Lessons from the evaluation of the South African National Female Condom Programme

Mags Beksinska, Phumla Nkosi, Zonke Mabude, Joanne E Mantell, Bongiwe Zulu, Cecilia Milford and Jennifer A Smit

PLOS ONE, 2020, vol. 15, issue 8, 1-21

Abstract: Background: Understanding of the facilitators and challenges to female condom (FC) uptake has been limited due to lack of evaluation of national FC programmes. Setting: The FC has been an integral component of South Africa’s (SA) HIV prevention programme for 20 years and is the largest government-funded FC programme worldwide. Methods: The national FC evaluation used a mixed-methods approach and consisted of key informant interviews and a telephone survey in a national sample of public and non-public sites. A sub-sample of sites participated in client and provider interviews, and a self-administered client survey. A review of distribution statistics from South Africa’s District Health Information System was also conducted. Results: All 256 public-sector and 28 non-public-sector facilities reported having ever distributed FCs. Less than 5% of these facilities reported stock-outs and less than 3% reported they had a supply of expired female condoms. Systems for male condom (MC) and FC distribution were complementary, with similar ordering, delivery and reporting processes. FC promotion by providers (n = 278) varied with regard to FC training, whether attitudes about FCs influenced providers offer of FCs, and how they counselled clients about FCs. Of the 4442 self-administered client surveys in 133 facilities, similar proportions of women (15.4%) and men (15.2%) had ever used FCs. Although FCs were available at almost all sites surveyed, only two-thirds of clients were aware of their availability. Conclusion: Data highlight the role of providers as gatekeepers to FC access in public and non-public sectors and provide support for further FC programme expansion in SA and globally.

Date: 2020
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Persistent link: https://EconPapers.repec.org/RePEc:plo:pone00:0236984

DOI: 10.1371/journal.pone.0236984

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