FHI 360 engages with our partners to introduce, scale up, strengthen, and institutionalize community-based family planning at the global and country level. Our work exemplifies our research to practice approach, which combines research on innovations with sustained research utilization to ensure that the results are put into practice. This work has focused on several specific community-based family planning approaches.
- We championed community-based access to injectable contraceptives (CBA2I), which was once innovative and is now a standard of practice. Beginning in 2004, we conducted pilot studies in Uganda and Madagascar on the acceptability, safety and effectiveness of CBA2I. A 2009 technical consultation organized by FHI 360 concluded that community health workers can safely and effectively administer injectable contraceptives in nonclinical settings, thus addressing the severe shortage for family planning providers. We have worked directly with stakeholders in Benin, Kenya, Madagascar, Malawi, Nigeria, Senegal, Rwanda, Uganda and Zambia to introduce and scale up this proven high-impact practice. We have developed several resources to support continued scale-up.
- We are leading the promotion of drug shops as a key component in community-based provision. The team has provided technical expertise in packaging and disseminating evidence and advocacy from Uganda on the delivery of injectables by drug shop operators.
- Under the Advancing Partners and Communities project in Uganda, we introduced community health worker-administered Sayana® Press, a subcutaneous formulation of the injectable contraceptive depot medroxyprogesterone acetate (DMPA-SC). In Malawi, we conducted a trial of self-administered DMPA-SC. Results published in The Lancet Global Health showed that self-administration led to a more than 50 percent increase in continuous DMPA-SC pregnancy protection, demonstrating that self-administered contraception may be a true game changer, especially for overcoming high rates of contraceptive discontinuation. The journey of DMPA-SC from research to practice is depicted in the short film, The Power of Self-Injectable Contraception. Since Advancing Partners and Communities ended in 2019, we have continued to support the introduction and scale-up of self-injectable contraception in Malawi. This brief highlights the findings and recommendations from a recent qualitative study of DMPA-SC self-injectors on waste management, training and adolescents’ experiences.
FHI 360 provides technical assistance to strengthen referrals for long-acting and permanent methods by community health workers and to support provision of emergency contraceptive pills. To include community-based family planning approaches, we also developed an online course provided through the Global Health eLearning Center.
