An assessment of the government of India’s initiative on contraceptives at the doorstep by Accredited Social Health Activists (ASHAs): Recommendations for national scale-up

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Objective: The Government of India (GOI) piloted a new initiative in 17 states where Accredited Social Health Activists (ASHAs) delivered contraceptives directly to households for a small fee.This paper details an assessment of the pilot with the aim of informing the GOI's national scale-up of the initiative.Methods: A mixed-method approach was used in May 2012 to assess operational issues, barriers and facilitators of implementation, and initiative experiences in 6 states.Participants included ASHAs, community women, and managers and other key implementers.Results: Community women and ASHAs found the initiative favorable and managers were positive about long term success.The assessment uncovered challenges in the supply chain, the packaging of the initiative's contraceptives, communication efforts, and orientation and reporting. Conclusion:The initiative is a promising strategy to address unmet need and to increase the uptake of birth-spacing methods.Assessment recommendations can inform and strengthen other community-based family planning programs.