Scaling Up Access to Contraceptive Choice in Zambia Through Mobile Community Nurses

Increasing contraceptive uptake is a key strategy in decreasing Zambia’s high maternal mortality rate. In order for Zambia to meet its target of increasing contraceptive prevalence rate (CPR) from 33% to 58% by 2020, cost effective and scalable solutions to increasing access to family planning (FP) are required. Due to a resource constrained health system, there are many nurses that are retired, under- and unemployed that wish to continue serving their communities. The Marie Stopes (MS) Ladies model is a bold idea to use these underutilized resources in a sustainable, income generating approach. Marie Stopes Zambia (MSZ) will equip and quality assure the MSZ Ladies so that they are able to deliver high quality mobile FP services, including long acting reversible contraception (LARC). On auto-rickshaws, MS Ladies will travel between low-income, high density compounds in and around Lusaka and Solwezi and offer women comprehensive FP services and HIV testing in their own homes or in available community spaces near "hotspots" such as market places. Through integrated innovation, the model combines a form of income generation for nurses with a low cost mode of transport in order to deliver mobile FP services and HIV testing. Having delivered FP services to 45,000 women in 2015, MSZ is a well-respected partner of the Ministry of Health (MoH), who has already indicated willingness to support scale up by providing supplies to the nurses after proof of concept.