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Changes in implant and other modern contraceptive use in Ethiopia after task sharing to permit Health Extension Workers to place Implanon

Jennifer Winston, University of North Carolina at Chapel Hill
Lisa M. Calhoun, University of North Carolina at Chapel Hill
David Guilkey, University of North Carolina at Chapel Hill
Ilene S. Speizer, University of North Carolina at Chapel Hill

In 2009, the Government of Ethiopia began allowing Health Extension Workers (HEWs) to place Implanon (Tilahun Y, 2017) as part of an effort to expand access to family planning to women across the country (Negussie A., 2017; Fostenson, 2016). We used the contraceptive calendar from the 2011 Ethiopia Demographic and Health Survey to evaluate whether HEW task sharing was associated with increased implant adoption and overall modern contraceptive use between 2005 and 2011. We used fixed effects models to allow each woman to serve as her own control. When controlling for year and parity, implant task sharing was associated with an increase of 1.6 percentage points (95%CI: 0.7 – 2.5, p<0.01) in implant use over the study period and an increase of 3.1 percentage points (95%CI: -0.1 – 6.3, p = 0.06) in use of any modern method in the same period. Task sharing was not associated with a change in use of traditional methods. Task sharing family planning distribution with HEWs may help contribute to meeting Ethiopia’s FP 2020 commitment to “uphold the rights of all people to access and choose voluntary family planning through a strong network of primary health care providers” (Family Planning 2020 , 2021).

Keywords: Family planning and contraception, Panel studies, Policy evaluation

See extended abstract.

  Presented in Session P9.