[CHW provision of family planning] has reduced on the long queues of especially clients for short-term methods, therefore reducing workload at the facility. — Midwife, Busia District, Uganda

Community-based family planning is recognized as a key strategy to help countries reach their FP2020 targets, specifically by providing modern contraception to an additional 120 million women and girls. For example, Sayana® Press—the subcutaneous formulation of the injectable contraceptive depot medroxyprogesterone acetate (DMPA-SC)—is designed with community distribution in mind, as it is simpler to administer than intramuscular injectable contraceptives.

Mobile clinics are one valuable CBFP strategy.

Mobile clinics are one valuable CBFP strategy. Photo: Christine Kim, University of North Carolina, Uganda 2017

Programs in a number of countries have shown that trained community health workers can successfully provide family planning services, including injectable contraceptives. This type of task sharing is a pragmatic solution to address the unmet need for family planning. In addition, home and self-injection is becoming recognized as the next frontier for improving access to contraceptive services. A recent study conducted by FHI 360 in Malawi provided evidence that CHWs can safely train women to self-inject DMPA-SC and that community-based provision of injectables for self-injection in low-resource settings is safe and feasible.

Over the next few months, K4Health is spotlighting CBFP. Visit our new topic page for key messages and definitions, essential resources, evidence, and tools. Experts from organizations that are putting CBFP into practice will write on such topics as self-injection, drug shops and community mobilization in Uganda, and implant provision via community health workers in Ethiopia.