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Community-based Programs: Introducing the Standard Days Method

Community-based Programs: Introducing the Standard Days Method. Lessons Learned Candide Agbobatinkpo Caroline Blair. Family planning method for women with menstrual cycles between 26 and 32 days Identifies days 8-19 of the cycle as fertile

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Community-based Programs: Introducing the Standard Days Method

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  1. Community-based Programs: Introducing the Standard Days Method Lessons Learned Candide AgbobatinkpoCaroline Blair

  2. Family planning method for women with menstrual cycles between 26 and 32 days Identifies days 8-19 of the cycle as fertile Helps a couple prevent or plan pregnancy by knowing which days they should avoid unprotected intercourse Uses CycleBeads™ as a tool to track her cycle days, monitor cycle length, and identify her fertile period. The Standard Days Method

  3. Couples used the method correctly in 97% of cycles Of the 478 women in the study, 43 got pregnant SDM Efficacy Study Results • With correct use, the failure rate is 4.8 • With typical use the failure rate is 12.0

  4. Can be offered by community-based providers Community-based mobilizers can refer to clinics Teaching does not require clinical skills Addresses an unmet need Increases choice and expands coverage Empowers women and involves men Offers a low-cost method Why Offer the SDM?

  5. 240 Condoms 2 CYPs 30 Pill Packets = 8 Depo injections 1 set of CycleBeads/SDM .58IUD Adapted from USAID Office of Sustainable Development, Bureau for Africa, Health and Family Planning Indicators Volume I, July 1999.

  6. Type of Providers TrainedSDM O/R Study* n=333 * IRH Operations Research Study, Ecuador, El Salvador, Honduras, Benin, India, Philippines, 2001-2003. Data currently being analyzed.

  7. Clinic-based v. Community-based Provider Technical Competence – The SDM Source: Final Operations Research study report

  8. Competency Improvement Over Time – By Provider Type Results of analysis of supervision guide in El Salvador, Honduras and India

  9. Competency Improvement Over Time – By Provider Type 12 months after training Results of Supervision Guide in El Salvador, Honduras and India

  10. Access-related factors Time Distance (to clinic) Cost (transport to clinic) Method-related factors Non-medical Non-hormonal Simple (easy to use) CHW-related factors Feasibility Capability (able to offer method) Credibility (client confidence/trust in CHW) Why women and men want to receive info from CHWs Benin OR study 2001-2003. Data currently being analyzed.

  11. Cumulative 6 Month Continuation Rates SDM O/R Study: 5 Programs (n=1240) IRH Operations Research Study, 2001-2003. Data currently being analyzed.

  12. Results: Male Involvement SDM continuation in villages targeting male participation vs. women focused villages p < .05 CARE India, OR Study 2001-2003

  13. Results:Suggested increase in Contraceptive Prevalence Ratefollowing SDM introduction into community programs Source: 1) Project Concern International, El Salvador, 2002; 2) Project Reports: CEDPA 2004

  14. Results: Suggested Increase in Dual ProtectionCouples and Condom Use Project reports, IRH

  15. BCC through Community Outreach - Benin • Health providers (clinic or community-based) were primary source of information. • Media (flyers, poster, radio, TV) primary source for half of Beninese users. • Family and community outreach played larger role in rural areas

  16. Demand Generation • The feasibility of long-term provision of the SDM depends on the ability of organizations to stimulate demand for the SDM.

  17. Zambia Mobilizers and Providers Benin Mobilizers and Providers Rwanda Mobilizers and Providers Ethiopia Providers DRC Mobilizers and Providers Successfully Offering the SDM in Africa through CHWs and CBDs

  18. CHWs and CBDs can play a role in SDM service delivery Community-based workers’ competencies were similar to those of clinicians’ CHWs/CBDs require more technical training and more intense supervision (initially) than clinicians Best to use an existing CHW network rather than create a parallel system Programmatic Recommendations

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