USAID Transform: Backup LARC Service Support in Ethiopia

Expanding Access to Long-Acting Reversible Contraceptives in Rural Communities of Ethiopia Through Integrated Backup Support from Health Centers

Lessons from the USAID Transform: Primary Health Care Activity

In response to increased demand for long-acting reversible contraceptive (LARC) insertion and removal services after the Federal Ministry of Health (FMOH) of Ethiopia launched its Implanon scale-up program in rural communities in 2009, the USAID: Transform Primary Health Care Activity (2017-2022) continued and expanded the integrated backup LARC service approach that the USAID Integrated Family Health Program (IFHP, 2008-2016) began in September 2011. In this intervention, a team of providers from health centers (HCs) regularly visits and provides a range of contraceptive services for clients at health posts (HPs) in rural communities.

In 2020, the Activity assessed the impact of this support, comparing rural HPs receiving backup support from HCs, with those that did not receive support. The assessment found that integrating backup LARC service support into the existing health system was a relatively easy way to support rural communities with family planning (FP) services. The intervention expanded contraceptive method mix and uptake among rural clients; saved clients time and money; reduced the burden of service provision on HCs; strengthened linkages among HCs, HPs, health extension workers (HEWs), and clients; and strengthened the capacity of frontline health workers. It also made service delivery more efficient, helped ensure equitable access to a continuum of care for rural clients, and strengthened health system capacity and ownership.