Increasing the effectiveness of community workers through training of spouses: a family planning experiment in Guatemala

As community-based distribution (CBD) systems for the delivery of contraceptive methods are implemented in developing countries around the world, there is growing interest in making these programs more effective. Previous research on the CBD program in Guatemala indicated the importance of the role of the spouse: those community volunteers (called "distributors") who received assistance from their spouses were more effective in selling contraceptives than those who did not. The current experiment was designed to test the effect of providing the spouses of distributors with a formal 3-day training course on family planning and contraceptives. "Effect" was operationally measured in terms of the level of contraceptive sales. To this end sales data were compared for the experimental group (33 distributors whose spouses received the training) and the control group (33 distributors whose spouses wanted to attend the training but could not because their primary occupation did not allow them to be absent) for periods of 6 months prior to and 6 months following the training. The results indicate that sales among the experimental group increased significantly, whereas no such increase was found among the controls. This suggests a strategy for increasing the effectiveness of community volunteer workers that has received relatively little attention in the literature to date.