Community Based Family Planning Services

CBD" (Community Based Distributors) are villagers who volunteer to give a range of integrated sexual reproductive health and HIV/AIDS service to their communities: they discuss family planning, sexually transmitted infections, HIV-prevention and other sensitive issues related to sexuality and reproductive health .e.g. gender based violence with their neighbours, and distribute condoms and oral contraceptives (pills) to those who request them. The CBD - women and men - are selected by their communities and receive an initial training of three weeks.

The TGPSH has supported training and follow-up of over 1323+ CBD. The main aim of the CBD-activities is to increase the use of contraceptives and condoms through better geographical and social access. CBDs, immediate supervisors and trainers are trained using Ministry of Health and Social Welfare guidelines and training curriculum. CBDs are chosen by their communities, and their responsibilities include providing information and basic counselling on reproductive health topics to the community and distributing condoms and oral contraceptives, as well as referral of clients for long-term contraception. Of recent, CBDs are increasingly being involved in home based care, PMTCT, malaria and immunization interventions

Follow up with clients, leaders, villagers and CBD in some of the CBD areas revealed that the services the CBD provide are very much appreciated by the community. Women and men stress the convenient and confidential provision of information and contraceptives in the privacy of their homes or at the CBDs house as a distinct advantage over walking to and waiting at the health service. Men in particular appreciate that they can get family planning information and condoms outside the health services that are very women-oriented. Apart from reaching men, CBDs also reach youth, disabled, the poor and moderate poor with their services. CBD enjoy being helpful in their communities, but also appreciate the increase of knowledge and experience as such, the extended social network from widened contacts within the group of CBD and within their communities, as well as the small financial benefit they realize during training sessions. CBDs are great asset in linking community members with formal health sector. Their potential in overcoming geographical and socio barriers is increasingly being recognized by other programmes.

Follow-up surveys in CBD areas showed that CBD activities had a measurable impact on contraceptive prevalence: the CPR increased from around 25% in 1999 to over 43% in 2004.

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