Skip to main content

Article on Performance Incentives for CHWs making a difference to women's Right to Contraception

By
An interesting link to a paper Danny Gotto authored with colleagues and will be presenting APHA Annual Meeting Expo Nov 2-6th in Philadelphia USA: 
https://apha.confex.com/apha/2019/meetingapp.cgi/Paper/439754 

Experience from Western Uganda with CHWs and Performance-Based Incentives: Making Rural Women’s Right to Contraception Real  

Abstract
Background: Ugandan women have a high unmet need for contraception and high levels of unintended pregnancy and unsafe abortion. Community health workers (CHWs) can expand access to family planning by delivering services and linking communities to primary care. This study evaluates a project in which CHWs received performance-based incentives (PBIs) for providing short-term contraception to rural community members, and for referring them to health centers for long-acting or permanent methods (LAPMs).
Methods: We retrospectively collected service delivery data from 10 program and 10 control health centers for 18 months prior to program launch, and the first 18 months of program activity. We used a difference-in-differences approach in which pre-program trends in monthly family planning uptake for control and program health centers were compared to post-program trends using multivariate, negative binomial regression models with fixed effects for health center and time quarters.
Key Findings: 45,421 clients received family planning counseling and services. Each CHW provided contraception to 27 clients/month, including 6 completed LAPM referrals. The program had a significant positive impact on LAPM uptake. Compared to control centers, program centers delivered 2-5 more implants/month (marginal effect=1.8 and 5.1 for Implanon and Jadelle implants respectively, p<0.01) and 3 more tubal ligations/month (marginal effect=5.11, p<0.01). We found no significant change in IUD or short-term methods uptake and inconclusive results for injectables.
Danny Gotto ACODEV & PHM Uganda
Conclusion
CHWs are capable of providing substantial family planning services to rural women. Incentivizing them based on performance and strengthening their links to facility-based providers shows promise for expanding rural access to care.

Comments

Post a Comment

Popular posts from this blog

Creating an Africa-wide People's Health Movement

By
Our manifesto As the IPHU participants from the 'Africa Group’ we have agreed that in order to strengthen the movement, we would each need to first start by working locally, strengthening the PHM activities in our respective countries, Ethiopia, Ghana, South Africa, Uganda and Zimbabwe. We commit to support each other in developing and strengthening the PHM in each of our countries as we work towards an Africa-wide People’s Health Movement. The role of PHM is to bring together organisations and individuals already working for the Right to Health under the banner of this shared vision of “Health for all, now!” PHM Africa is an organisation, not a movement. Anyone who endorses the charter and is working in the struggle for the right to health for all can join PHM Africa. The objectives and activities of our campaign are defined and developed by our members. We will strive to further the movement starting on this blog by connecting with others, sharing experiences,...
Post a Comment
Read more

PHA3-Regional Statement- East and Southern Africa

By
REGIONAL STATEMENT – EASTERN & SOUTHERN AFRICA PEOPLE’S HEALTH ASSEMBLY 3 CAPE TOWN 11 JULY 2012 For us the country circle is fundamental. Our starting point would be to identify International People’s Health University (IPHU) alumni in the country; these need to identify an issue and seek local allies who identify with or are working on the issue, begin to develop a campaign and then ask the region for support including connecting them with expertise globally. We have established four working country circles that have lessons we can learn from. We need to develop the embryonic circles in the region through outreach support from the regional level. This can be done by developing a manual based on the lessons from countries (case studies from South Africa, Zimbabwe, Ghana Kenya, as well as experiences from other regions) consisting of principles such as: We need a rallying point or issue that is centred around the right to health (RTH) and this can take di...
Post a Comment
Read more

Seeking Organisational Endorsements: Comments on ‘Draft Technical Paper’ prepared for the World Conference on SDH

By
Seeking Endorsements: Comments on ‘Draft Technical Paper’ prepared for the World Conference on Social Determinants of Health The World Health Organization (WHO) is convening the World Conference on Social Determinants of Health (WCSDH) from 19-21 October 2011 in Rio de Janeiro with the support of the Government of Brazil. The Conference will be organized in accordance with the Resolution 62.14 of the 62nd World Health Assembly and as a follow-up for the work of the WHO Commission on the Social Determinants of Health (CSDH). The WHO has published a ‘Draft Technical Paper’ on the WCSDH and initiated a consultation around it through inviting online submissions. The People’s Health Movement (PHM), in association with several public interest groups and networks, has been coordinating a collective civil society response to the Draft Technical Paper which we strongly believe is a step back from the report of the CSDH ‘Closing the Gap in a Generation: Health equity through action on soci...
Post a Comment
Read more