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The scale-up and integration of contraceptive service delivery into nursing school training in the Democratic Republic of the Congo

In Kinshasa, Democratic Republic of the Congo (DRC), modern contraceptive prevalence is low by international standards: 29.6% as of 2020. A 2015 pilot study demonstrated the feasibility and acceptability of using medical and nursing students to administer DMPA-SC (the subcutaneous injection) among o...

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Autores principales: Ntabona, Alexis, Binanga, Arsene, Bapitani, Mr Désiré Josué, Bobo, Beatrice, Mukengeshayi, Bitshi, Akilimali, Pierre, Kalong, Gloria, Mujani, Zenon, Hernandez, Julie, Bertrand, Jane T
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8227455/
https://www.ncbi.nlm.nih.gov/pubmed/34009259
http://dx.doi.org/10.1093/heapol/czab014
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author Ntabona, Alexis
Binanga, Arsene
Bapitani, Mr Désiré Josué
Bobo, Beatrice
Mukengeshayi, Bitshi
Akilimali, Pierre
Kalong, Gloria
Mujani, Zenon
Hernandez, Julie
Bertrand, Jane T
author_facet Ntabona, Alexis
Binanga, Arsene
Bapitani, Mr Désiré Josué
Bobo, Beatrice
Mukengeshayi, Bitshi
Akilimali, Pierre
Kalong, Gloria
Mujani, Zenon
Hernandez, Julie
Bertrand, Jane T
author_sort Ntabona, Alexis
collection PubMed
description In Kinshasa, Democratic Republic of the Congo (DRC), modern contraceptive prevalence is low by international standards: 29.6% as of 2020. A 2015 pilot study demonstrated the feasibility and acceptability of using medical and nursing students to administer DMPA-SC (the subcutaneous injection) among other methods at the community level. The more far-reaching discovery was the potential of clinically trained students to increase access to low-cost contraception in the short-run, while improving the quality of service delivery for future generations of healthcare providers. Scale-up involved integrating the family planning curriculum into the training of nursing students, including classroom instruction in contraceptive technology and service delivery, coupled with a year-long field practicum in which students offered a range of contraceptive methods during intermittent outreach events, door-to-door distribution or sales from their homes. Starting in 2015, a multi-agency team consisting of an international non-governmental organizations (NGO), several Ministry of Health directorates and a local NGO used the ExpandNet/WHO framework to guide this scale-up. This article details the nine steps in the scale-up process. It presents results on increases in contraceptive uptake, feedback from participating nursing school personnel and the employment experience of the graduates from this programme. Between 2015 and 2019, the family planning curriculum was incorporated into 30.8% of the 477 nursing schools in 7 of the 26 provinces in the DRC. Students delivered 461 769 couple-years of protection (the key output indicator for family planning programmes). Nursing school personnel were strongly favourable to the approach, although they needed continued support to adequately implement a set of additional interventions related to the service delivery components of the new training approach. Post-graduation, only 40.1% of graduates had paid employment (reflecting the staggering unemployment in the DRC); among those, over 90% used their family planning training in their work. We describe the multiple challenges faced during the scale-up process and in planning for expansion to additional schools.
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spelling pubmed-82274552021-06-28 The scale-up and integration of contraceptive service delivery into nursing school training in the Democratic Republic of the Congo Ntabona, Alexis Binanga, Arsene Bapitani, Mr Désiré Josué Bobo, Beatrice Mukengeshayi, Bitshi Akilimali, Pierre Kalong, Gloria Mujani, Zenon Hernandez, Julie Bertrand, Jane T Health Policy Plan Original Article In Kinshasa, Democratic Republic of the Congo (DRC), modern contraceptive prevalence is low by international standards: 29.6% as of 2020. A 2015 pilot study demonstrated the feasibility and acceptability of using medical and nursing students to administer DMPA-SC (the subcutaneous injection) among other methods at the community level. The more far-reaching discovery was the potential of clinically trained students to increase access to low-cost contraception in the short-run, while improving the quality of service delivery for future generations of healthcare providers. Scale-up involved integrating the family planning curriculum into the training of nursing students, including classroom instruction in contraceptive technology and service delivery, coupled with a year-long field practicum in which students offered a range of contraceptive methods during intermittent outreach events, door-to-door distribution or sales from their homes. Starting in 2015, a multi-agency team consisting of an international non-governmental organizations (NGO), several Ministry of Health directorates and a local NGO used the ExpandNet/WHO framework to guide this scale-up. This article details the nine steps in the scale-up process. It presents results on increases in contraceptive uptake, feedback from participating nursing school personnel and the employment experience of the graduates from this programme. Between 2015 and 2019, the family planning curriculum was incorporated into 30.8% of the 477 nursing schools in 7 of the 26 provinces in the DRC. Students delivered 461 769 couple-years of protection (the key output indicator for family planning programmes). Nursing school personnel were strongly favourable to the approach, although they needed continued support to adequately implement a set of additional interventions related to the service delivery components of the new training approach. Post-graduation, only 40.1% of graduates had paid employment (reflecting the staggering unemployment in the DRC); among those, over 90% used their family planning training in their work. We describe the multiple challenges faced during the scale-up process and in planning for expansion to additional schools. Oxford University Press 2021-05-02 /pmc/articles/PMC8227455/ /pubmed/34009259 http://dx.doi.org/10.1093/heapol/czab014 Text en © The Author(s) 2021. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine. https://creativecommons.org/licenses/by/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) ), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Ntabona, Alexis
Binanga, Arsene
Bapitani, Mr Désiré Josué
Bobo, Beatrice
Mukengeshayi, Bitshi
Akilimali, Pierre
Kalong, Gloria
Mujani, Zenon
Hernandez, Julie
Bertrand, Jane T
The scale-up and integration of contraceptive service delivery into nursing school training in the Democratic Republic of the Congo
title The scale-up and integration of contraceptive service delivery into nursing school training in the Democratic Republic of the Congo
title_full The scale-up and integration of contraceptive service delivery into nursing school training in the Democratic Republic of the Congo
title_fullStr The scale-up and integration of contraceptive service delivery into nursing school training in the Democratic Republic of the Congo
title_full_unstemmed The scale-up and integration of contraceptive service delivery into nursing school training in the Democratic Republic of the Congo
title_short The scale-up and integration of contraceptive service delivery into nursing school training in the Democratic Republic of the Congo
title_sort scale-up and integration of contraceptive service delivery into nursing school training in the democratic republic of the congo
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8227455/
https://www.ncbi.nlm.nih.gov/pubmed/34009259
http://dx.doi.org/10.1093/heapol/czab014
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