Community based distribution (CBD) programs address geographical cost bureaucracy and cultural and community barriers to family planning programs. Clients in the community setting are considered: Their values often include a strong desire for children for old age security as well as companionship and status for socially circumscribed women. Negative attitudes of male supremacy and of fertility as a sign of potentcy are countered by positive attitudes e.g. desires for a bright future for children. Organizational approaches vary from house-to-house service delivery (the predominate mode) to the use of the workplace and womens club. Personnel characteristics vary: uneducated women have been used successfully and successful programs use indigenous women for community activities where possible. Worker tasks are formidable involving entering homes uninvited; discussing sensitive topics; and providing contraceptives and dealing with the possibility of side effects. This probably explains the wide range of outcomes of CBD programs. The training and use of traditional midwives has proven successful in Thailand and in Southeastern Asia and Latin America generally and their exclusion from Egyptian programs led to some sabotage. Transaction evaluation takes into account the amount and frequency of contact (worker to population ratio and the other duties a worker has are important); quality of contact dependent on the identification of the worker with the client ("homophily") balanced by a need to possess sophisticated knowledge and a will to institute social change. Hostility towards family planning among clients while not widely extended is a problem for some workers. Attention to worker morale will help in preventing turnover and covert resistance. Examples are given of programs that have enjoyed some success attributable to good worker selection training and support and indirect program benefits for workers among other factors.