• Community

Role of the community

This article, published in International Family Planning Perspectives, examines three “community-based distribution” (CBD) programmes for non-clinical family planning services in Tanzania. These programmes use community organisations, structures and institutions to promote the use of safe and simple contraceptive technologies. In the programme which had the most highly-paid workers, costs per worker were high but so were the number of client visits per worker. The programme which paid its workers least also had high costs per worker because other costs, such as training and supervision, were higher. This programme also had higher costs per visit because the small amount of compensation offered to its workers resulted in a small number of visits. The article uses these results to show how paying CBD workers more can actually reduce the costs of such programmes.

The article concludes by looking at ways that CBD programmes can cut their costs when donor funding is expected to decline. It argues that the challenge is doing this while also minimising the reduction in visits to clients. Programmes therefore need to take a broader approach than simply slashing the salaries paid to community workers. Instead, programmes which pay community workers little might improve their performance by spending more on these workers’ compensation, but less on training and supervision.

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