University of California at Berkeley, School of Public Health, 229 University Hall, Berkeley, CA 94720-6390, United States of America.
Bull World Health Organ. 2011 Aug 1;89(8):556-64. doi: 10.2471/BLT.11.086710. Epub 2011 Apr 29.
To determine whether community-based health workers in a rural region of Ethiopia can provide injectable contraceptives to women with similar levels of safety, effectiveness and acceptability as health extension workers (HEWs).
This was a prospective non-randomized community intervention trial designed to test the provision of injectable contraceptives by community-based reproductive health agents (CBRHAs). Effectiveness, safety, acceptability and continuation rates were the outcomes of interest. The outcomes observed when injectable contraceptives were administered by HEWs in health posts and when they were administered by CBRHAs were compared by means of χ(2) tests for association among categorical variables and t-tests for independent samples to determine differences between group means.
A total of 1062 women participated in the study. Compared with health post clients, the clients of CBRHAs were, on average, slightly older, less likely to be married and less educated, and they had significantly more living children. Women seeking services from CBRHAs were also significantly more likely to be using injectable contraceptives for the first time; health post clients were more likely to have used them in the past. In addition, clients of CBRHAs were less likely to discontinue using injectable contraceptives over three injection cycles than health post clients.
Receiving injectable contraceptives from CBRHAs proved as safe and acceptable to this sample of Ethiopian women as receiving them in health posts from HEWs. These findings add to the growing body of evidence supporting the development, introduction and scale up of programmes to train community-based health workers such as CBRHAs to safely administer injectable contraceptives.
在埃塞俄比亚农村地区，确定社区卫生工作者是否能够以与卫生推广工作者（HEWs）相似的安全性、有效性和可接受性向妇女提供注射避孕方法。
这是一项前瞻性非随机社区干预试验，旨在测试社区生殖健康代理人（CBRHAs）提供注射避孕方法的情况。有效性、安全性、可接受性和续用率是感兴趣的结果。通过 χ(2)检验对分类变量进行关联分析和 t 检验对独立样本进行差异检验，比较了在卫生所由 HEWs 管理和由 CBRHAs 管理时注射避孕方法的结果。
共有 1062 名妇女参与了研究。与卫生所就诊者相比，CBRHAs 的就诊者平均年龄稍大，已婚比例较低，受教育程度较低，且生育子女明显较多。寻求 CBRHAs 服务的妇女也更有可能首次使用注射避孕方法；而卫生所就诊者更有可能在过去使用过它们。此外，与卫生所就诊者相比，CBRHAs 的就诊者在三个注射周期内停止使用注射避孕方法的可能性较小。
向 CBRHAs 提供注射避孕方法对埃塞俄比亚妇女来说，与从 HEWs 在卫生所提供的方法一样安全和可接受。这些发现增加了越来越多的证据，支持制定、引入和扩大培训社区卫生工作者（如 CBRHAs）以安全管理注射避孕方法的方案。
