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Expansion of Community-Based Family Planning in the DRC: Using a Systematic Approach to Scale-Up

JOURNAL: Government Ownership and Adaptation in Scale-Up: Experiences from Community-Based Family Planning Programme in the DRC

Between 2014 and 2018, with funding from USAID, the Evidence to Action (E2A) Project supported the Ministry of Health (MOH) of the Democratic Republic of the Congo (DRC) to scale up successful pilot interventions that provided integrated community-based family planning (FP) and primary health care services from South Kivu Province to health zones in three additional provinces: Lomami, Lualaba, and Kasai Central.

The original package of interventions, carried out over a four-year testing phase by Pathfinder International’s Flexible Family Planning, Reproductive Health and Gender-Based Violence Services for Transition Situations (Flex-FP) Project, were designed to support a largely transient population living in a post-conflict area of South Kivu Province.

FP interventions consisted of providing non-clinical contraceptive methods—condoms, Cyclebeads®, oral contraceptive pills, and counseling on lactational amenorrhea—by trained community-based distributors (CBDs). To comply with DRC’s existing policy on injections and complement the work of CBDs, the project recruited unemployed nurses living in the targeted communities to provide the injectable contraceptive Depo Provera (DMPA)®. Skilled health providers contracted by the project conducted mobile outreach services delivering primary healthcare services, including maternal and child health (MCH) services; nutrition; treatment of malaria, acute respiratory infections, and diarrhea; voluntary HIV-testing and counseling; and referral services for case management of the consequences of sexual and gender-based violence (SGBV). The combined interventions yielded an increased uptake of contraceptive methods in project health zones.

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