The Bixby Center for Population, Health, and Sustainability
  • About
    • About
    • Mission
    • Vision
    • Goals
    • Where We Work
    • Careers
  • People
    • Team
    • Archive
  • What We Do
    • Core Research
      • Global Population
      • Family Planning
      • Maternal Health
      • Safe Abortion
    • Special Programs & Initiatives
      • The OASIS Initiative
      • Girl-Child Education Initiative
      • Adolescent Reproductive Health
      • Women’s Health and Empowerment
      • Evidence for Development (E4D)
    • Opportunities
      • Internships
      • Volunteering
      • Fellowships
      • Mentorships
    • Teaching
      • Online Courses
      • Past Courses
    • Collaborations
    • Careers
    • Special
  • Publications
  • VSI Archive
  • News
    • News
      • In the Media
      • Press Release
      • Stories from the field
      • Newsletters
    • Events
      • Upcoming Events
      • Past Events
  • Contact

Mozambique: CBD of Injectable Contraceptives

Project Dates:  February 2014 – April 2015

Community-based access to injectable contraceptives in two districts in Mozambique

In the Family Planning Strategy 2010- 2014, the Ministry of Health in Mozambique approved the revitalization of the Agente Polivalente Elementar (APE) program, as well as the use of traditional birth attendants (TBAs) to mobilize the community for increased utilization of family planning methods. Building on this strategy and given the preference among Mozambican women for injectable contraceptives, the Bixby Center partnered with Pathfinder International and the Mozambican Association of Obstetrics and Gynecology to conduct a safety and feasibility assessment of a community-based distribution program of injectable contraceptives in two districts in Mozambique.The study aimed to explore the effectiveness of training two groups of community-based agents, APEs and traditional birth attendants (TBAs), to administer injectable contraceptives, thus bringing women greater access to their preferred method of contraception. From February 2014 through April 2015, the pilot study was conducted in the Montepuez and Chiure districts of northern Mozambique. A total of 25 APEs and 34 TBAs from the pilot districts were selected to receive training on CBD of injectable contraceptives.

Screen-Shot-2015-04-29-at-10.13.38-AM-300x223

The findings from this pilot study support that community-based distribution of injectable contraceptives by APEs and TBAs is safe, feasible, effective and acceptable to women. Almost 63% of TBA clients and 65.6% of APE clients reported never using a method to prevent pregnancy prior to this project. Overall, the pilot study demonstrated a high continuation rate (81.1%) after three injections, and when compared to APE clients, TBA clients had significantly higher continuation rates both at three months and at six months. In total, less than 0.5% of women reported any issue. Additionally, most clients reported no side effects at 3-month and at 6-month follow-up. Most women were satisfied with their provider; overall, at six months, dissatisfaction with the provider was low (9% among TBA clients and 4% among APE clients).

Funding: USAID/Washington; Pathfinder Mozambique

For more information on this study, please download the program brief.

Exploring community-based agents’ and postpartum women’s perceptions of community-based postpartum family planning in two districts in Mozambique

As a nested study to the project described above, the Bixby Center, in collaboration with the Mozambican Association of Obstetricians and Gynecologists, conducted 50 in-depth interviews with postpartum women and their community-based family planning providers. These interviews elucidated the enabling factors and barriers to family planning uptake in the postpartum period. Interviews with postpartum women aimed to explore their experiences with the injectable contraceptive provision project, their opinions and perceptions of community-based providers, their assessment of risk of pregnancy in the postpartum period, and their perspectives on using contraception during this period. Interviews with community-based family planning agents uncovered their opinions of family planning use among postpartum women and how this affects service provision, interactions with postpartum women in the program, challenges delivering information about risk of pregnancy in the postpartum period, and perceptions of the program. The long-term goal of this qualitative research was to develop a sustainable family planning distribution system that responds to low-resource, rural women’s needs and preferences without further burdening the skilled health workforce in Mozambique.

According to most respondents, community ideas about birth spacing and using injectables to promote women and children’s health were undergoing a transition. The direction of this shift supports women’s use of postpartum family planning. However, more acceptance for postpartum injectable use has not translated into increased autonomy or decision-making authority for women. There are two scenarios that can result in a woman’s use of postpartum contraception evident in the data: husband-initiated and woman-initiated postpartum family planning.It is clear that the custom of male decision-making about family planning continues to pervade the rural communities where this project was implemented. Perhaps more importantly, norms about women’s agency over reproductive decisions are not confined to the household level, but rather reach out into the community, compelling APEs and TBAs to reinforce male decision-making.

Funding: USAID/Washington; Bixby Center at UC Berkeley

Share this:

  • Click to share on Facebook (Opens in new window)
  • Click to share on Twitter (Opens in new window)
  • Click to print (Opens in new window)
  • More
  • Click to share on Reddit (Opens in new window)
  • Click to share on LinkedIn (Opens in new window)
  • Core Research
    • Global Population
    • Family Planning
      • Musanze Youth Center
      • Angola: Comprehensive Family Planning and Post Abortion Care
      • Ethiopia: CBD of Injectable Contraceptives
      • Mozambique: CBD of Injectable Contraceptives
      • Rwanda FP Service Integration Project
    • Maternal Health
    • Safe Abortion
  • Special Programs & Initiatives
  • Opportunities
  • Teaching
  • Collaborations
  • Special

Recent News

  • Bixby Center’s Affiliate UC Global Health’s Creative Expression Contest!

    February 22, 2021
  • Bixby Center’s affiliate CEGA has an open job opportunity

    February 21, 2021
  • Recommendations to Improve Medication-Assisted Treatment Implementation in Correctional Health

    February 21, 2021
  • Child Marriage: Latest Trends & Future Prospects

    February 9, 2021

Quick Links

  • What We Do
  • Announcements
  • Events
  • Opportunities
  • Careers
  • Stories from the Field

About

The Bixby Center for Population, Health, and Sustainability is dedicated to helping achieve slower population growth within a human right framework by addressing the unmet need for family planning. Learn more

Connect

University of California, Berkeley
2121 Berkeley Way West, Suite 6100
Berkeley, CA 94720-7360
Contact | Map

Follow @BixbyCenter

View Bixby's group on LinkedIn

©2016 Bixby Center for Population, Health & Sustainability. All Rights Reserved.
Web Design by HelloARI
SPH Berkeley