FHI, P.O. Box 13950, Research Triangle Park, NC 27709, USA.
Stud Fam Plann. 2011 Jun;42(2):117-24. doi: 10.1111/j.1728-4465.2011.00271.x.
This case study presents service monitoring data and programmatic lessons from scaling up Uganda's community-based distribution of depot medroxyprogesterone acetate (DMPA, marketed as Depo-Provera) to the public sector in two districts. We describe the process and identify implementation opportunities and challenges, including modifications to the service model. Analysis of monitoring data indicates that the number of women initiating DMPA with a community health worker (CHW) was 56 percent higher than the number of new DMPA acceptors served by clinics. Including continuing DMPA users, about three of every four DMPA clients chose CHWs as their service delivery point. CHW provision appears to be the preferred method of delivery for new DMPA users in this study, and may appeal even more to continuing clients. Lessons from scaling up in Uganda's public sector include recognizing the needs for ongoing assessment of support, a process to gain community "ownership," and spontaneous innovations to supplement CHW supervision.
本案例研究介绍了乌干达将基于社区的储存型醋酸甲羟孕酮（DMPA，商品名为Depo-Provera）分销扩大到两个地区公共部门的服务监测数据和方案经验教训。我们描述了这一过程，并确定了实施中的机遇和挑战，包括对服务模式的修改。监测数据分析表明，在社区卫生工作者（CHW）处开始使用 DMPA 的妇女人数比诊所服务的新 DMPA 接受者人数高出 56%。包括继续使用 DMPA 的用户在内，每四个 DMPA 客户中约有三个选择 CHW 作为其服务提供点。在这项研究中，CHW 服务似乎是新 DMPA 用户的首选提供方式，甚至可能对继续使用的客户更具吸引力。在乌干达公共部门扩大规模的经验教训包括认识到需要持续评估支持、获得社区“所有权”的过程以及补充 CHW 监督的自发创新。
