Task Sharing of Injectable Contraception Services in Pakistan: A Randomized Controlled Trial

Dawn S. Chin-Quee, Farina Abrejo, Mario Chen, Talib Lashari, Patrick Olsen, Zaheer Habib, Xiaoming Gao, Fauzia Assad, Farid Midhet, Shabir Chandio, Kayla Stankevitz, Sarah Saleem

Research output: Contribution to journalArticlepeer-review

2 Citations (Scopus)

Abstract

Provision of injectable contraceptive services by lay health workers is endorsed by normative bodies, but support for this practice is not universal. We assessed whether lay providers (lady health workers, LHWs) could perform as well as clinically trained providers (family welfare workers, FWWs) on appropriate screening, counseling, and injection of intramuscular and subcutaneous depot medroxyprogesterone acetate (DMPA) using a randomized controlled trial. In the urban sample (n = 355), 88 percent of FWW DMPA clients were appropriately screened versus 77 percent of LHW clients (noninferiority test p = 0.88). In rural facilities (n = 105), over 90 percent of both providers’ clients were screened appropriately. Appropriate counseling was low overall, but LHWs were significantly noninferior to FWWs (p = 0.003). Notably, LHWs demonstrated better injection technique than FWWs. We could not conclude that LHWs screened new DMPA users as well as FWWs from an urban sample of providers but results from the rural sample suggests that service delivery context played an important role.

Original languageEnglish
Pages (from-to)23-39
Number of pages17
JournalStudies in Family Planning
Volume52
Issue number1
DOIs
Publication statusPublished - Mar 2021

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