Strategies for Family Planning Service Delivery in Bas Zaire

An operations research project measured the impact and cost-effectiveness of 2 strategies for delivering family planning services in Bas Zaire: supplying dispensaries and community distributors with contraceptives and at the same time undertaking extensive outreach program and supplying these sources but doing no outreach. Before the project began only about 4-5% of urban women and 2-5% of rural women aged 15-44 who were living in union were using modern contraceptive methods. Within 2 years this proportion had increased to 10-19% in 4 study areas. However use of traditional methods decreased suggesting that many women substituted modern methods for traditional ones. Prevalence in the areas that received outreach was only 2-3% points higher than that in areas that received no outreach. A cost-effectiveness analysis shows that the cost of providing 1 couple with a month of contraceptive protection was higher in the rural area than in the urban area. In addition the cost per couple-month of protection was slightly higher when outreach was included. These results have several important implications. 1st the project demonstrates that both household distribution of contraceptives and the use of community distribution posts are viable culturally acceptable approaches to the delivery of family planning services in this region of Zaire. In addition the project demonstrates that the use of modern methods can be significantly increased by making them more readily accessible to the population. The results also show that many women will abandon traditional methods in favor of modern contraceptives when they become available at low cost.