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Original Articles
Open Access

Building on safety, feasibility, and acceptability: the impact and cost of community health worker provision of injectable contraception

Dawn Chin-Quee, John Bratt, Morrisa Malkin, Mavis Mwale Nduna, Conrad Otterness, Lydia Jumbe and Reuben Kamoto Mbewe
Global Health: Science and Practice November 2013, 1(3):316-327; https://doi.org/10.9745/GHSP-D-13-00025
Dawn Chin-Quee
aFHI 360, Division of Health Services Research, Research Triangle Park, NC, USA
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  • For correspondence: dchin-quee@fhi360.org
John Bratt
aFHI 360, Division of Health Services Research, Research Triangle Park, NC, USA
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Morrisa Malkin
bFHI 360, Division of Research Utilization, Research Triangle Park, NC, USA
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Mavis Mwale Nduna
cFHI 360, TB CARE I, Lusaka, Zambia
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Conrad Otterness
aFHI 360, Division of Health Services Research, Research Triangle Park, NC, USA
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Lydia Jumbe
dChildFund Zambia, Lusaka, Zambia
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Reuben Kamoto Mbewe
eRepublic of Zambia Ministry of Health, Lusaka, Zambia
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Figures & Tables

Figures

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  • Figure 1.
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    Figure 1.

    Safety of CHW Provision of Injectables

    Abbreviations: CHW, community health worker.

  • Figure 2.
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    Figure 2.

    Continued Use of Methods Obtained From CHWs

    Abbreviations: DMPA, depot medroxyprogesterone acetate.

    Source: FHI 360 Data Retriever Registers

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    Figure 3.

    Couple-Years of Protection (CYP), February 2010 to February 2011

    Abbreviations: CHW, community health worker; DMPA, depot medroxyprogesterone acetate.

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    Figure 4.

    Cost Per Couple-Year of Protection (CYP) at Different Levels of DMPA Continuation Attributable to CHW Intervention

    Abbreviations: CHW, community health worker; DMPA, depot medroxyprogesterone acetate.

Tables

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    Table 1. Couple-Years of Protection (CYP) by CHW-Provided Methods in Study Districts, February 2010 to February 2011
    Districts
    CYP provided by:LuangwaMumbwaTotal
    Condoms133851
    Oral contraceptive pills96295391
    Injectable DMPA7271,4792,206
    Total8361,8122,648
    • Source: FHI 360 Data Retriever Registers

    • Abbreviation: CHW, community health worker; DMPA, depot medroxyprogesterone acetate.

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    Table 2. Total and Annualized Incremental Costs of the Intervention (4,600 Zambia Kwacha  =  US$1)
    Intervention ActivityTotal Cost (US$)Annualized Cost (US$)
    Training of trainers (N = 10)5,1031,021
    Training of CHWs (N = 40)12,9646,482
    Practicum expenses4,8272,414
    Supervision of CHWs3,3343,334
    Overall intervention management3,2193,219
    DMPA commodities7,8537,853
    Total incremental costa37,30024,322
    • ↵ aAs noted, these estimates do not include costs of planning and design, because these are one-time activities that would not be repeated in scale up.

    • Abbreviations: CHW, community health worker; DMPA, depot medroxyprogesterone acetate.

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Global Health: Science and Practice: 1 (3)
Global Health: Science and Practice
Vol. 1, No. 3
November 01, 2013
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Building on safety, feasibility, and acceptability: the impact and cost of community health worker provision of injectable contraception
Dawn Chin-Quee, John Bratt, Morrisa Malkin, Mavis Mwale Nduna, Conrad Otterness, Lydia Jumbe, Reuben Kamoto Mbewe
Global Health: Science and Practice Nov 2013, 1 (3) 316-327; DOI: 10.9745/GHSP-D-13-00025

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Building on safety, feasibility, and acceptability: the impact and cost of community health worker provision of injectable contraception
Dawn Chin-Quee, John Bratt, Morrisa Malkin, Mavis Mwale Nduna, Conrad Otterness, Lydia Jumbe, Reuben Kamoto Mbewe
Global Health: Science and Practice Nov 2013, 1 (3) 316-327; DOI: 10.9745/GHSP-D-13-00025
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