Family Planning Counseling in Your Pocket: A Mobile Job Aid for Community Health Workers in Tanzania

To address low contraceptive use in Tanzania, a pilot intervention using a mobile job aid was developed to guide community health workers (CHWs) to deliver integrated counseling on family planning, HIV, and other sexually transmitted infections (STIs). 

In this article, we describe the process of developing the family planning algorithms and implementation of the mobile job aid, discuss how the job aid supported collection of real-time data for decision making, and present the cost of the overall system based on an evaluation of the pilot. The family planning algorithm was developed, beginning in June 2011, in partnership with the Tanzania Ministry of Health and Social Welfare based on a combination of evidence-based tools such as the Balanced Counseling Strategy Plus Toolkit. The pilot intervention and study was implemented with 25 CHWs in three wards in Ilala district in Dar es Salaam between January 2013 and July 2013. A total of 710 family planning users were registered and counseled using the mobile job aid over the six-month intervention period. Most new and continuing family planning users chose pills and male condoms (59% and 73%, respectively). The financial cost of implementing this intervention is estimated to be US$26,000 for the first year. For subsequent years, the financial costs are estimated to be 73% lower at $7,100. Challenges such as limited client follow-up by CHWs and use of data by supervisors identified during the pilot are currently being addressed during the scale-up phase by developing accountability and incentive mechanisms for CHWs and dashboards for data access and use.

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