Indicators for Monitoring and Evaluation of Community-Based Injectable Contraception: Multisourced Process and New Global Guidance

For many women, convenient access to family planning in their communities provides the impetus they need to start and maintain use of a family planning method. The benefits of family planning task shifting, which allows community health workers (CHWs) to provide methods such as oral contraceptive pills and injectables within communities, were publicly recognized by the World Health Organization (WHO) in 2009. WHO's 2012 global guidelines on task sharing recommended CHW provision of injectable contraception, accompanied by targeted monitoring and evaluation (M&E); however, the term “targeted” was not defined. To fill this gap, we undertook a literature review, technical consultation, and case studies in Malawi, Senegal, and Uganda to inform our development of a list of M&E indicators, supporting guidance, and job aids to help strengthen community-based access to injectable contraception programs and their ability to follow WHO recommendations. We identified 4 essential indicators: there are enough CHWs certified to provide injectables to meet project goals, CHWs are being appropriately supervised to ensure client safety, the stock of injectables is reliable and can meet project goals, and clients are receiving injections.