Operationalizing a New Policy on Implant Service Provision by Community Health Nurses

In many developing countries, primary-level workers, auxiliary staff, and community health workers are being trained to assume roles and perform functions traditionally reserved for mid- or high-level cadres of health workers as a means of optimizing the number and capacity of available providers. The intention of this process, known as “task shifting” or “task sharing,” is to increase levels of health care access.

Research conducted by the Population Council highlighted the need to expand the role of Community Health Nurses (CHNs) in providing new contraceptive technologies, including implants. The Ghana Health Service (GHS), in collaboration with the Population Council, subsequently convened a series of stakeholder meetings to discuss evidence from Ghana and other countries as well as the 2012 WHO global recommendations on task shifting. Meeting participants concluded that auxiliary nurses who were not previously mandated to provide implant insertion and removal services should be trained to offer the service and should be monitored to ensure compliance with safety standards. This process led to the revision of the government’s policy in February 2013 to allow CHNs to provide implant insertion and removal services.

The Evidence Project is providing technical assistance to support GHS efforts to implement the recent policy decision that enables CHNs to provide implant services. Specifically, the project is helping GHS update the “National Reproductive Health Service Policy Standards and Protocol” document and share it with key stakeholders to identify strategies for implementation. The project is also working with GHS and the Nurses and Midwifery Council to review the preservice curriculum and ensure the inclusion of implant training for CHNs.