Improving Reproductive Health through Community-Based Services

This distillation of 25 years of Pathfinder
International's experience in reproductive health services is a report describing their community-based efforts at the
grassroots level to expand access and knowledge, stimulate acceptance, and
create awareness and ownership of reproductive health and family planning
programmes. This booklet is organised around the following nine lessons and supporting examples from the field:

1. "The support of local leaders and the community as a whole is important for ensuring access and sustainability, stimulating changes in community behaviour. Building capacity of communities and creating local partnerships is crucial to success.
2. Integrating HIV information and other health services into community-based distribution programs does not distract from family planning and reproductive health aspects of the program and can be a cost effective way to reach a large population.
3. Systematic, effective referral networks, including referrals for long-term family planning, food security, and medical back-up are essential components of community-based services. Community health workers are an essential link between clinics and hard-to-reach areas.
4. Appropriate compensation of community health workers leads to increased productivity.
5. Programs must use multiple approaches to bring about behaviour changes in youth.
6. Alternative services projects must evolve into more cost-effective permanent operations. Use of depot holders, social marketing techniques, and linking with other organisations or programs improves coverage and acceptance.
7. Community-based service projects must evolve into more cost-effective permanent operations. Use of depot holders (keepers of family planning supplies in a village setting), social marketing techniques, and linking with other organisations or programs improves coverage and acceptance.
8. The financial and professional support of the private sector can be engaging to strengthen community programs and provide sustainability.
9. Income-generating activities can significantly improve the lives of participants and advance program goals."

The Pathfinder document concludes with the perspective that, though donor interest is not a constant, "the need to engage communities in their own health services always remains... The ideal health care situation requires an informed community that uses and supports their health care facilities, which provide compassionate, high quality care by well-trained professionals."

Copies of this report are available by contacting tech-comm@pathfind.org