An approach to evaluation of the effectiveness of health aides in recruiting and maintaining clients on oral contraceptives.

This paper discusses the relative effectiveness of Panchayat-based and clinic-based health aides in motivating women to accept oral contraceptives and in maintaining them as users. Every client who accepted oral contraceptives was given a record card to be used for subsequent follow-up visits. 18 Panchayat-based health workers and clinic-based health centers were identified. The Panchayat-based worker actively recruited women by making home visits whereas clinic-based workers spent more time with clients at the clinics. The results show that 1) the acceptance figures are virtually similar for both types of clients; 2) the drop out rate was greater in the first 3 months for clinic-based clients; 3) the hills women were more inclined to take contraceptives to avoid further pregnancies whereas women from the plains were more interested in spacing of children; 4) the continuation of oral contraceptives use was higher in Panchayat-based clinics; 5) the average number of acceptors at 12 months in the hills was higher in the Terai for both types of workers; and 6) acceptors from the hills comprised much older people suggesting that contraceptives were more frequently used once couples had enough children. In addition it was concluded that female health aides did exceptionally well in recruitment and maintenance of acceptors and thus should be utilized more widely in the provision of family planning services.