Community-Based Access to Injectables (CBA2I)
Community-based programs typically offer condoms and oral contraceptives and refer people to clinics for other methods. Programs in a growing number of countries, however, have demonstrated that well-trained community-based health workers can safely and effectively provide injectable contraceptives. Training and authorizing a wider range of providers to give injections can expand access to injectables, reduce unsafe unauthorized injections, and save programs money.
In the last decade, community health workers have provided DMPA injectables in more than a dozen countries, including Afghanistan, Bangladesh, Bolivia, Guatemala, Ethiopia, Haiti, Madagascar, Malawi, Nepal, and Uganda. In June 2009, a technical consultation held at the World Health Organization (WHO) in Geneva concluded that evidence supports the introduction, continuation, and scale-up of community-based provision of progestin-only injectable contraceptives.
Currently, more than 40 million women worldwide use injectable contraception to prevent pregnancy. Injectables are the fourth most popular method worldwide, after female sterilization, the intrauterine device, and oral contraceptives. In sub-Saharan Africa, injectables are the most popular method, chosen by 38% of women using modern methods.
Injectables appeal to the many women who seek a family planning method that is effective and long-acting and can be used privately. Mobilizing a range of providers to offer injectables, including community health workers, can help family planning programs meet the rising demand for injectables.
See the Community-Based Access to Injectable Contraceptives Toolkit for information and resources to strengthen the capacity of agencies and organizations to plan, implement, evaluate, promote, and scale up such programs and to advocate for changes to national policy and service delivery guidelines.