February 3, 2016 | The Editors

Government of Zambia injects new hope for expanded access to contraception for women

Thanks to years of impassioned and data-driven advocacy, injectable contraceptives will soon be available to women in Zambia.
A community health worker demonstrates inserting a Soloshot syringe into a vial.
Soon community health workers in Zambia will be able to administer injectable contraceptives, a safe and effective family planning method. Photo: PATH/Will Boase.

Last week, thousands of experts and advocates gathered at the International Conference on Family Planning in Bali around the theme “Global Commitments, Local Action”—a call to action that was illustrated by the government of Zambia’s recent decision to allow trained community-based health workers to administer injectable contraceptives to women.

The government action, highlighted at the conference by PATH country leader Dr. Nanthalile Mugala, will soon give more women in Zambia access to a safe and effective contraceptive method that until now had not been readily available.

“Years of impassioned, data-driven advocacy led to this critical milestone,” said Dr. Mugala, who spoke on behalf of the Community-Based Distributors (CBD) Task Force at a panel on successful advocacy practices for family planning.

“Many women in rural and remote areas in Zambia are not able to practice family planning because methods are unavailable or out of reach,” said Dr. Mary Nambao, deputy director for Mother Health, Ministry of Health in Zambia. “In line with our Family Planning 2020 commitment, the government of Zambia has taken action to increase access to injectable contraceptives through trained community-based distributors, ensuring that women have an additional choice for preventing unintended pregnancies and safeguarding their health.”

A woman with a baby in a back sling stands underneath a porch.
“Many women in rural and remote areas in Zambia are not able to practice family planning because methods are unavailable or out of reach.”—Dr. Mary Nambao, deputy director, Mother Health, Ministry of Health in Zambia. Photo: PATH/Gabe Bienczycki.

Driving policy action for women

Zambia’s step toward scale-up of this important family planning method provides a powerful example of how evidence-based advocacy can drive policy action.

In 2011-2012, a pilot study implemented by ChildFund Zambia and FHI360, with support from the Zambian government and the US Agency for International Development, showed that community-based distribution of injectable contraceptives was feasible, safe, and effective. The pilot study generated strong evidence for scale-up, but the study alone did not lead to policy action.

Recognizing the need for coordinated advocacy, PATH worked closely with CBD Task Force members, including the Ministry of Community Development Mother and Child Health, FHI360, ChildFund Zambia, Scaling Up Family Planning—and others—to bring the process to the finish line. Together, they marshalled existing data, built political will, and kept the issue high on the agenda of decision-makers and influencers, including key ministry officials and professional associations.

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PATH further contributed to the advocacy effort by packaging and sharing additional evidence on the safety and effectiveness of the approach in three districts that were permitted to continue scale-up beyond the pilot study. This evidence was a tipping point in catalyzing action.

Next steps: scaling new reproductive health options

This decision by Zambia marks the beginning of an important policy shift and shows how strategic advocacy can improve access to reproductive health care and contraceptive options. Now the focus of advocates turns to implementation.

“We applaud the government’s effort to respond to an advocacy initiative rooted in partnership and local evidence,” Dr. Mugala said. “This decision shows how political will can make a difference in expanding access to health. Now we are looking forward to ensuring that commitments made lead to improved reproductive health and quality of life for women in the community.”

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