Conducting advocacy is an essential part of introducing community-based access to injectables (CBA2I). Advocacy can help gain buy-in at national and local levels, identify potential partners, and generate support. There should be combined support from the Ministry of Health, donor community and implementing partners for the program to be successfully implemented.
This tab contains a range of tools that can be used to support advocacy efforts around expanding CBA2I. The comprehensive Advocacy Guide outlines six steps for CBA2I advocacy, while the shorter Community Health Worker Provision of Injectable Contraceptives: An Effective CBA2I Strategy contains a series of six targeted advocacy resources with information on safety and effectiveness of the provision of injectables by community health workers. The four briefs in this series can be used together or individually to help answer common questions and provide background information on the practice. The map depicting the expansion of CBA2I initiatives in sub-saharan Africa can be used as a stand-alone tool to illustrate how the practice has been scaled up throughout the region. The widely-endorsed brief on the conclusions from the WHO technical consultation, as well as the set of advocacy briefs, can be powerful advocacy tools, particularly for high-level decision makers.
While CBA2I is not a new practice, it is fairly new to SSA. The regions first pilot study was conducted by FHI 360 in 1 district in Ugnada in 2005. By 2009, Madagascar had changed policy and completed their pilot study. Nigeria and Kenya had initiated pilots. In Uganda, scale up to an additional 5 districts in both the public and private sector had begun, and discussions about changing policy were well underway. As of 2012, a total of 11 have adopted policies that support CBA2I. As of June 2016, a total of 11 countries have adopted policies that support CBA2I, 2 countries have policy dialogue and scale-up underway (Liberia, Zambia) and 5 additional countries have completed pilots or have pilots underway (Benin, Burkina Faso, DRC, Niger, Sierra Leone, Togo). As of March 2017, a total of 11 countries have adopted policies that support CBA2I, 3 countries have policy dialogue and scale-up underway (Liberia, Zambia, Benin) and 6 additional countries have completed pilots or have pilots underway (DRC, Sierra Leone, Tanzania, Togo, Burkina Faso, Niger). As of February 2018, a total of 12 countries have adopted policies that support CBA2I, 6 countries have policy dialogue and scale-up underway (Liberia, Niger, Burkina Faso and DRC, Tanzania and Benin) and 2 additional countries have completed pilots or have pilots underway (Sierra Leone and Togo). This practice has gained momentum as the evidence base has grown and countries have begun to focus on expanding access to FP at the community level to meet their development goals. These presentation focuse on SSA, as FHI 360 has worked there, however, Afghanistan and Pakistan both have robust CBA2I programs. One factor that helps explain the momentum we’ve seen since 2009 is the global advocacy efforts of FHI 360 and other organizations.