Number/percent of FP clients reached by a community-based worker in the past 12 months
A “community-based worker” is a health worker or promoter not based at a traditional health facility, though may be linked to a traditional health facility. They are sometimes referred to as “fieldworkers” or “outreach” workers. Community-based distribution of family planning (FP) methods is generally through an individual provider, local store, or commercial site, as well as other variations that are context specific. This indicator includes men and women who are new or current family planning clients that had a formal interaction with a community-based worker in the prior 12 months. The term “reached by” refers to formal interactions that may include counseling, commodity provision, FP service provision, or other formal interactions for the purposes of FP.
The indicator can be modified to fit program needs. Possible modifications include the adjustment of the time period (past six months, past three months) and refinement of “FP client” to only include clients receiving services related to modern FP methodss. Modern FP methods obtained from a community-based provider include hormonal pills, injectables, male and female condoms, and foam/jelly. Traditional or ‘non-modern’ methods include periodic abstinence, withdrawal and folk methods.
This indicator is most often reported as a count. If the data are available, the percentage can be calculated as:
(Number of male and female FP clients who were reached by a community-based worker in the past 12 months / total number of male and female FP clients ) x 100
Number of FP clients reached by community-based workers. If desired: type of FP method; total number of FP clients (facility-based + community outreach). Evaluators may also want to disaggregate data by age group (e.g. 15-19, 20-24, 25-29, etc.) and/or marital status (e.g. married, cohabitating, other)
Community-health worker records.
Facility-based records recording activities of community-health workers.
The indicator can be used to assess coverage of community-based distribution through the use of a population-based survey. In such a case the indicator could be modified to be “Percent of current FP users who received their method from a community-based worker in the past 12 months”.
The goal of using community-based providers is to increase contraceptive use by increasing access and raising demand through information, education, and communication activities. Women are increasingly able to access their method of choice from community health workers, so it’s important to have some measure of their reach (Scott et all, 2015). Quite often community-based workers are associated with a health facility and provide services for the catchment area of the facility. Community volunteers are often recruited to be community-based providers, making these kinds of initiatives particularly effective in rural and isolated communities where demand is limited and access to modern FP methods is low.
Broadly, this indicator measures how much of a role community-based providers play in providing access to FP methods. Specifically, it measures how a particular population of FP users is being reached with community-based services.
The indicator does not assess the quality of the interaction between the community-based worker and the FP user. It does not measure what specific activities occurred during the interaction, namely commodity distribution, education, or referral for services. There may be issues of data quality at a facility or in community-health workers’ records that could lead to double counting and inaccuracies that are difficult to verify.
family planning, community
Population-Health-Environment Programs. Washington DC: USAID.
Scott V, Gottschalk L, Wright K, Twose C, Bohren M, Schmitt M, Ortayli N, 2015. Community Health Workers’ Provision of Family Planning Services in Low- and Middle-Income Countries: a systematic review of effectiveness. Studies in Family Planning. 46(3); 241-261.