Community-based distribution of family planning services in Saradidi, Kenya.

Community-based distribution (CBD) of family planning services was initiated in 1980 in Saradidi, Kenya, as part of a community development effort. Family planning information and services in each village were provided by volunteer health helpers (VHH's) chosen and supported by the people in each village. The initial examination and supply of commodities was provided at a community clinic. Less than 1% of women 15 to 49 years of age used a family planning method before CBD was initiated. In 1983, 31 (17.3%) of 179 randomly selected currently married women and 26 (52.0%) of 50 currently married VHH's reported having used a family planning method; 38 (66.7%) were still using a method at the time of the survey. Family planning use increased with age and education. Women who used family planning had higher parity, were less likely to want more children and had had a longer time since the last delivery. From 1980 to 1983, 732 persons (including 121 men) were seen at the Saradidi clinic requesting family planning services; 17.2% were referred from the VHH's. About one-third of clients referred from VHH's to the clinic for examination and commodities actually came. Allowing VHH's to carry out the initial examination and provide the first supply of commodities to the acceptors might have significantly increased the rate of family planning use. The findings demonstrate an increased use of family planning services in Saradidi following the inception of CBD.