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Female condom Trial KZN (Evaluating the effect of distributing female condoms on use of dual protection against sexually transmitted infections & HIV

Project Focus
Promotion of dual protection (E

Project Location

Duration of Project
2003- 2007

Project Partners

PDoH, DDoH and Health facilities, FHI

Project Donors
USAID & PDoH ( Global Fund)

Contact Details
Zonke Mabude

Project Aim/ Objectives
The goal of the female condom evaluation study is to produce evidence for policy makers and program managers concerning the value of distributing and promoting the female condom in the context of a dual protection programme.
  1. To identify client-level factors associated with increases in protection occurring when the female condom is added to the male condom distribution system.
  2. To describe the profile of women using female condoms in all intervention sites in comparison to the target group.
  3. To compare reasons offered by respondents in intervention and control clinics for use and non-use of barrier method protection.
  4. To assess the relative cost-effectiveness of adding the female condom to a dual protection intervention based on male condom promotion, measured in terms of the incremental cost per one per cent gain in the proportion of clients using dual protection.
  5. To assess the extent of female condom re-use and the types of clients most apt to report this practice.
Project Activities
This is a randomized controlled trial that is implemented in two districts in KZN and with 24 primary health care facilities participating randomly allocated into the intervention and control arms of the study. The main phase include a baseline survey, training of providers on dual protection, supply of intervention sites with FCs and monitoring of the intervention over 9 months, and lastly a follow up survey assessing the effect of the dual protection promotion and provision on women in terms of reported unprotected sex acts.

Base line data collection
  • Data collection for the baseline survey was collected from 3600 women aged 15-49 years.

Provider Training on Dual Protection
  • The next step in the project was training of providers in all sites on dual protection counselling and promotion. Training manual development.

Supply of commodity (FC)
  • Following the provider training all intervention sites were supplied with FCs for 9 months while control sites were only distributing male condoms but promoting both types of condoms. FC supplies were provided by the NDoH and RHRU. Over 22 000 FCs were supplied to sites.

Monitoring of the intervention
  • Monitoring activities were undertaken over 9 months by RHRU fieldworkers. These activities included interviews with staff and client exit interviews.

Follow up survey
  • This phase was completed in November 2005.  Data was collected from 3 600 women attending the health facilities. Data validation, entry and cleaning was done and completed in June 2006.
  • Development of an analysis plan and descriptive data analysis is underway. A descriptive report will be published shortly.  Further analysis is planned.
Anticipated/Actual Results
  • Baseline survey conducted as planned and a report prepared and distributed to funders
  • All 12 intervention sites supplied continuously over the intervention period 9 months
  • Report on monitoring of the intervention
  • Female condom intervention sites supported by PDoH
  • Several FC training sessions held with the providers in the participating districts
  • Study updates are given during the NDoH Quarterly meetings

Additional Outputs
Papers and Presentations:
  1. Vijayakumar G, Mabude Z, Smit J, Beksinska M, Lurie M. A Review of the impact of the female condom on proportion of protected sex acts and STI incidence. International Journal of STD and AIDS, 2006; 17 (10): 652-659 
  2. Oral presentations at the Reproductive Health priorities Conference
  3. AIDS Conference S.A; Poster presentation:  Z Mabude, Jenni Smit, Mags Beksinska, Immo Kleinschmidt. Predictors of condoms use among women attending KZN primary health care services. 2005.
  4. Zonke Mabude, Jabu Khumbuza, Jenni Smit, Mags Beksinka. Monitoring Counselling Quality in a Dual Protection Intervention Implemented in Selected Public Sector Facilities in KZN. Reproductive Health Priorities Conference 2005.
  5. Mabude Z, Smit J, Beksinska M, Kleinscmidt I, Hatzell Theresa. Risk Perception and Condom Use among Women attending Public Sector Primary Health Care Facilities in KwaZulu – Natal. 2005
Future Plans
  • Complete data analysis and write final report
  • Disseminate findings
  • Publish more papers

Projects in the Barrier Methods & Contraception Cluster:

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