Objectives: The subcutaneous depot medroxyprogesterone acetate (DMPA-SC) injectable contraceptive was introduced in South West Nigeria in 2015 through private sector channels. The introduction included community-based distribution and was supported by a social marketing approach. From program monitoring and evaluation, aimed at understanding performance, market reach and other process measures, we identify lessons learned to inform future scale-up efforts.
Methods: We synthesized the findings from a core set of key performance indicators collected through different methods: (1) implementer performance indicators, (2) phone survey of DMPA-SC users (n=541) with a follow-up after 3 months (n=342) and (3) in-depth interviews with 57 providers and 42 users of DMPA-SC.
Results: Distribution of DMPA-SC to private providers was concentrated in states with large urban populations. A shift toward focusing on high-volume family planning facilities coincided with a rapid increase in distribution in late 2016. Users reached in the phone survey were generally older and married with children; few were under age 25. Users and providers reported favorable opinions of DMPA-SC. Many users reported choosing DMPA-SC due to recommendations from providers and friends, and the hope of experiencing reduced side effects compared to other methods. While users reported positive experiences interacting with community-based distributors, the delivery model encountered a number of challenges - high turnover, low motivation, lack of an appropriate compensation package and logistical costs - and was ultimately disbanded.
Conclusions: In the DMPA-SC introductory program in Nigeria, distribution was amplified when focused on high-volume contraceptive providers. Although community-based distribution can be one effective service delivery model for reaching underserved populations, more consideration for balancing cost recovery and public health goals through private sector approaches are needed in the context of South West Nigeria. Additional communications and outreach efforts are needed to reach younger, unmarried users with contraceptive services.
Download full-text PDF |
Source |
---|---|
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6197840 | PMC |
http://dx.doi.org/10.1016/j.contraception.2018.07.005 | DOI Listing |
BMC Health Serv Res
January 2025
Innovations & Grants, Stop TB Partnership, Global Health Campus - Chemin du Pommier 40, Le Grand-Saconnex, 1218, Geneva, Switzerland.
Introduction: In Pakistan, almost one-third of people who develop tuberculosis (TB) are missed by the National TB Program (NTP). A considerable number of people with TB receive treatment in the private sector but remain unnotified. This study documents the outcomes of an intervention to identify people with TB through private pharmacy engagement, building on mapping TB medicine sales in Punjab Province.
View Article and Find Full Text PDFHealthcare (Basel)
January 2025
Department of Health Services Research, Care and Public Health Research Institute-CAPHRI, Maastricht University Medical Center, Faculty of Health, Medicine and Life Sciences, Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands.
Background: This systematic review assesses the role of the Cooperative Health Insurance System (CHIS) in achieving Universal Health Coverage (UHC) in Saudi Arabia's evolving healthcare system by consolidating and analyzing findings from diverse studies to provide a comprehensive overview of CHIS's impact and also identifies contextual challenges and practical insights that can inform similar reforms globally.
Methods: We report results following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The following six databases were searched for relevant studies: PubMed, Scopus, CINAHL, Business Source Complete, APA PsycINFO, and SocIndex.
JMIR Form Res
January 2025
School of Nursing, University of Pennsylvania, 418 Curie Blvd, Philadelphia, PA, 19104, United States, 1 8123695216.
Background: While the significance of care navigation in facilitating access to health care within the lesbian, gay, bisexual, transgender, queer, and other (LGBTQ+) communities has been acknowledged, there is limited research examining how care navigation influences an individual's ability to understand and access the care they need in real-world settings. By analyzing private sector data, we can bridge the gap between theoretical research findings and practical applications, ultimately informing both business strategies and public policy with evidence grounded in real-world efficacy.
Objective: The objective of this study was to evaluate the impact of specialized virtual care navigation services on LGBTQ+ individuals' ability to comprehend and access necessary care within a national cohort of commercially insured members.
J Family Med Prim Care
December 2024
Department of Pharmacology, NEIGRIHMS, Mawdiangdiang, Meghalaya, India.
Introduction: Antimicrobial resistance is a public health concern with global ramifications. Antibiotic misuse and overuse, are rampant in our country but more alarming is the data on the use of antibiotics primarily because of lack of access is another threat. A majority of the data on drug sales and consumption in India comes from the private sector and is typically gathered from private commercial organization.
View Article and Find Full Text PDFLancet Reg Health West Pac
January 2025
School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, NSW, Australia.
Background: Access to essential medicines is imperative for delivering effective healthcare, yet a significant proportion of the global population continues to face barriers in obtaining them. The South Pacific Region (SPR) faces unique medicine access challenges due to geographic remoteness, economic limitations, and, strained healthcare infrastructure. To gain further insight, this study aimed to assess the availability, pricing, and, affordability of essential medicines stratified by World Bank income group.
View Article and Find Full Text PDFEnter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!