Programs for the community-based distribution (CBD) of family planning engage nonprofessional individuals to provide family planning information and selected contraceptive methods–typically condoms, pills, and spermicides–as well as referral for other services. Family planning programs in Africa, Asia, and Latin America have implemented CBD programs for 30 years, based on the conviction that providing information and methods at the community level increases the social acceptability of family planning generally and increases access to and use of contraceptives, particularly in rural areas.
Population Council focus
The Council has a long history as one of the pioneers in developing and introducing CBD programs, particularly in Africa. The Council currently focuses on expanding the range of services and skills a CBD agent can offer, reaching adolescents and men with family planning messages and condoms, and developing models for shifting professional providers out of clinics and into community health facilities.
Population Council impact
- The Council has supported the Government of Ghana in developing and scaling up an innovative CBD effort, the USAID-funded Community-based Health Planning and Services Initiative (CHPS), which relocated nurses from clinics to community health compounds and linked them with male community leaders, leading to a 15-percent decrease in fertility.
- In Kenya, the Ministry of Health has adapted the “community midwifery” model that was developed by the Council, originally to increase skilled attendance for deliveries and now also to deliver a range of contraceptive methods, including injectables.
- In its first year, the Council’s USAID-funded FALAH project in Pakistan has reached a quarter of a million women with family planning messages across 25 districts to raise awareness of the benefits of family planning in this deeply conservative setting.
Projects
ExCHANGE: Expanding Community Healthcare Accessibility Network (more)
ExCHANGE is designed to transfer and adapt evidence-based strategies from the Community-based Health Planning and Services Initiative (CHPS) to other countries in sub-Saharan Africa
(1/2005 - ongoing)
Addis Birhan: Fostering Husbands’ Involvement and Support in Amhara Region, Ethiopia (more)
Addis Birhan promotes HIV prevention by changing social norms and promoting gender-equitable relationships through educating and engaging husbands in issues related to reproductive health, including HIV prevention, family planning, gender violence, alcohol and drug abuse, and domestic responsibilities.
(1/2007 - 12/2013)
Ethiopia
Meserete Hiwot: Supporting Married Adolescent Girls in Rural Ethiopia to Prevent HIV Infection and Promote Reproductive Health
Meserete Hiwot ("Base of Life") addresses the social isolation of married adolescents and builds their knowledge and skills in HIV and reproductive health through community-based mentoring sessions.
(1/2007 - 12/2013)
Ethiopia
Taking Critical Services to the Home: Scaling Up Home-based Maternal and Postnatal Care, Including Family Planning, Through Community Midwives (more)
Council research aims to improve access to skilled delivery care, newborn care, and post-delivery family planning services among women living in remote and resource-poor areas.
(1/2007 - 10/2011)
Kenya
Increasing Access to Family Planning and Reproductive Health Services through Community Health Workers: Case Study of a Dual-cadre Model in India (more)
The Council conducted research on community health workers in India to examine how different cadres of health workers function in relation to one other in order to improve access to reproductive health and family planning services in rural areas.
(10/2010 - 9/2011)
India
Community-based Health Planning and Services (more)
The CHPS program of service delivery change is achieved by forging partnerships between health care providers and the communities they serve.
(1/1991 - 9/2010)
Ghana
Institutionalizing a Successful Adolescent Reproductive Health and HIV Intervention Program: Expanding the Kenya Adolescent Reproductive Health Program Experience in Kenya (more)
Council researchers identified selected activities from the Kenya Adolescent Reproductive Health Program and institutionalized them within the study sites.
(9/2003 - 5/2008)
Kenya
Resources
"Community health workers for maternal and child health," fact sheet (PDF)
Jarvis,Leah; Termini,Nancy
Publication date: 2012
Increasing access to family planning and reproductive health services through community work: A case study of a dual cadre model in India (PDF)
Ahmad,Jaleel; Bhatnagar,Isha; Khan,M.E.
Publication date: 2012
Increasing postpartum contraception in rural India: Evaluation of a community-based behavior change communication intervention (abstract) (PDF)
Sebastian,Mary Philip; Khan,Mohammed Ejaz; Kumari,Kaushal; Idnani,Rukma
International Perspectives on Sexual and Reproductive Health 38(2): 68-77
Publication date: 2012
Introduction of emergency contraceptive pills (ECPs) through lady health workers (LHWs) program in Pakistan: Findings of an evaluation study (PDF)
Mahmood,Arshad; Bin Nisar,Yasir
Publication date: 2012
Providers' and key opinion leaders' attitudes, beliefs, and practices regarding emergency contraception in India: Final survey report
Khan,M.E.; Varma,Deepthi S.; Bhatnagar,Isha; Dixit,Anvita; Brady,Martha
Publication date: 2012
Repositioning community-based family planning in Ghana: A case study of Community-based Health Planning and Services (CHPS) (PDF)
Ntsua,Stephen; Tapsoba,Placide; Quansah-Asare,Gloria; Nyonator,Frank K.
Case study report
Publication date: 2012
Addis Birhan project: Working with boys and men to address young girls' social vulnerability (PDF)
Erulkar,Annabel S.; Apicella,Louis; Ferede,Abebaw
Promoting Healthy, Safe, and Productive Transitions to Adulthood Brief (no. 6)
Publication date: 2011
A report on consultation on ECP held at India Habitat Centre, New Delhi, India on August 9, 2011
Khan,M.E.; Varma,Deepthi S.; Bhatnagar,Isha
Publication date: 2011
Community health workers and the media can be effective in providing health information to married adolescent girls in the community (PDF)
APHIA II Operations Research Project in Kenya OR Summary (no. 9)
Publication date: 2011
Community health workers can effectively provide information and referrals to people living with HIV in their communities (PDF)
APHIA II Operations Research Project in Kenya Programme Brief (November)
Publication date: 2011
Improving maternal and neonatal health in northern India: A case study of Bahraich and Jhansi
Khan,Nizamuddin; Khan,M.E.
Publication date: 2011
Strengthening the delivery of comprehensive reproductive health services at the community level in Kenya (PDF)
APHIA II Operations Research Project in Kenya OR Summary (no. 10)
Publication date: 2011
Assessing the potential acceptability of a new cadre of community midwives for pregnancy and delivery related care in rural Pakistan: Findings from a qualitative study (PDF)
Wajid,Abdul; Mir,Ali Mohammad; Rashid,Zubaida; Aziz,Abida
Publication date: 2010
Equity in access to maternal and child health services in five developing countries: What works (abstract)
Talukder,Md.Noorunnabi; Rob,Ubaidur
International Quarterly of Community Health Education 31(2): 119-131
Publication date: 2010
Lessons learned from the Ghana Essential Medicines Initiative (PDF)
Population Council
GEMI (Ghana Essential Medicines Initiative) Final Report
Publication date: 2010
Looking back, moving forward: Implementing PMTCT programs in resource-constrained settings, Horizons studies 1999 to 2007 (PDF)
Baek,Carolyn; Rutenberg,Naomi
Horizons Synthesis Background Papers
Publication date: 2010
'Meserete Hiwot' (Base of Life): Supporting married adolescents with HIV prevention and reproductive health in rural Ethiopia (PDF)
Erulkar,Annabel S.; Lamesgin,Aragaw; Muthengi,Eunice
Program Brief, December
Publication date: 2010
Community-based Health Planning and Services (CHPS): Community Health Officer Registers--Instruction Manual (PDF)
Publication date: 2009
Community-based Health Planning and Services (CHPS): Community Health Officer Training Manual (Facilitator's Guide), Volume 1 (PDF)
Publication date: 2009
Community-based Health Planning and Services (CHPS): Community Health Officer Training Manual (Facilitator's Guide), Volume 2 (PDF)
Publication date: 2009
Community-based Health Planning and Services (CHPS): Community Health Officer Training Manual (Facilitator's Guide), Volume 3 (PDF)
Publication date: 2009
Community-based Health Planning and Services (CHPS): Community Health Officer's Training Workbook, Volume 1 (PDF)
Publication date: 2009
Community-based Health Planning and Services (CHPS): Community Health Officer's Training Workbook, Volume 2 (PDF)
Publication date: 2009
Community-based Health Planning and Services (CHPS): Community Health Officer's Training Workbook, Volume 3 (PDF)
Publication date: 2009
Community-based Health Planning and Services (CHPS): Community Health Volunteer's Training Manual (PDF)
Publication date: 2009
Community-based Health Planning and Services (CHPS): Preceptor's Guide for Community Health Nursing Training Schools, Volume 1 (PDF)
Publication date: 2009
Community-based Health Planning and Services (CHPS): Preceptor's Guide for Community Health Nursing Training Schools, Volume 2 (PDF)
Publication date: 2009
Community-based Health Planning and Services (CHPS): Preceptor's Guide for Community Health Nursing Training Schools, Volume 3 (PDF)
Publication date: 2009
Community-based Health Planning and Services (CHPS): Tutor's Guide for Community Health Nursing Training Schools, Volume 1 (PDF)
Publication date: 2009
Community-based Health Planning and Services (CHPS): Tutor's Guide for Community Health Nursing Training Schools, Volume 2 (PDF)
Publication date: 2009
Community-based Health Planning and Services (CHPS): Tutor's Guide for Community Health Nursing Training Schools, Volume 3 (PDF)
Publication date: 2009
Creating a space for men and youth at health and family welfare centers in Bangladesh
Mutahara,Marium ul; Rahman,Md.Mafizur; Al-Sabir,Ahmed
Publication date: 2009
Revitalizing family planning: Lessons learned on strengthening contraceptive provision (PDF) (HTML)
FRONTIERS Legacy Themes
Publication date: 2009
Strengthening voice and accountability in the health sector
Talukder,Md.Noorunnabi; Rob,Ubaidur
Publication date: 2009
Emergency contraception: Health care providers quick reference guide (PDF)
Publication date: 2008
From pilot to program: Scaling up the Kenya Adolescent Reproductive Health Project (PDF)
Evelia,Humphres; Nyambane,Japheth; Birungi,Harriet; Askew,Ian; Trangsrud,Rikka; Muthuuri,Eva; Chaami,Irene; Odawa,Agnes; Musyoka,Lucy; Mutungi,Susan; Githuiya,Margaret; Omuruli,Joan
FRONTIERS Final Report
Publication date: 2008
The effect of community nurses and health volunteers on child mortality: The Navrongo Community Health and Family Planning Project (abstract)
Pence,Brian Wells; Nyarko,Philomena; Phillips,James F.; Debpuur,Cornelius
Scandinavian Journal of Public Health 35(6): 599-608
Publication date: 2007
Accelerating reproductive and child health programme impact with community-based services: The Navrongo experiment in Ghana
(abstract)
Phillips,James F.; Bawah,Ayaga A.; Binka,Fred N.
Bulletin of the World Health Organization 84(12): 949-953
Publication date: 2006
The effect of community nurses and health volunteers on child mortality: The Navrongo Community Health and Family Planning Project (PDF)
Pence,Brian Wells; Nyarko,Philomena; Phillips,James F.; Debpuur,Cornelius
Policy Research Division Working Paper (no. 200)
Publication date: 2005
Bridging the gap between evidence-based innovation and national health-sector reform in Ghana (PDF)
Awoonor-Williams,John Koku; Feinglass,Ellie S.; Tobey,Rachel; Vaughan-Smith,Maya; Nyonator,Frank K.; Jones,Tanya C.; Phillips,James F.
Policy Research Division Working Paper (no. 191)
Publication date: 2004
Community involvement in reproductive health: Findings from research in Karnataka, India (PDF)
Foundation for Research in Health Systems
FRONTIERS Final Report
Publication date: 2004
Etude expérimentale sur l'offre de services à base communautaire de santé de la reproduction au Sénégal: Une étude de cas dans le District Sanitaire de Kébémer" [Testing a community based distribution approach to reproductive health service delivery in Senegal: A study of community agents in Kébémer] (PDF)
Sanogo,Diouratie; Cisse,Mady; Ndoye,Adama; Ndoye,Laty G.; Faye,Ousmane; Mboup,Balla Mbacke
FRONTIERS Final Report
Publication date: 2004
Testing a community- based distribution approach to reproductive health service delivery in Senegal (a study of community agents in Kébémer) (PDF)
Sanogo,Diouratie; Cisse,Mady; Ndoye,Adama; Ndoye,Laty G.; Faye,Ousmane; Mboup,Balla Mbacke
FRONTIERS Final Report
Publication date: 2004
Evidence-based development of health and family planning programs in Bangladesh and Ghana (PDF)
Phillips,James F.; Jones,Tanya C.; Nyonator,Frank K.; Ravikumar,Shruti
Policy Research Division Working Paper (no. 175)
Publication date: 2003
New approaches to integrating STIs, HIV/AIDS, family planning and reproductive health in Bazèga, Burkina Faso
Kabore,Inoussa; Tapsoba,Placide; Askew,Ian; Myers,Jenny
FRONTIERS Final Report
Publication date: 2003
The Ghana Community-based Health Planning and Services Initiative: Fostering evidence-based organizational change and development in a resource-constrained setting (PDF)
Nyonator,Frank K.; Awoonor-Williams,John Koku; Phillips,James F.; Jones,Tanya C.; Miller,Robert A.
Policy Research Division Working Paper (no. 180)
Publication date: 2003
Best practices in CBD programs in sub-Saharan Africa: Lessons learned from research and evaluation (PDF)
Frontiers in Reproductive Health; Family Health International; Advance Africa
FRONTIERS Report
Publication date: 2002
Community-Based Health Planning and Services (CHPS) in Ghana: A multi-level, qualitative assessment in the Volta Region
Nyonator,Frank K.; Agbadja,Comfort; Gbeddy,Dennis; Nyarko,George; Jones,Tanya C.; Miller,Robert A.; Phillips,James F.
Publication date: 2002
Services à base communautaire de SR: 60 agents opérationnels à Kébémer, Sénégal. Update n°2. Juillet 2002.
FRONTIERS Update no. 2
Publication date: 2002
Using men as community-based distributors of condoms (PDF)
Green,Cynthia P.; Joyce,Stephanie; Foreit,James R.
FRONTIERS Program Brief (no. 2)
Publication date: 2002
Zimbabwe: CBD roles modified to address Zimbabwe's HIV/AIDS crisis (PDF)
FRONTIERS OR Summary (no. 29)
Publication date: 2002
An assessment of the Zimbabwe National Family Planning Council's community based distribution programme (PDF)
Maggwa,Baker Ndugga; Askew,Ian; Marangwanda,Caroline S.; Nyakauru,Ronika; Janowitz,Barbara
FRONTIERS Final Report
Publication date: 2001
Approche d'offre SBC de SR à Kébémer: Un espoir annoncé pour les communautés rurales du Sénégal. [Strategy for reproductive health community-based services: Hope for rural communities in Senegal]
Sanogo,Diouratie
Publication date: 2001
Ecuador: Use commercial marketing to increase sustainability (PDF)
FRONTIERS OR Summary (no. 19)
Publication date: 2001
Ecuador: Utilice la mercadotecnia comercial para aumentar la sustentabilidad (PDF)
FRONTERAS Resúmenes de Investigación Operativa (número 14)
Publication date: 2001
Evidence for the importance of community involvement: Implications for initiatives to prevent mother-to-child transmission of HIV (PDF)
Leonard,Ann; Mane,Purnima; Rutenberg,Naomi
Community Involvement in Initiatives to Prevent Mother-to-Child Transmission of HIV: A Collaborative Project
Publication date: 2001
Ghana: Community workers can communicate STI and HIV/AIDS messages effectively (PDF)
FRONTIERS OR Summary (no. 21)
Publication date: 2001
Honduras: Marketing new reproductive health services is cost-effective (PDF)
FRONTIERS OR Summary (no. 26)
Publication date: 2001
Women, communities, and the prevention of mother-to-child transmission of HIV: Issues and findings from community research in Botswana and Zambia (PDF)
Nyblade,Laura; Field-Nguer,Mary Lyn
Community Involvement in Initiatives to Prevent Mother-to-Child Transmission of HIV: A Collaborative Project
Publication date: 2001
An assessment of the community based distribution programs in Ghana (PDF)
Chege,Jane; Sanogo,Diouratie; Askew,Ian; Bannerman,Angela; Grey,Steve; Glover,Evam Kofi; Yankey,Francis; Nerquaye-Tetteh,Joana
FRONTIERS Final Report
Publication date: 2000
Community-based distribution in Tanzania: Costs and impacts of alternative strategies to improve worker performance (abstract) (PDF)
Janowitz,Barbara; Chege,Jane; Thompson,Andrew; Rutenberg,Naomi; Homan,Rick
International Family Planning Perspectives 26(4): 158-160, 193-195
Publication date: 2000
From the home to the clinic: The next chapter in Bangladesh's family planning success story rural sites (PDF)
Bates,Linda; Islam,Md Khairul; Schuler,Sidney Ruth; Alauddinn,Md
FRONTIERS Final Report
Publication date: 2000
Lessons from community-based distribution of family planning in Africa (PDF)
Phillips,James F.; Greene,Wendy L.; Jackson,Elizabeth F.
Policy Research Division Working Paper (no. 121)
Publication date: 1999
The impact of family planning household service delivery on women's status in Bangladesh (PDF)
Phillips,James F.; Hossain,Mian Bazle
Policy Research Division Working Paper (no. 118)
Publication date: 1998
How do family planning worker visits affect woman's behavior in Bangladesh?
Arends-Kuenning,Mary
Policy Research Division Working Paper (no. 99)
Publication date: 1997
The equity and efficiency of doorstep delivery of contraceptives in Bangladesh
Arends-Kuenning,Mary
Policy Research Division Working Paper (no. 101)
Publication date: 1997
The impact of outreach on the continuity of contraceptive use in rural Bangladesh (abstract)
Hossain,Mian Bazle; Phillips,James F.
Studies in Family Planning 27(2): 98-106
Publication date: 1996
The long-term demographic role of community-based family planning in rural Bangladesh (abstract)
Phillips,James F.; Hossain,Mian Bazle; Arends-Kuenning,Mary
Studies in Family Planning 27(4): 204-219
Publication date: 1996
A model of costs of a CBD programme (PDF)
RamaRao,Saumya; Townsend,John W.; Khan,M.E.
Asia and Near East OR/TA Special Report
Publication date: 1995
The long-term demographic role of community-based family planning in rural Bangladesh
Phillips,James F.; Hossain,Mian Bazle; Arends-Kuenning,Mary
Policy Research Division Working Paper (no. 73)
Publication date: 1995
What's New
- FRONTIERS Legacy Themes: Results and lessons learned from ten years of operations research have been synthesized and grouped into eight major legacy themes. (more)
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