Evidence map›Paper›PMID 37594954›Full record

ArticlePloS one2023

Strengthening systems to provide long-acting reversible contraceptives (LARCs) in public sector health facilities in Uganda and Zambia: Program results and learnings.

Aniset Kamanga, Micheal Lyazi, Margaret L Prust, Naomi Medina-Jaudes, Lupenshyo Ngosa, Margaret Nalwabwe, Martha Ndhlovu, Dynes Kaluba, Angel Mwiche, Richard Mugahi and 6 more

Abstract read
In one paragraph

Article in PloS one, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

16 authors.

Aniset KamangaClinton Health Access Initiative, Inc., Lusaka, Zambia.
Micheal LyaziClinton Health Access Initiative, Inc., Kampala, Uganda.
Margaret L PrustClinton Health Access Initiative, Inc., Boston, MA, United States of America.
Naomi Medina-JaudesClinton Health Access Initiative, Inc., Boston, MA, United States of America.
Lupenshyo NgosaClinton Health Access Initiative, Inc., Lusaka, Zambia.
Margaret NalwabweClinton Health Access Initiative, Inc., Kampala, Uganda.
Martha NdhlovuClinton Health Access Initiative, Inc., Lusaka, Zambia.
Dynes KalubaDepartment of Public Health, Zambia Ministry of Health, Ndeke House, Lusaka, Zambia.
Angel MwicheDepartment of Public Health, Zambia Ministry of Health, Ndeke House, Lusaka, Zambia.
Richard MugahiUganda Ministry of Health, Reproductive and Infant Health, Kampala, Uganda.
Joy BatusaClinton Health Access Initiative, Inc., Kampala, Uganda.
Morrison ZuluClinton Health Access Initiative, Inc., Lusaka, Zambia.
Andrew MusokeClinton Health Access Initiative, Inc., Kampala, Uganda.
Hilda ShakweleClinton Health Access Initiative, Inc., Lusaka, Zambia.
Caitlin GloverClinton Health Access Initiative, Inc., Boston, MA, United States of America.
Emma AldrichClinton Health Access Initiative, Inc., Boston, MA, United States of America.ORCID 0000-0001-6286-7628

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionIn Uganda and Zambia, both supply- and demand-side factors hamper availability of long-acting reversible contraceptives (LARCs), including implants and intrauterine devices (IUDs), at public sector facilities. This paper discusses results of a program aimed at increasing access to and uptake of LARC services in public sector facilities through capacity building of government health workers, strengthening government supply chains, and client mobilization.

methodsFrom 2018-2021, the Ministries of Health (MOHs) in Uganda and Zambia and Clinton Health Access Initiative (CHAI) worked to increase readiness to provide LARC services within 51 focal facilities in Uganda and 85 focal facilities in Zambia. Annual facility assessments of LARC-related resources were conducted and routine service delivery data were monitored.

resultsAt baseline, few focal facilities had supplies and skilled staff to provide LARC services. At endline, over 90% of focal facilities in both countries had a provider trained to provide both implants and IUDs and 55% had the commodities and equipment needed for implant provision. In Uganda and Zambia, respectively, 65% and 38% of focal facilities had commodities and equipment for IUD provision at endline. Both programs observed significant increases in the number of implants provided at focal facilities; in Uganda implant volumes increased five-fold from 4,560 at baseline to 23,463 at endline, and in Zambia implant volumes increased nearly four-fold from 1,884 at baseline to 7,394 at endline. Uganda did not observe growth in IUD volumes, whereas Zambia observed significantly increased IUD service volumes from 251 at baseline to 3,866 at endline.

conclusionsPublic sector facilities can be rapidly and sustainably capacitated to provide LARCs when both catalytic and systems strengthening interventions are deployed for health worker capacity building, supply chain management, and community mobilization to ensure client flow. Investments should be intentionally sequenced and coordinated to generate a virtuous cycle that enables continued LARC service provision.

Indexed as

Contraceptive AgentsPublic SectorHealth FacilitiesHumansUgandaZambiaContraceptive Agents

Identifiers

PMID37594954
PMCPMC10437908

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.