Task-shifting the provision of DMPA-SC in the DR Congo: Perspectives from two different groups of providers

Julie H. Hernandez, Pierre Akilimali, Annie Glover, Rebecca Emel, Albert Mwembo, Jane Bertrand

Research output: Contribution to journalArticlepeer-review

9 Scopus citations


Objectives: To document the experience of three groups of Family Planning service providers participating in task-shifting for the provision of subcutaneous depot-medroxyprogesterone acetate (DMPA-SC) at the community level in the DRC. Study design: This article compares results from interviews with DMPA-SC providers in two separate pilot studies: 1) 53 medical and nursing school students teaching women how to self-inject (2016–2017); and 2) 34 lay community health workers providing DMPA-SC in rural areas of Lualaba (2017). All providers gave information on socio-demographic characteristics, recruitment,) training, supervision, experience and satisfaction with the provision of DMPA-SC. The paper examines variations in responses from the different provider cadres. Results: Despite substantive variations in provider profiles in terms of age, educational and marital status, reported levels of satisfaction with offering DMPA-SC in the community were consistently high. Over 90% of all providers declared being comfortable or very comfortable interacting with FP clients, and more than three quarters of them were very comfortable performing an injection. Over 90% of Lualaba providers and over 80% of student providers gave correct responses to DMPA-SC protocol questions regarding referral of clients to facilities and side-effects management. The vast majority declared being (very) satisfied with their experience providing DMPA-SC. Conclusions: Providers with and without a clinical background, when properly trained and supervised, can provide DMPA-SC at the community level in both urban and rural settings of the DRC. Support strategies from the Family Planning environment (continuous contraceptive supplies and adequate referral system to fixed facilities) are key to engaging community health workers and sustainably leveraging task-shifting opportunities. Implication statement: This study provides additional evidence on the acceptability and feasibility of task-shifting in relation to DMCP-SC and supports further scale-up efforts.

Original languageEnglish
Pages (from-to)449-453
Number of pages5
Issue number5
StatePublished - Nov 2018


This article was developed under grant #OPP1128892 awarded to the Tulane University School of Public Health and Tropical Medicine by the Bill & Melinda Gates Foundation . The funding source was not involved in the design or conduct of the research. The findings and conclusions contained within are those of the authors and do not necessarily reflect positions or policies of the Bill & Melinda Gates Foundation. The authors thank Perri Sutton for her diligent oversight of the work under this grant. The authors also thank M. Tesky Koba for his coordination of the data collection in Lualaba.

FundersFunder number
Bill and Melinda Gates Foundation


    • DMPA-SC
    • Democratic Republic of Congo
    • Family planning
    • Providers
    • Task-shifting


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