Community-Based Family Planning

Community-based family planning (CBFP) brings family planning information and methods to women and men where they live rather than requiring them to visit health facilities. One of the main objectives of CBFP programs is to increase access to and choice of contraceptive methods in underserved areas. CBFP programs work through a variety of channels, including community health workers, community depots, drug shops, mobile services, and the private sector. Advancing Partners & Communities supports the expansion of CBFP services to help accomplish the goal of making the full range of modern family planning methods available at the community level.  CBFP services involve a significant level of community ownership and should also be linked to the government’s health system so as to not duplicate, replace, or ignore the existing system.

Photo credit: Amy Cotter/USAID

Below are select resources related to key issues within community health systems strengthening.

Gender Norms of Health Care Providers

Gender norms are part of the community and affect everyone. Community health programs must recognize that everyone, including program designers and healthcare providers themselves, are socialized into certain ways of thinking and behaving as women and men, and about women and men. As a result, women and men often experience stigma and discrimination from healthcare providers. Healthcare providers should receive training in gender sensitivity to challenge their thinking about gender norms and be mindful of gender issues when interacting with clients.

Female Community Health Volunteer National Survey Report 2014
January 2016 | Report

The 2014 Female Community Health Volunteer (FCHV) survey provides a comprehensive assessment of the FCHV program in Nepal. The document reports the findings of a national-level quantitative survey of FCHVs and from complementary qualitative interviews with key national, district level, and community stakeholders. The results are intended to increase understanding of the current status of the FCHV program and reflect on stakeholder perceptions of program experience and performance.

Community Health Worker Motivation

In the face of global health worker shortages, the use of community health workers (CHWs) is an important health care delivery strategy for underserved populations. In Uganda, community-based programs often use volunteer CHWs to extend services, including family planning, in rural areas. This study examined factors related to CHW motivation and level of activity in three family planning programs in Uganda.

Community Health Policy Matters
May 2017 | Video

APC’s Community Health Policy Matters video tells the story of fictional characters Winnie and Mary, and how a fragmented health system affects each woman’s ability to access family planning services in her respective community. This animated video highlights how policy can improve the health system for women.

Nepal’s Community-based Health System Model: Structure, Strategies, and Learning
January 2016 | Brief

The Community-based Health System Model briefs identify and discuss critical health system inputs and processes that have contributed to the implementation and expansion of community-based service delivery in different countries. Countries were selected for their geographic diversity, type of service delivery model, and programmatic scale-up. This brief reviews Nepal’s community health model to inform future policy, program design, and implementation in other countries.

Keeping community health workers in Uganda motivated: key challenges, facilitators, and preferred program inputs
January 2014 | Study

This study examined factors related to community health workers (CHWs) motivation and level of activity in three family planning programs in Uganda. In the face of global health worker shortages, CHWs are an important health care delivery strategy for underserved populations. In Uganda, community-based programs often use volunteer CHWs to extend services, including family planning, in rural areas.

Community Health Workers Provision of Injectables

CHW provision of injectables is an important issue that should be widely expanded:

Sayana® Press: A Guide for Trainers of Providers
January 2015 | Training Guide

This trainer’s guide provides content for training on the progestin-only injectable contraceptive Sayana® Press. These materials were first used in 2012 to train facility- and community-based providers on use of Sayana Press (formerly depo-subQ in Uniject) in acceptability studies in Senegal and Uganda.

Long-Acting and Reversible Contraceptives

Long-acting reversible contraception (LARC)—intrauterine devices and contraceptive implants—are safe and appropriate contraceptive methods for most women and adolescents. Expanding access to LARC for young people will drastically reduce the rate of unintended pregnancies, unsafe abortions, and maternal and infant morbidity and mortality across the globe.

Situation Analysis of Community-Based Referrals for Family Planning
March 2016 | Brief

This analysis aims to review the evidence on current models of community-to-facility referrals for LARC/PM, to provide recommendations on promising models that should be tested for effectiveness, and to provide an agenda for future research.

Vouchers: Addressing inequities in access to contraceptive services
March 2015 | Brief

The just published HIP brief written by Ben Bellows, Population Council; Elaine Menotti, USAID; and Shawn Malarcher, USAID, describes how vouchers can address key challenges for family planning programs, discusses the potential contribution to improving the quality and use of contraceptive services, outlines key issues for planning and implementation, and identifies knowledge gaps.

CHSS

Strengthening Community-based Family Planning Systems through Collaborative Improvement in Busia District, Uganda
April 2017 | Brief

In this second issue of the APC Quality Improvement Brief, APC describes the progress to date in systematic efforts to improve the quality of CBFP in Busia District and plans to scale up these efforts in two other districts in Uganda.

Community-Based Family Planning Course
January 2017 | E-Learning

This course orients the learner to the essential elements for designing and implementing successful, sustainable CBFP programs. It describes three popular approaches to CBFP—provision by community health workers (CHWs), mobile outreach services, and drug shops—and provides an opportunity for users to practice what they learned using a case study.

Applying a Quality Improvement Model to Strengthen Community-based Family Planning Services in Busia District, Uganda
April 2016 | Brief

In February 2015 APC, implemented by FHI 360 in Uganda, conducted a collaborative site assessment for CBFP programs with the MOH in the three pilot sites, Bulumbi, Buhehe and Buteba. The assessment identified areas for service delivery improvement, which were quantified by the QI monitoring that started in June 2015.

Below you will find links to resources created by APC and other organizations.

External Resources

Vouchers: Addressing inequities in access to contraceptive services
March 2015 | Brief

The just published HIP brief written by Ben Bellows, Population Council; Elaine Menotti, USAID; and Shawn Malarcher, USAID, describes how vouchers can address key challenges for family planning programs, discusses the potential contribution to improving the quality and use of contraceptive services, outlines key issues for planning and implementation, and identifies knowledge gaps.

Technical Reference Materials: Family Planning
February 2015 | Guide

These technical reference materials are a guide to help implementers think through their ability and needs in choosing to implement a family planning project or a family planning component of an integrated health project.

Sexual and Reproductive Health and Rights Are Key to Global Development: The Case for Ramping Up Investment
February 2015 | Journal Article

This policy analysis argues the policymakers and other stakeholders involved in negotiating the post-2015 development agenda should heed the overwhelming evidence that investing in sexual and reproductive health is effective and cost-effective. 

Highlights: Findings from 2014
January 2015 | Report

Highlights, the annual report published by the Center for Health Market Innovations (CHMI), identifies emerging healthcare practices, documents and analyzes the impact of these practices, and spotlights programs looking to improve, scale-up and adapt to new settings.

SBCC for PPFP e-Learning Course
December 2014 | E-Learning

Social and Behavior Chance Communications for Postpartum Family Planning e-learning course teaches participants how to strategically design and implement activities to promote improved postpartum family planning behaviors and use of services.

Partnerships to Advance Family Planning: Lessons from Senegal
December 2014 | Summary

Participants at the annual meeting of the Ouagadougou Partnership examine lessons learned from Senegal as they work to advance women’s health and family planning in the subregion.

Community-Based Family Planning Toolkit
July 2014 | Toolkit

This toolkit presents a collection of carefully selected resources for health policy makers, program managers, service providers, information officers, and others.

Keeping community health workers in Uganda motivated: key challenges, facilitators, and preferred program inputs
January 2014 | Study

This study examined factors related to community health workers (CHWs) motivation and level of activity in three family planning programs in Uganda. In the face of global health worker shortages, CHWs are an important health care delivery strategy for underserved populations. In Uganda, community-based programs often use volunteer CHWs to extend services, including family planning, in rural areas.

Facts for Family Planning
October 2013 | Publication

This publication from USAID contains 10 easy-to-read chapters on important FP topics such as delaying first pregnancy, spacing pregnancies, understanding fertility, and FP methods, with special chapters focused on unmarried youth and HIV/AIDS.

A guide to family planning for community health workers and their clients
December 2012 | Flip Chart

This flip-chart from WHO is a tool for use during family planning counseling or group sessions with clients.

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April 22, 2015 | Event

Join WHO/IBP, UNFPA, USAID and the IBP HIPs Task Team for a Series of Webinars around Maximizing FP Investments through Evidence Based Programming.

April 21, 2015 | Event

Please join the Evidence to Action (E2A) Project for a Contraceptive Technology Update with Jeff Spieler on Wednesday, April 29 at the E2A office or remotely.

April 14, 2015 | Event

Read more about two upcoming events in April and May from APC on Sayana® Press and emergency contraception.

March 06, 2015 | Blog

International Women’s Day is a global awareness day and call to action commemorating the economic, political and social achievements of women worldwide, as well as acknowledging the barriers to gender inequality. Advancing Partners & Communities (APC) is working to protect and advance women’s rights by decreasing instances of GBV and FGM/C and increasing access to CBFP.

March 05, 2015 | Tool

These modules provide opportunities for the global health community to learn more about effective in-service training and pre-service education, and about key global health topics including family planning and reproductive health and maternal and newborn health.

March 05, 2015 | Event

Join The Chicago Council and a network of international thought-leaders for a discussion on how an investment in women’s health can lead to a more equitable and prosperous future. The event will also be streamed live. Follow #IWD2015 and #makeithappen on twitter for updates. 

February 09, 2015 | Article

This article describes the issue of teenage pregnancy in Ghana and how the Health Keepers Network is educating community members, especially youth, and providing them with lifesaving health products to bridge the knowledge gap and help improve sexual and reproductive health in the area. 

December 16, 2014 | Event

Jhpiego recently announced the next installment in a series of webinars expanding upon their webinar introducing the Contraceptive Implants Learning Resource Package (LRP). These webinars will address specific aspects of implants provision and provider training.

November 04, 2014 | Announcement

Today, FP2020 released its second annual progress report detailing progress and achievements made in the last year. This year, FP2020’s coordinated, forward-focused efforts have achieved measurable results, including bringing the total number of pledging countries up to 29. 

September 24, 2014 | Blog

K4Health's new blog post from FHI360's Kirsten Krueger, MSW and John Stanback, PhD, promotes task sharing as a solution to the global health worker crisis and provides practical actions individuals can do to support task sharing in family planning.

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Check back again for related photo galleries or videos.

Stella Nyarko introducing health products to her clients

Stella Nyarko became a HealthKeeper through a women’s association. She now provides communities with family planning information and health protection products.

Mr. Tetteh (right) sharing ideas with a passenger

Bernard Tetteh is a 45 year old station guard and transport service operator in Anloga, in the Volta Region. As a station guard, he takes the opportunity to educate people on reproductive health issues.

Photo of a DKT Community Representative in the Eastern Region gives family planning education to a community savings group in Oborpa, in the Manya Krobo Municipal district. Photo Credit: F. Nuertey

Although modern contraceptive methods are widely available in family planning facilities across all ten regions of Ghana, convincing women to adopt a method continues to be a challenge.

Mrs. Diana Bona (standing) during one of her outreaches

Diana Bona, a public health nurse and the regional focal person for adolescent health in the Greater Accra region, is committed to increasing access to adolescent health education in schools within her region.

Through partnership with local government and lower health centers, WellShare International is offering community-based HIV counseling and testing services through outreaches and is integrating family planning alongside other services.

Mrs. Patience Gyasi explains how to use the secure pill to a client.

Mrs. Patience Gyasi is a licensed chemical seller at the LA Dadekotopon District, in the Greater Accra Region. For the past 25 years, she has devoted her life to providing health care, including family planning services to her community.

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