An Evaluation of the Government of India’s Initiative on Contraceptives at the Doorstep by Accredited Social Health Activists (ASHAs)

The Government of India piloted a new initiative in 17 states whereby local accredited social health activists (ASHAs) deliver contraceptive methods directly to the households within a modified supply chain designed to avoid stockouts and delays in supply. This paper details a process evaluation of the new initiative, undertaken by FHI 360 as requested by the Ministry of Health and Family Welfare, Government of India with the purpose of providing recommendations for its national scale-up. The objective of the evaluation was to identify operational issues, including service delivery mechanisms, program monitoring and record keeping at various levels. These objectives were achieved using quantitative and qualitative methods across six geographically representative states. The evaluation highlighted several operational challenges for the government of India to consider during scale-up. The packaging of the initiative’s contraceptive supply could be modified to highlight the price and to differentiate it from the free supply. Social marketing would improve community awareness and acceptance of the new charges. Reporting formats could be simplified, and develop guidelines on stock requisition and removal of free-supply stocks. The initiative is a promising strategy for addressing unmet family planning need and increasing the uptake