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

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Listed:
  • Mags Beksinska
  • Phumla Nkosi
  • Zonke Mabude
  • Joanne E Mantell
  • Bongiwe Zulu
  • Cecilia Milford
  • Jennifer A Smit

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.

Suggested Citation

  • Mags Beksinska & Phumla Nkosi & Zonke Mabude & Joanne E Mantell & Bongiwe Zulu & Cecilia Milford & Jennifer A Smit, 2020. "Lessons from the evaluation of the South African National Female Condom Programme," PLOS ONE, Public Library of Science, vol. 15(8), pages 1-21, August.
  • Handle: RePEc:plo:pone00:0236984
    DOI: 10.1371/journal.pone.0236984
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    References listed on IDEAS

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    1. Government of India, 2017. "National Health Policy 2017," Working Papers id:11664, eSocialSciences.
    2. Mantell, Joanne E. & Dworkin, Shari L. & Exner, Theresa M. & Hoffman, Susie & Smit, Jenni A. & Susser, Ida, 2006. "The promises and limitations of female-initiated methods of HIV/STI protection," Social Science & Medicine, Elsevier, vol. 63(8), pages 1998-2009, October.
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    1. Khushali Roy & Aliayah Himelfarb & Kapil Karrah & Laura Porterfield & Lauren Paremoer & Hani Serag & Wei-Chen Lee, 2022. "The Social, Behavioral, and Ethical Modalities of COVID-19 on HIV Care in South Africa: A Systematic Review," IJERPH, MDPI, vol. 19(15), pages 1-19, August.

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