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

Figures & Tables

Download figure
Open in new tab
Download powerpoint
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.
Download figure
Open in new tab
Download powerpoint
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.
Download figure
Open in new tab
Download powerpoint
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.

TABLE 1 Results of Observation of CHEWs’ Counseling Skills, Bauchi and Sokoto States of Nigeria, 2013–2014 (%)

Checklist Item	Baseline (N = 164)	Endline (N = 144)
Welcomed the client in a friendly manner	99	100
Provided information on different types of contraceptives (to new clients)	70^*	96^*
Asked open-ended questions	76^*	88^*
Encouraged client to ask questions	67^*	90^*
Treated client with respect	95^*	100^*
Saw client in private	77^*	94^*
Discussed a return visit	78^*	89^*
Asked client her concerns with any method	62^*	83^*
Used visual aids	31^*	72^*
Used client record	59^*	82^*
Assured client of confidentiality	52^*	91^*

TABLE 2 Client Satisfaction With Services Provided by CHEWs, Bauchi and Sokoto States of Nigeria, 2013–2014

Assessment	Baseline, % (N)	Endline, % (N)
Satisfied with the services provided today	99 (156)	100 (146)
Felt that needs for family planning were met	90 (159)^*	99 (144)^*
Thought that the right amount of information was provided on family planning method of choice	65 (153)^*	88 (144)^*
Thought other clients could hear what clients said	27 (148)	20 (142)
Believed the information shared with the provider would be kept confidential	86 (152)	93 (145)
Had any questions	46 (163)	56 (150)
The CHEW let clients ask the questions	90 (68)	98 (82)
The CHEW responded to questions to clients’ satisfaction	96 (53)	97 (78)
Stated that CHEW treated them well	99 (163)	99 (145)
Stated that CHEW was friendly during the appointment	97 (163)	99 (146)
Stated that CHEW was attentive and responsive to clients’ needs	99 (163)	100 (145)
Satisfied with CHEWs’ activities	98 (163)	100 (144)
Would recommend a friend to receive family planning services at this health facility	94 (156)^*	99 (146)^*

TABLE 3 Information CHEWs Provided to Clients on Their Chosen Contraceptive Method, Bauchi and Sokoto States of Nigeria, 2013–2014

Information Provided by CHEWs	Baseline, % (N)	Endline, % (N)
Explained how to use the method effectively	97 (160)	99 (145)
Described possible side effects	79 (159)^*	95 (145)^*
Told what to do if clients have any problems	83 (157)^*	97 (146)^*
Explained that only condoms provide protection against STIs	54 (159)^*	71 (143)^*
Told how many years of protection against pregnancy the method provides	82 (158)^*	97 (144)^*
Told when to return for a follow-up visit	96 (158)	92 (144)

Abbreviation: CHEW, community health extension worker; STIs, sexually transmitted infections.
↵*P<.05.
Source: Client exit survey.