Strengthening Family Planning with Community-based Nutrition Interventions in Ethiopia : A Qualitative Study

Sellen, Daniel ; Sharif, Sharmin ; Tefera, Bethlehem ; Hyder, Ziauddin

World Bank, Washington, DC

关键词: ACCESS TO FAMILY PLANNING;    ADOLESCENTS;    AGED;    AGRICULTURE;    ANTENATAL CARE;   

RP-ID  :  71077

学科分类：社会科学、人文和艺术（综合）

来源: World Bank Open Knowledge Repository

【 摘 要 】

A small-scale, exploratory, andqualitative operational research study was conducted inearly 2011 to capture and examine stakeholder perspectiveson integrated family planning (FP) programs implementedthrough Ethiopia's health extension program (HEP).Qualitative indications are that various stakeholders onboth the supply and the demand side perceive that specificcommunity-based nutrition (CBN) activities also deliveredwithin HEP serve to link nutrition, family planning, andother health issues in socially acceptable and qualitativelyeffective ways. Remarkable concordance of qualitativeindicators of service delivery, uptake, and satisfaction wasnoted on both the supply and demand side of service deliveryat the sites studied. Respondent reports suggested thefollowing: (i) active and successful delivery of both CBNand FP activities; (ii) some challenges with record keeping,supervision, and supplies; (iii) strong uptake of servicesand messages; (iv) a highly positive community-levelperception of service quality, even in a partiallycapacitated kebele (neighborhood); and (v) an engagedresponse by participants. Qualitative indicators ofcommunity-level HEP staff, volunteer performance, andcommunity satisfaction were generally positive. However,gaps and challenges to improving integration and delivery ofFP and CBN within HEPs and in achieving sustainability inscale-up of integrated programs include (i) increasingcapacity to support implant removal, (ii) maintaining humanresources for health within the health extension program,and (iii) addressing the needs of youth in general andout-of-school youth in particular. Recommendations forimproved delivery of integrated FP and CBN programs are toexplore ways to (i) step up planning and resourcing forcontraceptive implant removal, (ii) reduce staff turnover atthe health posts and health centers, (iii) strengthenintegrative supportive supervision and management of CBN,(iv) enhance recruitment and training of youth as healthworkers, (v) target adolescents and out-of-school youth forFP and CBN, (vi) harmonize integrated FP and CBN messaging,(vii) harmonize donor support for integration, and (viii)measure the effectiveness of integration.