Bertrand Jane T, Makani Paul Bukutuvwidi, Hernandez Julie, Akilimali Pierre, Mukengeshayi Bitshi, Babazadeh Saleh, Binanga Arsene
Tulane School of Public Health and Tropical Medicine, 1440 Canal St., Suite 1900, New Orleans, LA 70112, USA.
Institut Supérieur de Statistiques, Kinshasa, DRC.
Contraception. 2017 Sep;96(3):211-215. doi: 10.1016/j.contraception.2017.05.014. Epub 2017 Jun 21.
The objectives were to assess acceptors' attitudes toward Sayana® Press as a method and toward the mechanism of community-based distribution by medical and nursing (M/N) students, known locally as "DBCs," in Kinshasa, Democratic Republic of the Congo, and to evaluate the experience of these DBCs.
In 2015, surveys were conducted among (1) acceptors of Sayana® Press on the day of the initial injection, (2) these same acceptors 3 months later and (3) the DBCs providing community-based services. The analysis was descriptive and involved no significance testing.
Acceptors of Sayana® Press expressed high levels of satisfaction with the method, despite some pain experienced at injection and subsequent side effects. Although most were satisfied with the counseling and services received from the DBCs, less than one third realized that the providers were M/N students. The DBCs expressed satisfaction in serving as community-based distributors; more than 95% would recommend it to others. Their primary complaints were lack of remuneration, stockouts and need for greater supervision.
Consistent with results from previous pilot introductions of Sayana® Press in three African countries, clients were highly satisfied with Sayana® Press as a method. The reported preference for resupply at health centers may reflect a lack of client awareness that the DBCs administering methods near the health center were not in fact staff from the health center. The pilot served to gain acceptance for the use of M/N students in community-based distribution, paving the way for additional task-shifting pilots in Kinshasa.
Sayana® Press represents a promising new method for increasing access to modern contraception in low-income countries. The Kinshasa experience is the first to test the use of medical and nursing students as providers at the community level. The study reports high levels of satisfaction on three counts: acceptors of the contraceptive method, acceptors of the mode of service delivery, and DBCs in their role as providers of contraception at the community level. However, many clients were not aware that the DBCs were students. The study represents an important contribution to the literature on task-shifting, especially in a country with chronic shortages of healthcare personnel.
目标是评估刚果民主共和国金沙萨的接受者对赛尼亚纳®按压式注射器作为一种方法以及对医学和护理（M/N）专业学生进行社区分发机制（当地称为“DBC”）的态度，并评估这些DBC的经验。
2015年，对以下人群进行了调查：（1）初次注射当天的赛尼亚纳®按压式注射器接受者；（2）3个月后的同一批接受者；（3）提供社区服务的DBC。分析为描述性分析，未进行显著性检验。
赛尼亚纳®按压式注射器的接受者对该方法表示高度满意，尽管注射时有些疼痛以及随后出现了副作用。虽然大多数人对从DBC获得的咨询和服务感到满意，但不到三分之一的人意识到提供者是M/N专业学生。DBC对作为社区分发者表示满意；超过95%的人会向他人推荐。他们主要的抱怨是缺乏报酬、缺货以及需要更多监督。
与之前在三个非洲国家试点引入赛尼亚纳®按压式注射器的结果一致：客户对赛尼亚纳®按压式注射器作为一种方法高度满意。报告中对在卫生中心重新供应的偏好可能反映出客户缺乏认识，即那些在卫生中心附近实施该方法的DBC实际上并非卫生中心的工作人员。该试点有助于使社区分发中使用M/N专业学生得到认可，为金沙萨更多的任务转移试点铺平了道路。
赛尼亚纳®按压式注射器是一种有前景的新方法，可增加低收入国家获得现代避孕措施的机会。金沙萨的经验是首次在社区层面测试使用医学和护理专业学生作为提供者。该研究在三个方面报告了高度满意度：避孕方法的接受者、服务提供方式的接受者以及DBC作为社区层面避孕提供者的角色。然而，许多客户并不知道DBC是学生。该研究对任务转移文献做出了重要贡献，尤其是在一个长期缺乏医护人员的国家。
