Delivering contraceptive vaginal rings. Task shifting and task sharing in the delivery of family planning services: Experiences from Kenya.

Expanding the provision of contraceptive methods by mid and lower-level health workers with varying levels of knowledge and skills can significantly improve access to contraception for all individuals and couples. Many countries with a shortage of human resources are implementing various forms of task sharing or task shifting as a strategy for delivering contraceptive methods within communities and in health care facilities. This report describes the task shifting and task sharing policies and experiences that are relevant to the provision of family planning services in Kenya and the potential place for contra-ceptive vaginal rings. The exercise sought to document the feasibility effectiveness and acceptability of mid and lower-level providers in the provision of family planning services and the extent to which these activities have been implemented. A review of the way reproductive health services including family planning are provided shows that many health workers are already implementing task sharing and task shifting approaches with varying degrees of success. Three examples are addressed in this report: provision of bilateral tubal ligation by clinical officers provision of depot medroxyprogesterone acetate (DMPA) by CHWs and sustaining community-based MNH and family planning services through task sharing activities between community midwives and community health workers. The report also highlights how the provision of integrated RH/FP/HIV services could be delivered by various levels in the national health care system through task sharing. Opportunities for facilitating the delivery of progesterone contraceptive vaginal rings (PCVR) within the national health care system in Kenya are also described. (excerpt)