Informal Condom Distribution
Condom Shortage in Malawi
In 2012, BRIDGE II and other stakeholders observed critical shortages in the supply of condoms and other supplies to individuals living in rural Malawi, including BRIDGE II catchment communities. After noting the shortages and realizing its impact on the health of Malawians, USAID entrusted BRIDGE II with the responsibility of facilitating distribution of free condoms through informal channels to the public. Informal condom distribution was implemented in 8 of the 11 BRIDGE II implementation districts: Mulanje, Thyolo, Phalombe, Nsanje, Chikwawa, Zomba, Chiradzulu and Mwanza.
Informal Condom Distribution
BRIDGE II’s informal condom distribution program eased access to condoms for communities in Malawi, most of which were at a great distance from health facilities that provided them. Additionally, community health facilities were also reporting critical shortages, meaning that people who were able to travel to clinics and health facilities could not access condoms there either.
Collaboration with Local, National, and International Partners
BRIDGE II developed and implemented the condom distribution program in collaboration with the USAID-funded, JSI-implemented Deliver Project and participating District Health Offices. USAID procured the condoms, and the Deliver Project delivered them to the Health Centers along with other health commodities. BRIDGE II trained 1,390 Informal Condom Distributors (ICDs) (bicycle taxi drivers, market women and Community Based Organization members) in communities around 139 Health Centers (HC) to distribute the free condoms locally and demonstrate how to use them correctly. Each of the 139 HCs had 10 informal condom distributors and they all worked on a voluntary basis. Condom distribution activities in a particular district were coordinated by a district focal person from the DHOs office. There was also another desk officer, usually a Senior Health Surveillance Assistant, at HC level who managed activities within the catchment area.
The ICDs received their monthly consignments from their local HCs. At the end of the month, each ICD compiled a report, outlining the number of condoms that he or she received at the start of the month, the number of condoms distributed and the number at hand. S/He then sent this to the HC where an aggregated report for a particular HC catchment area was compiled and sent to BRIDGE II through Frontline SMS. BRIDGE II calculated monthly projections for the next month for each HC catchment area based on consumption levels as extracted from the reports and sent it to JSI/Deliver for the next round of delivery.
BRIDGE II conducted quarterly review and planning meetings with district and HC focal persons and the ICDs to collect and share successful strategies, challenges, and develop solutions to common challenges encountered. The project also supplied the HC desk officers with airtime for sending SMS based reports to BRIDGE II.
- Over twenty million male condoms were distributed over the lifetime of the project.
- After one year of intervention, research findings indicated that informal condom distribution at community level increased condom uptake and acceptance. The odds of using male condoms for those who received condoms from ICDs were 58% higher than those who did not (1). Additionally, the odds of using male condoms were 28% higher for those who ever received training on condom use from the distributors than those who did not (2).
(1) adj OR = 1.58, p< .001
(2) adj OR = 1.28, p< .05