Health Institution Versus Community-based Contraception Distribution Does Payment For Modern Contraceptives Influence Utilization

A randomized field trial involving two modes ofrncontraceptive distribution, clinical and community-based,rnwhich were again divided into "free" and "paying"rnsubgroups was carried out in four rural servicerncooperatives (s.C.) ( consisting of 4-6 FarmersrnAssociations) of Sululta, Oromia Region, from Oct/92 -rnFeb/93. The baseline survey revealed no importantrndifferences in potential confounders among the selectedrn8- Farmers Kssociat~ons (FAl--(--2 -F~from each S.C.).rnOf the total 110 clients, 75 (68.2%) were femalesrnwhile 35(31.8%) were males. After 17 weeks of programrnintervention the contraceptive prevalence rate was 5.8%rnat Community Based Distribution (CBD) , while 2 . 6% atrnclinics. There was a significant difference (p= .043)rnbetween paying and free groups in continuation rates .rnThe main reasons for not starting oral pills was lack ofrnknowledge while those in favour of starting were tornprevent pregnancy, already having enough children and thernneed for birth spacing. The majority (80.0%) of malernclients started taking condoms to prevent STDs and AIDs.rnThe high attendance rate of women at CBD sites mayrnbe due to easier accessibility and may CBD programs tornreach a large majority of the rural population. Thernincreasing trend of continuation, which may be due tornvalue given to paid items, might also help broaden thernacceptance of family planning services.

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