Community-based distribution of contraception: a pilot project in Khayelitsha, Cape Town.

PIP: This article describes a pilot project in informal settlements in Khayelitsha, Cape Town, South Africa, to use community-based distribution (CBD) for contraceptive delivery. The article presents preliminary findings from a baseline survey conducted among a sample of 696 women and 679 men in all CBD areas. The pilot program began in March 1996. Most people lived in informal housing with or without access to services. Three nongovernmental organizations (NGOs) piloted the program. Qualitative and quantitative studies were conducted to determine the nature of contraceptive services and the response of the population to these services. Qualitative studies included in-depth interviews with key staff at five contraceptive clinics and health NGOs serving the target areas. Findings reveal a range of problems including limited hours of operations and long waiting lines. Services focused on injectables. Quality of care problems included perceived side effects, limited client information, poor client-staff relations, and limited follow-up. A number of clinic problems would be reduced with CBD distribution. The survey among the suburbs of Harare, Makhaza, Site B, and Griffiths Mxenge, in August 1995 and February 1996, reveals that men and women differed in the desired family size. Respondents had less children than they preferred. Support was strongly in favor of contraception. Contraceptive use was 66%. 83% were using injectables. 75% reported that the method choice was made by the provider. Almost all believed that germs caused sexually transmitted diseases, but there was misinformation on transmission modes.^ieng

Informal sector shops and AIDS prevention. An exploratory social marketing investigation.

Shopkeepers at 88 informal sector shops in the black township of Khayelitsha were interviewed to explore whether such shops should be considered as venues for the dissemination of AIDS prevention information and condoms through social marketing programmes. The existence of a variety of media and interpersonal information sources on the premises, the presence of opinion leadership and the willingness of several owners to distribute posters and pamphlets and sell condoms suggests that such shops should be further investigated as avenues for AIDS prevention efforts. A relationship was found between the degree to which a shop exhibited aspects of social influence and the degree to which it was established in terms of infrastructure, income and experience of personnel. It was concluded that shopkeepers might be an important group to target early in a programme, because they might then influence others' reaction to it. Finally, it would be important for shop personnel and other township residents to be part of the design, planning and implementation of AIDS prevention programmes.