Community-Based Distribution in Tanzania: Costs and Impacts of Alternative Strategies to Improve Worker Performance

Donor funds may be inadequate to support the growing demand for services provided by community-based distribution (CBD) programs. One solution may be to reduce the remuneration of CBD agents, but this approach may lower their productivity. Programs also need to consider reducing other costs, including those for supervision and training. The cost per agent visit—including costs associated with payments to agents and to supervisors and the costs of training—was calculated for three CBD programs in Tanzania. The output measure was visits in which contraceptives were provided or referrals made for family planning services. Simulations were used to examine the impact of changes in agent remuneration on costs per visit, assuming different levels of spending on training and supervision. [from abstract]