A study to assess the client referral service of community based distribution of contraceptives in Nyamira District, Kenya.

Abstract

Attaining sustainable development in the presence of high Population growth has been a difficult issue in many countries of the world. Therefore fertility reduction is needed through implementation of community assisted Family planning programmes2. The community approach to Family planning now referred to as Community Based Distribution of Contraceptives (CBD) addresses the need for non professional personnel to deliver contraceptives through training community auxiliary staff. The question of client referral is an important aspect of CBD programmes so that clients are brought closer to the services that they need and if the referral is not functional the whole programme may be jeopardised. This was a descriptive study carried out in Nyamira District. A total of 300 referral clients, 94 CBD agents and 25 clinic staff were interviewed on different aspects of the CBD referral services in the area. Over 75% of referrals made were either for TL or Depo and above 75% of TL and Depo referrals received appropriate information about the method. Compliance for referral was found to be high (91%). There was a significant difference in the number of contacts made with the CBD agents before referral for Depo compared to TL clients. 77% of TL clients had more than three contacts as opposed to 55% of Depo There was a significant difference in the time taken to attend to health facility between TL and Depo clients. 95% of depo clients attended within the first two months compared to 59% of TL clients. The proportion of clients who received appropriate services at the health facility was over 75%. The general attitude of clients towards the CBD services was positive. Most of the clinic staff agreed that CBD activities has made their work easier by reducing work load at the clinic, nearly all of them give quick service to CBD referral clients. Most of the CBD agents followed up their clients at home to ascertain if they went for the referral. In conclusion the CBD referral services in Nyamira District is operational but there is need to increase TL services to meet the demand. There is supportive effort from health facilities to facilitate effective referral. The general attitude towards the CBD activities from clients, staff and CBD agents is positive. .