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Family Planning Counseling in Your Pocket: A Mobile Job Aid for Community Health Workers in Tanzania
To address low contraceptive use in Tanzania, a pilot intervention using a mobile job aid was developed to guide community health workers (CHWs) to deliver integrated counseling on family planning, HIV, and other sexually transmitted infections (STIs). In this article, we describe the process of dev...
Autores principales: | , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Global Health: Science and Practice
2016
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4982253/ https://www.ncbi.nlm.nih.gov/pubmed/27353622 http://dx.doi.org/10.9745/GHSP-D-15-00393 |
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author | Agarwal, Smisha Lasway, Christine L’Engle, Kelly Homan, Rick Layer, Erica Ollis, Steve Braun, Rebecca Silas, Lucy Mwakibete, Anna Kudrati, Mustafa |
author_facet | Agarwal, Smisha Lasway, Christine L’Engle, Kelly Homan, Rick Layer, Erica Ollis, Steve Braun, Rebecca Silas, Lucy Mwakibete, Anna Kudrati, Mustafa |
author_sort | Agarwal, Smisha |
collection | PubMed |
description | To address low contraceptive use in Tanzania, a pilot intervention using a mobile job aid was developed to guide community health workers (CHWs) to deliver integrated counseling on family planning, HIV, and other sexually transmitted infections (STIs). In this article, we describe the process of developing the family planning algorithms and implementation of the mobile job aid, discuss how the job aid supported collection of real-time data for decision making, and present the cost of the overall system based on an evaluation of the pilot. The family planning algorithm was developed, beginning in June 2011, in partnership with the Tanzania Ministry of Health and Social Welfare based on a combination of evidence-based tools such as the Balanced Counseling Strategy Plus Toolkit. The pilot intervention and study was implemented with 25 CHWs in 3 wards in Ilala district in Dar es Salaam between January 2013 and July 2013. A total of 710 family planning users (455 continuing users and 255 new users) were registered and counseled using the mobile job aid over the 6-month intervention period. All users were screened for current pregnancy, questioned on partner support for contraceptive use, counseled on a range of contraceptives, and screened for HIV/STI risk. Most new and continuing family planning users chose pills and male condoms (59% and 73%, respectively). Pills and condoms were provided by the CHW at the community level. Referrals were made to the health facility for pregnancy confirmation, injectable contraceptives, long-acting reversible contraceptives and HIV/STI testing. Follow-up visits with clients were planned to confirm completion of the health facility referral. The financial cost of implementing this intervention with 25 CHWs and 3 supervisors are estimated to be US$26,000 for the first year. For subsequent years, the financial costs are estimated to be 73% lower at $7,100. Challenges such as limited client follow-up by CHWs and use of data by supervisors identified during the pilot are currently being addressed during the scale-up phase by developing accountability and incentive mechanisms for CHWs and dashboards for data access and use. |
format | Online Article Text |
id | pubmed-4982253 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2016 |
publisher | Global Health: Science and Practice |
record_format | MEDLINE/PubMed |
spelling | pubmed-49822532016-08-17 Family Planning Counseling in Your Pocket: A Mobile Job Aid for Community Health Workers in Tanzania Agarwal, Smisha Lasway, Christine L’Engle, Kelly Homan, Rick Layer, Erica Ollis, Steve Braun, Rebecca Silas, Lucy Mwakibete, Anna Kudrati, Mustafa Glob Health Sci Pract Field Action Report To address low contraceptive use in Tanzania, a pilot intervention using a mobile job aid was developed to guide community health workers (CHWs) to deliver integrated counseling on family planning, HIV, and other sexually transmitted infections (STIs). In this article, we describe the process of developing the family planning algorithms and implementation of the mobile job aid, discuss how the job aid supported collection of real-time data for decision making, and present the cost of the overall system based on an evaluation of the pilot. The family planning algorithm was developed, beginning in June 2011, in partnership with the Tanzania Ministry of Health and Social Welfare based on a combination of evidence-based tools such as the Balanced Counseling Strategy Plus Toolkit. The pilot intervention and study was implemented with 25 CHWs in 3 wards in Ilala district in Dar es Salaam between January 2013 and July 2013. A total of 710 family planning users (455 continuing users and 255 new users) were registered and counseled using the mobile job aid over the 6-month intervention period. All users were screened for current pregnancy, questioned on partner support for contraceptive use, counseled on a range of contraceptives, and screened for HIV/STI risk. Most new and continuing family planning users chose pills and male condoms (59% and 73%, respectively). Pills and condoms were provided by the CHW at the community level. Referrals were made to the health facility for pregnancy confirmation, injectable contraceptives, long-acting reversible contraceptives and HIV/STI testing. Follow-up visits with clients were planned to confirm completion of the health facility referral. The financial cost of implementing this intervention with 25 CHWs and 3 supervisors are estimated to be US$26,000 for the first year. For subsequent years, the financial costs are estimated to be 73% lower at $7,100. Challenges such as limited client follow-up by CHWs and use of data by supervisors identified during the pilot are currently being addressed during the scale-up phase by developing accountability and incentive mechanisms for CHWs and dashboards for data access and use. Global Health: Science and Practice 2016-06-20 /pmc/articles/PMC4982253/ /pubmed/27353622 http://dx.doi.org/10.9745/GHSP-D-15-00393 Text en © Agarwal et al. http://creativecommons.org/licenses/by/3.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are properly cited. To view a copy of the license, visit http://creativecommons.org/licenses/by/3.0/. When linking to this article, please use the following permanent link: http://dx.doi.org/10.9745/GHSP-D-15-00393. |
spellingShingle | Field Action Report Agarwal, Smisha Lasway, Christine L’Engle, Kelly Homan, Rick Layer, Erica Ollis, Steve Braun, Rebecca Silas, Lucy Mwakibete, Anna Kudrati, Mustafa Family Planning Counseling in Your Pocket: A Mobile Job Aid for Community Health Workers in Tanzania |
title | Family Planning Counseling in Your Pocket: A Mobile Job Aid for Community Health Workers in Tanzania |
title_full | Family Planning Counseling in Your Pocket: A Mobile Job Aid for Community Health Workers in Tanzania |
title_fullStr | Family Planning Counseling in Your Pocket: A Mobile Job Aid for Community Health Workers in Tanzania |
title_full_unstemmed | Family Planning Counseling in Your Pocket: A Mobile Job Aid for Community Health Workers in Tanzania |
title_short | Family Planning Counseling in Your Pocket: A Mobile Job Aid for Community Health Workers in Tanzania |
title_sort | family planning counseling in your pocket: a mobile job aid for community health workers in tanzania |
topic | Field Action Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4982253/ https://www.ncbi.nlm.nih.gov/pubmed/27353622 http://dx.doi.org/10.9745/GHSP-D-15-00393 |
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