Facilitating community participation in family planning and contraceptives service provision and uptake: community and health provider perspectives

Background: Although community participation has been identified as important for improved and sustained health outcomes in primary healthcare services provision, challenges still remain on how to design and successfully implement it in large scale public health programmes, including family planning and contraceptive (FP/C) service provision. Zambian participants in a multi-country project (the UPTAKE project) provided input in the development of an intervention involving community and health provider participation in FP/C services provision and uptake. This study reports on some of the thematic areas identified by the study participants as critical to facilitating community participation in this project. Methods: This was an exploratory qualitative research study, conducted in Central Province, Kabwe district, in 2017. Twelve focus group discussions were conducted with community members (n=114) and two with healthcare providers (n=19). Ten in-depth interviews were held with key community and health sector stakeholders. Data were analyzed using thematic analysis approach. Results: Four thematic categories were identified from the data as critical to facilitating community participation in FP/C services. Firstly, accountability in recruitment of community representatives and incorporation of community feedback in FP/C services programming. Secondly, engagement and learning best approaches to involve both local and NGO structures in FP/C services provision. Thirdly, building trust through credible community-based distributors and dissemination of appropriate FP/C services information. Fourthly, promoting facilitative strategies that look to address some structural failures such as defeminisation of FP/C services and motivation of community members. Conclusions: Understanding and considering community members’ and healthcare providers’ views regarding contextualized and locally relevant participatory approaches, facilitators to and challenges to participation, can greatly aid the design, implementation and success of community participation public health programmes. Key words: Community, participation, family planning, contraceptives, programs, accountability, trust, strategies, motivation