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ORIGINAL ARTICLE
Open Access

Community Health Workers as Social Marketers of Injectable Contraceptives: A Case Study from Ethiopia

Karen Weidert, Amanuel Gessessew, Suzanne Bell, Hagos Godefay and Ndola Prata
Global Health: Science and Practice March 2017, 5(1):44-56; https://doi.org/10.9745/GHSP-D-16-00344
Karen Weidert
aUniversity of California at Berkeley, School of Public Health, Bixby Center for Population Health and Sustainability, Berkeley, CA, USA.
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Amanuel Gessessew
bMekelle University College of Health Sciences, Mekelle, Ethiopia.
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Suzanne Bell
cJohns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
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Hagos Godefay
dTigray Regional Health Bureau, Mekelle, Tigray, Ethiopia.
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Ndola Prata
aUniversity of California at Berkeley, School of Public Health, Bixby Center for Population Health and Sustainability, Berkeley, CA, USA.
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  • For correspondence: ndola@berkeley.edu
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    FIGURE

    Program Model for Combining Community-Based Distribution and Social Marketing in Tigray, Ethiopia

    Abbreviations: CBD, community-based distribution; CHW, community health worker; SM, social marketing.

Tables

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    TABLE 1.

    Background Characteristics Among All Women of Reproductive Age at Project Baseline (September 2011) and Endline (May 2014), Tigray, Ethiopia

    Baseline (N=1490)Endline (N=1501)
    Age
        15–1919.318.5
        20–2417.120.7
        25–2917.917.2
        30–3415.714.5
        35–3913.413.3
        40–448.37.9
        45–497.57.9
    Marital status
        Never married13.612.5
        Married/cohabiting72.376.4
        Divorced/widowed13.910.9
    Education
        No education53.648.4
        1–4 years13.214.3
        5–9 years22.425.9
        Secondary or greater10.611.1
    Number of children ever born, mean3.94.0
    Number of living children, mean3.63.5
    Desired number of children, mean4.14.5
    • Data reported as percentages unless otherwise specified.

    • View popup
    TABLE 2.

    Changes in Knowledge of Contraceptive Methods Among Women of Reproductive From Project Baseline (September 2011) to Endline (May 2014), Tigray, Ethiopia

    Baseline (N=1490) %Endline (N=1501) %% ChangeP Value
    Female sterilization21.033.861<.001
    Male sterilization7.915.495<.001
    Pill91.796.25<.001
    IUD23.950.6112<.001
    DMPA/injectables96.197.92<.01
    Implants69.888.627<.001
    Male condom57.178.537<.001
    Female condom16.526.359<.001
    LAM30.134.214<.05
    Rhythm method31.334.09NS
    Withdrawal12.620.160<.001
    Emergency contraception11.215.135<.01
    • Abbreviations: DMPA, depot medroxyprogesterone acetate; IUD, intrauterine device; LAM, lactational amenorrhea method; NS, not significant.

    • View popup
    TABLE 3.

    Changes in Key Family Planning Indicators Among Women of Reproductive Age From Project Baseline (September 2011) to Endline (May 2014), Tigray, Ethiopia

    Baseline No. (%)Endline No. (%)% ChangeP Value
    Unmet need1077 (16.4)179 (11.9)–28<.01
    Currently using contraception448 (30.1)566 (37.7)25<.001
    Currently using DMPA307 (20.6)408 (27.2)32<.001
    By age group
        15–1921 (7.3a)39 (14.1)93<.01
        20–2453 (21.3)99 (31.8)49<.01
        25–2991 (34.1)93 (36.1)6NS
        30–3461 (26.1)77 (35.5)36<.05
        35–3948 (24.0)59 (29.5)23NS
        40–4421 (17.1a)27 (22.7)33NS
        40–497 (6.3a)14 (11.9a)88NS
    CHW as preferred source of contraception124 (8.3)467 (31.1)275<.001
    • Abbreviations: CHW, community health worker; DMPA, depot medroxyprogesterone acetate; NS, not significant.

    • ↵a Estimate was based on less than 25 cases.

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    TABLE 4.

    Changes in Most Recent Source of DMPA Among Women Who Have Ever Used DMPA From Project Baseline (September 2011) to Endline (May 2014), Tigray, Ethiopia

    Baseline (N=662) %Endline (N=840) %% ChangeP Value
    Most recent source of DMPA
        Government hospital1.1a0.5a−56.4.19
        Government health center59.837.9−36.7<.001
        Government health post37.830.5−19.4<.001
        CBRHA0.8a25.53085.0<.001
        Other0.6a0.0aNANA
    Preferred source of DMPA
        Government hospital1.8a1.4a−20.6.54
        Government health center51.441.4−19.4<.001
        Government health post39.953.834.9<.001
        CBRHA2.7a34.11161.1<.001
        Other9.70.1a−98.8<.001
    • Abbreviations: CBRHA, community-based reproductive health agent; DMPA, depot medroxyprogesterone acetate.

    • ↵a Estimate was based on less than 25 cases.

    • View popup
    TABLE 5.

    Changes in Quality of Family Planning Service Markers From Project Baseline (September 2011) to Endline (May 2014) as Reported by Women of Reproductive Age Who Are Currently Using Contraception, Tigray, Ethiopia

    Baseline (N=448) %Endline (N=566) %% ChangeP Value
    Told about side effects46.868.746.9<.001
    Told what to do if they experience side effects43.563.145.0<.001
    Told about other methods65.482.926.7<.001
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Global Health: Science and Practice: 5 (1)
Global Health: Science and Practice
Vol. 5, No. 1
March 24, 2017
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Community Health Workers as Social Marketers of Injectable Contraceptives: A Case Study from Ethiopia
Karen Weidert, Amanuel Gessessew, Suzanne Bell, Hagos Godefay, Ndola Prata
Global Health: Science and Practice Mar 2017, 5 (1) 44-56; DOI: 10.9745/GHSP-D-16-00344

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Community Health Workers as Social Marketers of Injectable Contraceptives: A Case Study from Ethiopia
Karen Weidert, Amanuel Gessessew, Suzanne Bell, Hagos Godefay, Ndola Prata
Global Health: Science and Practice Mar 2017, 5 (1) 44-56; DOI: 10.9745/GHSP-D-16-00344
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