Global Evidence

© 2007 Virginia Lamprecht, Courtesy of PhotoshareIn June 2009, the World Health Organization (WHO) hosted a technical consultation on expanding access to injectable contraceptives. Global experts examined the evidence of community health workers (CHWs) providing this service. The consultation concluded that appropriately trained CHWs can provide injectable contraceptives safely and effectively and that this approach is acceptable to women. The consultation also concluded that there is sufficient evidence to support expansion of CHWs providing injectable contraception. 

In 2017, new WHO recommendations for task sharing were developed that recommended family planning services can be safely and effectively provided by different health workers cadres, under specified circumstances.  These recommendations included task sharing to allow CHWs to provide injectables in the context of targeted supervision and monitoring and evaluation.  You can read a summary of the recommendations in this two-page Marie Stopes International publication on task sharing here

Thirty-five million women worldwide use injectable contraceptives to prevent pregnancy, and this number is projected to grow. In sub-Saharan Africa, injectable contraception is relied upon by more than one-third of women who use modern contraceptive methods, making it the most widely-used modern method in the region. Despite their popularity, levels of unmet need for injectables remain high in many countries. This is largely due to the serious health workforce shortages currently faced by 57 countries across the globe. In Africa alone, 36 of the continent’s 46 countries face critical shortages of doctors, nurses, and midwives.

For more information on global evidence on community-based access to injectables (CBA2I), you can access materials from the 2009 WHO technical consultation, including the widely-endorsed conclusions from the technical consultation, and country experiences, including peer-reviewed literature, presentations, and other materials.