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ORIGINAL ARTICLE
Open Access

Task Shifting Provision of Contraceptive Implants to Community Health Extension Workers: Results of Operations Research in Northern Nigeria

Zulfiya Charyeva, Olugbenga Oguntunde, Nosa Orobaton, Emmanuel Otolorin, Fatima Inuwa, Olubisi Alalade, Dele Abegunde and Saba’atu Danladi
Global Health: Science and Practice September 2015, 3(3):382-394; https://doi.org/10.9745/GHSP-D-15-00129
Zulfiya Charyeva
aPalladium, Washington, DC, USA
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  • For correspondence: Zulfiya.Charyeva@thepalladiumgroup.com
Olugbenga Oguntunde
aPalladium, Washington, DC, USA
bTargeted States High Impact Project (TSHIP), Bauchi, Nigeria
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Nosa Orobaton
bTargeted States High Impact Project (TSHIP), Bauchi, Nigeria
cJSI Research & Training Institute, Arlington, VA, USA
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Emmanuel Otolorin
bTargeted States High Impact Project (TSHIP), Bauchi, Nigeria
dJhpiego – an affiliate of Johns Hopkins University, Abuja, Nigeria
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Fatima Inuwa
bTargeted States High Impact Project (TSHIP), Bauchi, Nigeria
dJhpiego – an affiliate of Johns Hopkins University, Abuja, Nigeria
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Olubisi Alalade
bTargeted States High Impact Project (TSHIP), Bauchi, Nigeria
dJhpiego – an affiliate of Johns Hopkins University, Abuja, Nigeria
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Dele Abegunde
bTargeted States High Impact Project (TSHIP), Bauchi, Nigeria
cJSI Research & Training Institute, Arlington, VA, USA
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Saba’atu Danladi
aPalladium, Washington, DC, USA
bTargeted States High Impact Project (TSHIP), Bauchi, Nigeria
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Figures & Tables

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  • Figure1
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    A family planning client from Bauchi state receives counseling on Jadelle implants by a Community Health Extension Worker (CHEW). Observation of counseling sessions confirmed that CHEWs provided accurate and complete information.

  • Figure2
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    A Community Health Extension Worker (CHEW) at Dorowa Dispensary, Dambam LGA, in Bauchi state, practices inserting contraceptive implants on an arm model. After achieving competency on the arm model, CHEWs inserted implants under supervision on actual clients.

  • Figure3
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    A male Community Health Extension Worker (CHEW) from Muzuwa Dispensary, Dambam LGA, in Bauchi state, inserts a contraceptive implant. Over 40% of the CHEWs in the pilot task shifting study were men, revealing the acceptance of male providers by women to deliver implant services.

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    TABLE 1 Results of Observation of CHEWs’ Counseling Skills, Bauchi and Sokoto States of Nigeria, 2013–2014 (%)
    Checklist ItemBaseline (N = 164)Endline (N = 144)
    Welcomed the client in a friendly manner99100
    Provided information on different types of contraceptives (to new clients)70*96*
    Asked open-ended questions76*88*
    Encouraged client to ask questions67*90*
    Treated client with respect95*100*
    Saw client in private77*94*
    Discussed a return visit78*89*
    Asked client her concerns with any method62* 83*
    Used visual aids31*72*
    Used client record59*82*
    Assured client of confidentiality52*91*
    • Abbreviation: CHEW, community health extension worker.

    • ↵*P<.05.

    • Source: Observation checklist for counseling and clinical procedures.

    • View popup
    TABLE 2 Client Satisfaction With Services Provided by CHEWs, Bauchi and Sokoto States of Nigeria, 2013–2014
    AssessmentBaseline, % (N)Endline, % (N)
    Satisfied with the services provided today99 (156)100 (146)
    Felt that needs for family planning were met90 (159)*99 (144)*
    Thought that the right amount of information was provided on family planning method of choice65 (153)*88 (144)*
    Thought other clients could hear what clients said27 (148)20 (142)
    Believed the information shared with the provider would be kept confidential86 (152)93 (145)
    Had any questions46 (163)56 (150)
     The CHEW let clients ask the questions90 (68)98 (82)
     The CHEW responded to questions to clients’ satisfaction96 (53)97 (78)
    Stated that CHEW treated them well99 (163)99 (145)
    Stated that CHEW was friendly during the appointment97 (163)99 (146)
    Stated that CHEW was attentive and responsive to clients’ needs99 (163)100 (145)
    Satisfied with CHEWs’ activities98 (163)100 (144)
    Would recommend a friend to receive family planning services at this health facility94 (156)*99 (146)*
    • Abbreviation: CHEW, community health extension worker.

    • ↵*P<.05.

    • Source: Client exit surveys.

    • View popup
    TABLE 3 Information CHEWs Provided to Clients on Their Chosen Contraceptive Method, Bauchi and Sokoto States of Nigeria, 2013–2014
    Information Provided by CHEWsBaseline, % (N)Endline, % (N)
    Explained how to use the method effectively97 (160)99 (145)
    Described possible side effects79 (159)*95 (145)*
    Told what to do if clients have any problems83 (157)*97 (146)*
    Explained that only condoms provide protection against STIs54 (159)*71 (143)*
    Told how many years of protection against pregnancy the method provides82 (158)*97 (144)*
    Told when to return for a follow-up visit96 (158)92 (144)
    • Abbreviation: CHEW, community health extension worker; STIs, sexually transmitted infections.

    • ↵*P<.05.

    • Source: Client exit survey.

Additional Files

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  • GHSP-D-15-00129 Supplementary Material

    Charyeva et al. doi: 10.9745/GHSP-D-15-00129

    • Supplementary Material - Charyeva et al. doi: 10.9745/GHSP-D-15-00129
    • Supplementary Material - Charyeva et al. doi: 10.9745/GHSP-D-15-00129
    • Supplementary Material - Charyeva et al. doi: 10.9745/GHSP-D-15-00129
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Global Health: Science and Practice: 3 (3)
Global Health: Science and Practice
Vol. 3, No. 3
September 10, 2015
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Task Shifting Provision of Contraceptive Implants to Community Health Extension Workers: Results of Operations Research in Northern Nigeria
Zulfiya Charyeva, Olugbenga Oguntunde, Nosa Orobaton, Emmanuel Otolorin, Fatima Inuwa, Olubisi Alalade, Dele Abegunde, Saba’atu Danladi
Global Health: Science and Practice Sep 2015, 3 (3) 382-394; DOI: 10.9745/GHSP-D-15-00129

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Task Shifting Provision of Contraceptive Implants to Community Health Extension Workers: Results of Operations Research in Northern Nigeria
Zulfiya Charyeva, Olugbenga Oguntunde, Nosa Orobaton, Emmanuel Otolorin, Fatima Inuwa, Olubisi Alalade, Dele Abegunde, Saba’atu Danladi
Global Health: Science and Practice Sep 2015, 3 (3) 382-394; DOI: 10.9745/GHSP-D-15-00129
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