Program Design & Management

Community-based family planning (CBFP) programs vary greatly in scale and design. Some programs cover national populations while others cover small geographical areas and target specific populations.

A number of guides are available in the Program Design & Management section of the CBFP Toolkit to help with planning, implementing, and managing CBFP programs. In addition, several specific program elements are covered in this section of the toolkit, including: research to help tailor programs, selection of community-based distribution agents, supervision and support of community health workers, logistics, costs and financing, referral networks, sustainability, scale-up, quality considerations, engaging the private sector, and integrating CBFP with other services. In addition, resources to  help with safe injection and waste management for those CBFP programs providing injectables are included. 

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CBFP Program Development Guides (10 resources)

Several guides are included in this section to help with planning and implementing CBFP programs generally, as well as guides specifically geared toward mobile outreach services, community-based access to injectable programs, and involving men in family planning programs.

    Research to Help Tailor Programs (5 resources)

    In planning CBFP activities, it helps to have a variety of qualitative and quantitative information about the community you plan to serve. This section includes a number of helpful guides on various qualitative and quantitative research methods that a CBFP program can utilize.

      Selection of CBD Agents (5 resources)

      CBD agents need to be respected and play a positive role in benefiting their community. A central question is whether the sex of community workers affects clients' willingness to use a method and their access to services. The resources provided in this section include information about the effectiveness of male and female CBD agents.

        Supervision (11 resources)

        Questions arise about how best to motivate community health workers and what the impact of paying them or providing incentives is. Other factors besides pay, however, also affect worker performance, such as active and supportive supervision. This section of the toolkit includes resources to help CBFP programs supervise and support community health workers to improve their performance and job satisfaction.

          Logistics (15 resources)

          The supply chain is responsible for getting the contraceptives from the manufacturer to the family planning client. It encompasses a number of activities along the way, such as transporting and storing the contraceptives, maintaining adequate supply levels, and keeping records. The resources included in this section provide information on how to design and manage an effective logistics system to ensure that CBFP programs can deliver contraceptives to the community.

            Costs and Financing (5 resources)

            The resources in this section provide an overview of different financing models for CBFP programs, such as using paid versus volunteer community health workers and providing free family planning services versus charging a nominal fee.

              Referral Networks (3 resources)

              Community health workers are an essential link between clinics and their communities, which are often hard-to-reach. A strong referral system, with clear guidance to the community health workers on when to refer, is essential to community-based programs. Local private and public-sector clinic providers should be encouraged to accept referral relationships with community health workers both to better serve clients and to strengthen their own business models.

                Sustainability (8 resources)

                Resources included in this section provide guidance on how to work toward building sustainable community-based family planning programs by lowering and recovering costs and/or building capacity of the community to contribute local resources to the program or to even own and manage the program.

                  Scale-Up (15 resources)

                  The term “scaling up” typically refers to expanding program activities to reach more people and more areas, thus increasing impact. Scaling up is done best by planning for it from the start, with vision and commitment. By looking ahead, program planners can build in the components needed for large scale. Such components are difficult to add or alter later. This section of the CBFP Toolkit contains resources and tools on how to scale up reproductive health programs.

                    Quality Considerations (4 resources)

                    In this section of the CBFP Toolkit, resources on a number of issues related to ensuring quality services are provided, such as ensuring programs adhere to the principle of informed choice and working with the community to define and implement quality programs.

                      Engaging the Private Sector (2 resources)

                      Governments and donors often focus on strengthening the public sector health system as a way to bring affordable services to everyone. However, engaging the private sector is an important component of increasing access to family planning, meeting consumer preferences, and aiding in sustainability of public family planning programs. The resources included in this section of the CBFP Toolkit define the private health sector and its role in providing essential health and family planning services.

                        Integrated Services (12 resources)

                        Offering multiple health care services through a community-based program can benefit clients, providers and programs. Integrating services can address a wider range of health needs conveniently for clients. It also can be more efficient for programs and so can serve more people for the same expenditures. Services commonly integrated with family planning include: HIV care and prevention; maternal, newborn, and child health care; child immunization services; and postabortion care services. Some key resources for integrating family planning into other health services are provided below. For a more comprehensive treatment of the topic of integrating family planning with HIV services, please see the K4Health Family Planning and HIV Services Integration Toolkit (www.k4health.org/toolkits/fphivintegration) and the Resources for HIV/AIDS and Sexual and Reproductive Health Integration website (http://www.hivandsrh.org/).

                          Safe Injection and Waste Management (5 resources)

                          CBFP programs that include injectables in their method mix will need to consider safe injection practices and waste management issues in the design and implementation of their program. This section of the CBFP Toolkit includes resources that will help program planners address safe injection and waste management.