USAID/PAKISTAN’S MCH PROGRAM FAMILY …
Transcript of USAID/PAKISTAN’S MCH PROGRAM FAMILY …
USAID/PAKISTAN’S MCH PROGRAM, FAMILY PLANNING/REPRODUCTIVE HEALTH COMPONENT
QUARTERLY PROGRESS REPORT (January –March 2016) P/1
Cooperative Agreement No:
AID-391-A-13-00007
Submitted by:
Marie Stopes Society (MSS)
USAID/PAKISTAN’S MCH PROGRAM
FAMILY PLANNING/REPRODUCTIVE HEALTH
COMPONENT
Quarterly Progress Report: January – March, 2016
USAID/PAKISTAN’S MCH PROGRAM, FAMILY PLANNING/REPRODUCTIVE HEALTH COMPONENT
QUARTERLY PROGRESS REPORT (January –March 2016) P/2
TABLE OF CONTENTS
LIST OF TABLES
P/3
LIST OF FIGURES
P/3
ACRONYMS
P/4
CHAPTER 2:
OBJECTIVE 1 - INCREASING
THE SIZE AND CAPACITY OF
HEALTH WORKFORCE
P/7
CHAPTER 3:
OBJECTIVE 2 - SCALING UP
FACILITY-BASED SERVICE
DELIVERY
P/9
CHAPTER 4:
OBJECTIVE 3 - SCALING UP
OUTREACH AND
COMMUNITY-BASED
SERVICE DELIVERY
P/11
CHAPTER 6:
IMPACT STORIES
P/23
ANNEX-1
P/26
CHAPTER 1:
EXECUTIVE SUMMARY
P/5
CHAPTER 5:
CROSS CUTTING THEMES
P/15
USAID/PAKISTAN’S MCH PROGRAM, FAMILY PLANNING/REPRODUCTIVE HEALTH COMPONENT
QUARTERLY PROGRESS REPORT (January –March 2016) P/3
LIST OF TABLES
Table 1: KPIs achieved to-date (through Mar 2016)
Table 2: Region wise overview of SF providers Q2
Table 3: Region wise camp analysis
LIST OF FIGURES
Figure-1: CYPs generated during Q2 (Jan-Mar 2016)
Figure-2: Clients served in Q2 (Jan-Mar 16)
Figure-3: Comparison of participants trained in Q2, segregated by modules Q1 and Q2
Figure-4: Comparison of participants trained in Q1 and Q2, segregated by gender
Figure-5: Public and private service providers trained with USG Funds in Q2 (Jan– Mar 16)
Figure-6: Regional QA Scores and QA Visits in Q2 (Jan-Mar 16)
Figure-7: Comparison of services Q1 vs Q2 SF
Figure-8: CYPS generated by method mix in SF Q2 (Jan-Mar 2016)
Figure-9: CYPs Generated Q2 (Jan-Mar 2016)
Figure-10: Comparison of SF CYPs generated in Q1 and Q2, Segregated by method mix
Figure-11: CYPs generated by FP method
Figure-12: Parity distribution among TL clients in SF
Figure-13: Age distribution among TL in Q2
Figure-14: Comparison of services Q1 vs Q2
Figure-15: CYPs generated in Q2 (Jan to Mar 16)
Figure-16: CYPs generated by method in Q2 (Jan to Mar 16)
Figure-17: Average CYP generated per camp – monthly
Figure-18: Age distribution among TL Clients in Q2 (Jan-Mar 16)
Figure-19: Parity Distribution among TL Clients in Q2 (Jan-Mar 16)
USAID/PAKISTAN’S MCH PROGRAM, FAMILY PLANNING/REPRODUCTIVE HEALTH COMPONENT
QUARTERLY PROGRESS REPORT (January –March 2016) P/4
ACRONYMS
BCC BEHAVIOR CHANGE COMMUNICATION
B&M BRANDING AND MARKING
CIO CHIEF INFORMATION OFFICER
CMW COMMUNITY MIDWIVES
CM COMMUNITY MOBILIZATION
CPR CONTRACEPTIVE PREVALENCE RATE
CYP COUPLE YEARS OF PROTECTION
DCO DISTRICT COORDINATION OFFICER
DO DEVELOPMENT OBJECTIVE
DOH DEPARTMENT OF HEALTH
EPI ENTERPRISE DISTRICT OFFICER
ERP ENTERPRISE RESOURCE PLANNING
FHE FIELD HEALTH EDUCATOR
FP FAMILY PLANNING
FP/RH FAMILY PLANNING/REPRODUCTIVE
HEALTH
FLAME FRANCHISE DATA UTILIZING LOCAL
APPLICATION
GOS GOVERNMENT OF SINDH
GM GENERAL MANAGER
HR HUMAN RESOURCE
HTSP HEALTH TIMING AND SPACING OF
PREGNANCY
HSSC HEALTH SYSTEM STRENGTHENING
COMPONENT
IPC INTERPERSONAL COMMUNICATION
IR INTERMEDIATE RESULTS
IRMNCH INTEGRATED REPRODUCTIVE
MATERNAL NEWBORN CHILD HEALTH
IT INFORMATION TECHNOLOGY
IUCD INTRAUTERINE CONTRACEPTIVE
DEVICE
JHU.CCP JOHNS HOPKINS UNIVERSITY CENTER
FOR COMMUNICATION PROGRAM
JSI JOHN SNOW INTERNATIONAL
KPI KEY PERFORMANCE INDICATORS
LAPM LONG-ACTING PERMANENT METHOD
LHS LADY HEALTH SUPERVISOR
LHV LADY HEALTH VISITOR
LHW LADY HEALTH WORKER
M&E MONITORING AND EVALUATION
MCH MATERNAL AND CHILD HEALTH
MCHIP MATERNAL AND CHILD HEALTH
INTEGRATED PROGRAM
MNCH MATERNAL, NEWBORN AND CHILD
HEALTH
MSI MARIE STOPES INTERNATIONAL
MSS MARIE STOPES SOCIETY
MWRA MARRIED WOMEN OF REPRODUCTIVE
AGE
NP-FP & PHC NATIONAL PROGRAMME FOR
FAMILY PLANNING & PRIMARY
HEALTHCARE
OMU OUTREACH MOBILE UNITS
OR OUTREACH
PMP PROJECT MANAGEMENT PLAN
PWD POPULATION WELFARE DEPARTMENT
QA QUALITY ASSURANCE
RH REPRODUCTIVE HEALTH
RME RESEARCH, MONITORING AND
EVALUATION
SDP SERVICE DELIVERY POINTS
SF SOCIAL FRANCHISE
SFS SENIOR FIELD SUPERVISOR
SMH SAFE MOTHERHOOD
SOPS STANDARD OPERATING PROCEDURES
SSF SURAJ SOCIAL FRANCHISE
ST SHORT-TERM
STI SEXUALLY TRANSMITTED INFECTIONS
TL TUBAL LIGATION
TMS TIME MANAGEMENT SYSTEM
TSD TECHNICAL SERVICES DEPARTMENT
USAID UNITED STATES AGENCY FOR
INTERNATIONAL DEVELOPMENT
USG UNITED STATES GOVERNMENT
UNICEF UNITED NATIONS CHILDREN'S
EMERGENCY FUND
VFM VALUE FOR MONEY
USAID/PAKISTAN’S MCH PROGRAM, FAMILY PLANNING/REPRODUCTIVE HEALTH COMPONENT
QUARTERLY PROGRESS REPORT (January –March 2016) P/5
CHAPTER 1
EXECUTIVE SUMMARY
The Family Planning/Reproductive Health (FP/RH) project serves as Component 1 for the United States Agency for International Development (USAID) Pakistan’s Maternal Child Health (MCH) Program. FP/RH interventions contribute to achieving the fifth development objective (DO) of the USAID MCH Program: to improve MCH outcomes in the focused areas and support the following two intermediate results (IRs) under DO 5: IR 5.1 Improved utilization of quality FP/RH and Maternal, Newborn and Child Health (MNCH) services Couple years of protection (CYP) in United States Government (USG) supported programs Number of women and children receiving FP/RH and MNCH services in USG-assisted sites
IR 5.1.1: Improved availability of quality FP/RH and MNCH services Number of people trained in FP/RH and MNCH through USG support
Quarterly achievements against IRs for the period January to March 2016 are presented in this report. The practice of healthy timing and spacing of pregnancies (HTSP), particularly through the voluntary uptake of modern family planning (FP) methods, is fundamental to the wellbeing of mother and child. All married couples have a right to select their family’s size and the spacing between their children. Since its inception in October 2013, the FP/RH project has focused on building awareness of HTSP and FP methods amongst the women and communities it serves through Field Health Educators (FHEs) and providing married women of reproductive age (MWRA) access to a range of voluntary and quality modern FP methods. The FP/RH service delivery model operates through two interventions: the Suraj Social Franchise (SF) network and the outreach (OR) model. Additionally MCH Rohri also provides FP and MCH services. Both SF and OR are supported by demand generation activities conducted by FHEs. The project operates in 29 districts of Sindh, grouped into three regions: Karachi, Hyderabad, and Sukkur; and three districts of Punjab grouped into one region, Multan. The highlights for the reporting quarter i.e. January – March 2016 include: FP services were offered through a network of 301 SF Providers; 14 OR teams; and 4 Outreach Mobile
Units (OMU) A total of 303,099 MWRAs were reached through door to door visits, Mohalla and Mashwara
meetings in the SF channel, and 122,421 in the OR channel. 111,767 clients were provided voluntary FP services; 85,316 through the SF; 26,337 though the OR
Channel and 114 through MCH services. 279,632 Couple Years of Protection (CYPs) were generated; 214,604 through the SF; 64,790 though
the OR Channel and 238 through MCH services. As a result of services provided during the reported period, an estimated 88 maternal deaths and an
estimated 99,046 unintended pregnancies averted
During the reporting quarter FP/RH utilized various initiatives to enhance effectiveness and increase
access to voluntary FP services. These include an evolving model of community mobilization
(CM)interventions; organizational and system strengthening activities; the helpline service; effective
program management; a continued interest in building sustainability in project interventions; and
research, monitoring and evaluation activities focused on seeding evidence-based decision making.
USAID/PAKISTAN’S MCH PROGRAM, FAMILY PLANNING/REPRODUCTIVE HEALTH COMPONENT
QUARTERLY PROGRESS REPORT (January –March 2016) P/6
Table-1: KPIs achieved to date (through Mar 2016)
Key Performance Indicators (KPIs)1
Year 12 (through Sep 2014)
Year 2 (Oct 2014– Sep 2015)
Year 3, Qtr. 1
(Oct 2015–Dec 2015)
Year 3, Qtr. 2
(Jan 2016– Mar 2016)
Results to date
(through Mar 2016)
Number of OR teams added 12 4 -13 -1 14
Number of OMU teams added 0 2 1 1 4
Number of SF providers added 135 165 +4 (-24)4 +41(-20) 301
OR camps held 825 1,361 479 489 3,154
CYPs generated 339,022 592,164 244,060 279,632 1,454,878
Total clients provided voluntary FP services
142,706 242,389 94,840 111,767 591,702
Voucher clients 88,403 146,859 57,277 67,283 359,822
Unintended pregnancies averted 159,956 242,155 87,053 99,046 588,210
Maternal deaths averted 218 287 79 88 672
Figure-1: CYPs generated during Q2 (Jan-Mar 2016)
Figure-2: Clients served in Q2 (Jan-Mar 16)
1KPIs related to unintended pregnancies and maternal deaths averted were estimated using MSI’s Impact2 model: https://mariestopes.org/impact-2 2In this report, Year 1 has cumulative figure of Year 0, i.e. the period from Dec 2012-Sep 2013 funded by SIFPO, and Year 1, i.e. the period from Oct 2013 – Sep 2014, funded by the Co-op Agreement. 3One OR team was converted to an OMU in Punjab 4During the reporting period, 4 providers were added and 24 SF providers separated from the network
+
279,632
CYPs Generated
104,049CYPs
Generated in Hyderabad
34,736CYPs
Generated in Karachi
32,203CYPs
Generated in Multan
108,644CYPs
Generated in Sukkur
279,632CYPs Generated
214,604 SF CYPs
64,790OR & OMU
CYPs
238MCH CYPs
111,767Clients Served
44,304Clients
served in Hyderabad
18,668Clients
served in Karachi
11,568Clients
served in Multan
37,227Clients
served in Sukkur
111,767
Clients Served
85,316 SF Clients
26,337OR & OMU
Clients
114 MCH Clients
USAID/PAKISTAN’S MCH PROGRAM, FAMILY PLANNING/REPRODUCTIVE HEALTH COMPONENT
QUARTERLY PROGRESS REPORT (January –March 2016) P/7
CHAPTER 2
OBJECTIVE 1: INCREASING THE SIZE AND CAPACITY OF THE
HEALTH WORKFORCE
Overview
Skilled health workers frequently prefer urban placement, rendering peri-urban and rural populations under-served with a proportionally higher unmet need for FP services. The clinical (hands on) and counseling trainings provided by the FP/RH project increases the availability of skilled service providers in rural and remote settings. Mid-level service providers and doctors are engaged in the FP/RH training component and trained according to their eligibility for FP service provision established by the concerned regulatory authorities. Simultaneously FHEs and senior field supervisors (SFSs) associated with each USG funded service delivery points (SDP) are trained on knowledge and communication skills which aid them in generating demand for FP services and removing barriers to the uptake of voluntary FP services by MWRAs in target communities. Once trained and inducted into the Suraj Network or recruited in the OR teams, the quality of FP service provision is monitored by the Quality Assurance (QA) teams. These teams facilitate a continuous loop of quality evaluation and service improvement by using the Marie Stopes International (MSI) QA guidelines adapted to local context. The FP service quality measures include technical competence, clinical governance, facilities and supplies.
Performance and Achievements
Training highlights:
Trained 802( 758 females and 44 males) participants in FP/RH with USG support
684 of those trained were from the private sector (525 from SF and 159 from OR) and 118 from
the public sector
684 private sector providers included 31 doctors, 38 nurses, 90 lady health visitors (LHVs), 96
community midwives (CMWs), 331 FHEs, 78 SFSs, 10 male mobilizers and 10 counselors
118 public sector providers included 9 Lady Health Workers (LHWs), 61 LHSs, 42 CMWs, 1 nurse
and 5 program manager
Out of the total trained, 572 received FP counselling training and 77 received FP clinical training;
A new module on community mobilization was introduced and 153 field staff attended this
training
In addition to the 802 participants, 98 project staff members were also trained
Quality Assurance (QA)
The quality assurance (QA) team made 127 visits to USG-supported SDPs Areas identified for refresher training included infection prevention and sexually transmitted
infections (STI) knowledge Internal QA scores for SF-A+ in Karachi improved over last quarter by 1%, with an average QA
score of 82% for SF-A and 90% each for SF-A+ and OR; QA scores for Sukkur decreased by 5% in SF-A and 3% in OR. This was primarily because, out of the 31 SF-A providers, 15 had been newly inducted. The average QA score were 83% for SF-A, 88% for SF-A+ and 95% for OR.
QA scores for SF-A for Multan improved by 6%, with an average QA score of 94% for SF-A; QA scores for SF-A for Hyderabad improved by 2%, with an average QA score of 90% for SF-A and 91% each for SF-A+ and OR in FP/RH Y3 Q2
OR channels of all three regions ranked green i.e. attained a QA score of over 90%
USAID/PAKISTAN’S MCH PROGRAM, FAMILY PLANNING/REPRODUCTIVE HEALTH COMPONENT
QUARTERLY PROGRESS REPORT (January –March 2016) P/8
Figure-5: Public and private service providers trained with USG Funds in Q2 (Jan– Mar 16)
Figure-6: Regional QA Scores and QA Visits in Q2 (Jan-Mar 16)
Figure-3: Comparison of participants trained in Q2, segregated by modules Q1 and Q2
Figure-4: Comparison of participants trained in Q1 and Q2, segregated by gender Q1 and Q2, segregated by gender
83%82%
90%
88%
90%91%
95%
90%91%
75%
80%
85%
90%
95%
100%
Sukkur Karachi Hyderabad Sukkur Karachi Hyderabad Sukkur Karachi Hyderabad
SF-A SF-A+ OR
2077
136
572
0
153
0
100
200
300
400
500
600
700
FPRH Y3 Q1 FPRH Y3 Q2
FP Clinical FP Counselling Community Mobilization
6 44
150
758
0
100
200
300
400
500
600
700
800
900
FPRH Y3 Q1 FPRH Y3 Q2
Male Female
118
684
0100200300400500600700800
Public Service Providers trained Private Service Providers trained
USAID/PAKISTAN’S MCH PROGRAM, FAMILY PLANNING/REPRODUCTIVE HEALTH COMPONENT
QUARTERLY PROGRESS REPORT (January –March 2016) P/9
CHAPTER 3
OBJECTIVE 2: SCALING UP FACILITY-BASED SERVICE DELIVERY
Overview
Suraj SF plays an essential role in addressing the unmet need for FP/RH in rural, remote areas. Two categories of Suraj providers (SFA5 and SFA+6) are located in underserved low income communities. To help facilitate community access to a range of quality voluntary family planning services, each provider is assigned an FHE. These FHEs reach the target population through household visits, Mohalla7 meetings, Mashwara8 meetings. They inform women about the Suraj facilities, promoting an informed voluntary choice regarding modern family planning methods. For clients of low socioeconomic status with minimal, if any, access to FP services, FP/RH provides vouchers to make the voluntary FP service of choice available to marginalized members of the community.
Performance and Achievements
SF highlights:
Voluntary FP services were provided through a network of 301 SF providers across four regions: Karachi (52); Hyderabad (108); Sukkur (102); and Multan (39)
289 FHEs supported demand-generation for SF providers, with 255,099 household visits, 834 Mohalla meetings, and 212 Mashwara meetings, reaching 303,099 MWRA
A total of 214,604 CYPs were generated 89% of the CYPs generated were from voluntary uptake of modern long term (LT) FP methods 85,316 clients were served, of which 49% chose long-term FP methods, i.e. intra uterine contraceptive
device (IUCD) and implants 67,283 clients were given the FP method of choice using vouchers distributed by FHEs to eligible,
willing clients The highest uptake in SF was for IUCD (41,272) with only a 1% removal rate. This was followed by
injectable (15,452) 1,513 voluntary tubal ligation (TL) and 493 implant services were provided by population welfare
department (PWD)-certified doctors in the Suraj network (SF A) The majority of the women who opted for a permanent method service were aged between 25-35
years, opting for a voluntary TL service after having 5-6 children
Regional SF Performance
The highest number of CYPs were achieved by Sukkur region through its network of 102 SF providers: they also attained the highest CYP generated per provider
Hyderabad had the highest percentage of paying clients i.e. 28% of total clients
SF Quality Scores
The quality assurance (QA) team visited 32 providers in the Sukkur region (attaining an average QA score of 85%); 28 providers in Karachi (average QA score of 85%); four providers in Multan (average QA score of 94%); and 47 providers in Hyderabad (average QA score of 91%)
5SF A are mid-level providers who provide short-term and long-acting (IUCDS only) FP methods 6SF A+ are doctors who can provide a full range of comprehensive FP services (short-term, long-acting, and permanent) after receiving PWD certification for implants and TL 7Mohalla meetings are conducted by FHEs with a group of MWRA who are educated on women’s health issues, especially healthy timing and spacing of pregnancies and are provided information on FP methods and the voluntary FP services available in the community 8Mashwara (consultation) meetings include SSF provider’s participation together with FHE in a group meeting, where the community women get an opportunity to ask questions directly from the provider and seek consultation on FP Services.
USAID/PAKISTAN’S MCH PROGRAM, FAMILY PLANNING/REPRODUCTIVE HEALTH COMPONENT
QUARTERLY PROGRESS REPORT (January –March 2016) P/10
4%
89%
7%
Short term Long term Permanent
Region Provider
SF-A Provider
SF-A+ Total
providers
Hyderabad 88 20 108
Karachi 42 10 52
Multan 36 3 39
Sukkur 89 13 102
Total 255 46 301
Table-2: Region wise overview of SF providers Q2
Figure-7: Comparison of SF services Q1 vs Q2
73,675
85,316
65,000
70,000
75,000
80,000
85,000
90,000
Qtr. 1 Qtr. 2
Figure-8: CYPS disaggregated by method mix in SF Q2 (Jan-Mar 2016)
Figure-9: CYPs Generated and MWRA reached in Q2 (Jan-Mar 2016)
285,894
303,099
182,376
214,604
110,000
160,000
210,000
260,000
250,000
270,000
290,000
310,000
Oct 15 - Dec 15 Jan 15 - Mar 15
MWRA reached CYP generated
Figure-10: Comparison of SF CYPs generated in Q1 and Q2, Segregated by method mix
Figure-11: CYPs generated by FP method in SF (Jan-Mar 2016)
6,888
163,688
11,8007,866
191,608
15,130
0
50,000
100,000
150,000
200,000
250,000
Short-term Long-term Permanent
Q1-FY 2016 Q2-FY 2016
2,293 1,711 3,863 158
189,630
1,714 10515,130
0
40000
80000
120000
160000
200000
Co
nd
om
s
Pill
s
Inje
ctio
ns
Mu
ltilo
ad
Co
pp
er T
Jad
elle
Imp
lan
on
Tub
al L
igat
ion
s
Short Term Methods Long Term Methods Permanent Methods
Figure-12: Parity distribution among TL clients in SF Q2 (Jan-Mar 2016)
Figure-13: Age distribution among TL clients in SF Q2 (Jan-Mar 2016)
40
440
681
270
6913
3% 29% 45% 18%5%
1%
0
200
400
600
800
1-2 3-4 5-6 7-8 9-10 10+
Nu
mb
er o
f TL
Clie
nts
Number of child(ren)
4
981
454
59 13 2
0%65% 30%
4% 1% 0%0
200
400
600
800
1000
1200
< 25 25 - 35 35 - 40 40 - 45 45 - 49 > 49
Age group
Nu
mb
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f TL
clie
nts
USAID/PAKISTAN’S MCH PROGRAM, FAMILY PLANNING/REPRODUCTIVE HEALTH COMPONENT
QUARTERLY PROGRESS REPORT (January –March 2016) P/11
CHAPTER 4
OBJECTIVE 3: SCALING UP OUTREACH AND COMMUNITYBASED
SERVICE DELIVERY
Overview The Outreach intervention in the FP/RH service delivery model provides a comprehensive range of FP methods to underserved communities who do not have access to a full range of FP services; particularly long acting permanent methods (LAPMs). OR teams are trained and certified by the PWD in Implant insertions and TL. Leveraging public sector infrastructure, the outreach program utilizes public health facilities with functional operating theaters in close coordination with district health officials. Camp plans are shared and support from LHWs is solicited for making referrals for clients seeking to avail a voluntary LAPM. OR services are delivered across the four FP/RH project regions. An additional aspect of this intervention is the Outreach Mobile Unit (OMU) which enables access to clients living in communities who neither have access to public health facilities nor private clinics for availing an FP method of choice. Clients are provided with a voluntary short or long term method of choice by trained staff in a refurbished and equipped vehicle. The OMU staff in Punjab have PWD certified doctors who can provide voluntary implant services to clients in addition to IUCD and injectable services, thereby expanding choice.
Performance and Achievements
OR highlights:
A complete range of voluntary FP services were provided through 14 trained/certified OR teams and 4 OMUs
489 OR camps were conducted across the four regions 138 FHEs supported demand-generation activities for the USG supported OR teams and OMUs,
conducting 101,556 household visits, 763 Mohalla meetings and 86 Mashwara meetings, reaching a total of 122,421 MWRA
64,790 CYPs were generated in the reporting period 64% of the CYPs were generated through provision of permanent methods A total of 26,337 clients were served 4,177 voluntary TL were provided, and 869 implants inserted by PWD-certified doctors in the OR
teams A majority of the women opting for permanent methods were in the 35–40 year age group; with the
majority opting for a voluntary TL after having 5-6 children
OR Quality Scores
The QA team visited:
Three OR teams in the Sukkur region, attaining an average QA score for this quarter of 95% Seven OR teams in the Karachi region, attaining an average QA score for this quarter of 90%
USAID/PAKISTAN’S MCH PROGRAM, FAMILY PLANNING/REPRODUCTIVE HEALTH COMPONENT
QUARTERLY PROGRESS REPORT (January –March 2016) P/12
Region Total camps
Hyderabad 204
Karachi 63
Multan 99
Sukkur 123
Table -3: Region wise camp conducted in Q2 Figure-14: Comparison of services for OR in Q1 vs Q2
20,420
26,337
0
5,000
10,000
15,000
20,000
25,000
30,000
Qtr. 1 Oct 15 to Dec 15 Qtr. 2 Jan 16 to Mar 16
10%
26%
64%
Short Term
Long term
Permanent
402 4,845
578 352 - 132
13,409
3,302 - -
41,770
-
10,000
20,000
30,000
40,000
50,000
EC
Co
nd
om
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Pill
s
Dep
o
No
ri
Mu
ltilo
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Co
pp
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Jad
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Imp
lan
on
Fem
pla
nt
Tub
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igat
ion
s
Short Term Methods Long Term MethodsPermanent Methods
6 11 10 9 14 1524 28 34 37 31 35
8291
11186
134 134
0
50
100
150
200
Oct 2015(138)
Nov 2015(174)
Dec 2015(167)
Jan 2016(157)
Feb 2016(153)
Mar 2016(179)
AV
G N
UM
OF
CYP
S /
PR
OV
IDER
/MO
NTH
Permanent
Long-Term
Short-Term
15
731
2080
1062
230 59
0%18% 50% 25% 6% 1%
0
500
1000
1500
2000
2500
1-2 3-4 5-6 7-8 9-10 10+
Nu
mb
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f TL
Clie
nts
hav
ing
Number of child(ren)
2
1156
1984
1017
18 0
0% 28% 47% 24% 0% 0%
0
500
1000
1500
2000
2500
< 25 25 - 35 35 - 40 40 - 45 45 - 49 > 49Nu
mb
er o
f TL
Clie
nts
Age group (Year)
Figure-15: CYPs generated in Q2 (Jan to Mar 16) Figure-16: CYPs generated by method in Q2 (Jan to Mar 16)
Figure-17: Average CYP generated per camp – monthly trend analysis for Q1 & Q2
Figure-18: Parity Distribution among TL Clients in OR in Q2 (Jan-Mar 16)
Figure-19: Age distribution among TL Clients in OR in Q2 (Jan-Mar 16)
USAID/PAKISTAN’S MCH PROGRAM, FAMILY PLANNING/REPRODUCTIVE HEALTH COMPONENT
QUARTERLY PROGRESS REPORT (January –March 2016) P/13
Confronting Challenges QA scores for Sukkur decreased by 5% in SF. 15 new SF providers were added to the region this quarter. The QA made action plans following their QA visits which were followed up accordingly. Refresher trainings were arranged on infection prevention (IP) and STI. With more frequent visits by the QA teams in the coming quarter, it is expected that gaps will be addressed and QA scores will improve for the new providers. The OR intervention provides a comprehensive range of voluntary FP services, including LAPM, which is critical to expanding choice within the broader context where LHWs provide STMs. Although 90% of the CYPs in OR came from LAPM (64% from voluntary sterilization and the remaining 26% from LARC (21% from IUCD and 5% from Implants)). A gradual increase in the number of clients has been witnessed for short term methods, contributing to 10% of CYPs generated by OR in the reporting period. This is especially expected in areas not covered by LHWs and also where LHWs are out of FP stocks. FP/RH is working towards increasing the capacity of LHWs and equipping them with the knowledge of a full range of FP methods. This is expected to enhance their role in voluntary FP service provision; making referrals for LAPMs; and for addressing discontinuation by providing effective counselling to address their concerns during door to door visits. FP/RH is also supporting MCH partners in their advocacy for strengthening the LHW program by improving coordination and identifying and communicating service delivery gaps. Further advocacy is planned for strengthening the LHW Program through John Snow International (JSI), leveraging their government partnerships in public health. Effective provision of services in OR was a tangible challenge during the early half of Q2. Teams focused on better coordination with district health officials aiming at zero camp cancellations in public health facilities; quick adaption to changing field situations e.g. converting OR teams to OMU in the Rahim Yar Khan district where the environment is not conducive for TL camps. It was encouraging to note that service provision gradually increased over the three months of the reporting period, representing more effective utilization of project resources and increased access to voluntary FP for clients. Reaching MWRA in far flung and remote communities in the catchment populations is a challenge. The FP/RH team is working on a comprehensive community mobilization strategy to better reach these communities, with geographical zones being defined for each catchment population and districts identifying volunteers and communities in each zone. This is expected to build ownership of communities and facilitate reach to more challenging groups. Community social volunteers (CSV) and community resource groups (CRG) will be engaged to reach FHEs within catchment populations.
Lessons learnt for attaining success
The FP/RH service delivery model is carefully designed to complement FP service provision by the public sector. The SF intervention builds capacity of mid-level providers to provide LARC services in communities with access only to STM through LHWs (if operational in that area). The presence of an SF provider therefore expands choice by expanding the range of FP methods available. This is evidenced by 89% of CYPs generated in SF in the reporting quarter being from voluntary uptake of modern long term FP methods. The remaining 7% is generated though provision of voluntary sterilization by a small sub set of SF A+ providers who are doctors and are PWD certified for provision of LAPM. Only 4% of CYPs generated in SF are from short term methods, frequently provided in areas where there are no LHWs.
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The OR intervention further compliments this service delivery approach through engaging doctors trained by the PWD in LAPM. This intervention addresses high unmet need for permanent methods as SF, being mid-level providers, can only provide IUCD as a long term method of choice. 64% of CYPs generated in OR were through the provision of voluntary TL. OR also provides access to voluntary uptake of implants which make up 5% of OR CYPs versus 1% in SF as SF is largely operated by mid-level providers who are not eligible for the provision of implants. OR camps are conducted at public health facilities. Through this effective public private partnership, FP/RH together with the support of Government of Sindh (GoS) is able to provide MWRA full range of comprehensive voluntary FP services to support the achievement of FP2020 commitments.
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CHAPTER 5
CROSS-CUTING THEMES
Research The research department promotes data-driven decision making and strategy development. It provides contextual evidence to support improved organizational and national policies. Updates for the current reporting quarter are listed below. Client Exit Survey 2015: Data collection is complete and data analysis is underway. Report writing
and dissemination will take place next upcoming quarter. Provider insight study: This study explored social and organizational facilitators and barriers that
effect provision of family planning services. Findings of the study reflect sustainability options, quality of provision, and challenges in the service provision. The final study report is under review by the senior project management team.
Willingness to pay/financial sustainability study: To improve financial sustainability for family planning services in the Suraj Social Franchise network in Pakistan, FP/RH has planned a study to investigate clients’ willingness (current and potential) to pay. The study will also explore how changes in price would affect demand and how socio-demographic factors affect perception of clients, FHEs, and providers on ‘willingness to pay’ (WTP) for contraception. Study protocol and data collection tools are being developed with Marie Stopes International. Approval from local and international ethics review boards will be sought in the next quarter.
A study for non-user clients: To understand the beliefs and practices among non-users (males and females) in adopting voluntary family planning in Pakistan, FP/RH plans to conduct a qualitative study in upcoming quarters. The concept note of this study has been approved by the MCH Program monitoring and evaluation working group and suggestions incorporated in the study protocol.
Participation in events and training sessions: The research team attended an international conference on family planning in Indonesia. There is a global focus on reaching poor communities, adolescents, and those who are in most need using advanced technological tools. MSI organized a session on the definition of an ‘additional user’1 and how programs could align their goals with national/global FP2020 commitments.
Capacity building: The FP/RH research, monitoring & evaluation department promotes evidence-based decision making by building the capacity of its staff in research, monitoring and evaluation skills. This quarter, a survey on RME training needs was conducted to assess the knowledge of personnel in the organization. Based on this assessment, customized trainings will be organized next quarter. This will strengthen the research infrastructure by increasing the skill set of the staff and improving the quality of research throughout the project.
Monitoring and Evaluation The M&E component ensures the consolidation and reporting of key performance indicators. The component coordinates with FP/RH sub-departments to ensure the timely generation and dissemination of information to management for evidence-based decision making. This quarter the M&E team worked on: Performance Monitoring Dashboard: The M&E team is streamlining and integrating all data from
multiple sources, such as service provider profiles, service numbers of SF and OR, training and QA data. A consultant is developing interactive dashboards to improve program decision making.
9Refers to a net increase in the absolute number of users above a specified baseline
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SF Trend Analysis: The RME department analyzed service data from the program’s inception through December 2015. This revealed: 1) a dip in client flow during scale up, but productivity soon returned; 2) SF providers take 7–9 months on average to reach peak productivity (client flow), then productivity can be expected to level off; and 3) The provider drop-out rate was about 19% (mainly due to failure to comply with MSS protocols, followed by personal reasons).
Implementation of TrainNET Software: The team is working on issues highlighted by the TrainNET software which were discussed during sessions led by USAID. Guidelines are being developed to optimize its implementation.
USAID Pak Info Training Session: The M&E team attended the MCH Pak-Info training session in quarter 2 of the reporting period. They were instructed to enter data against three indicators: number of women served, number of people trained, and changes in the sites (Suraj facilities). They agreed to upload annual reports, the updated M&E plan, success stories, and any relevant narrative reports on Pak-Info under the heading of USAID.
Sharing of Train-Smart software template: The team developed a report template for the Train-Smart software. The template has been shared with maternal and child health integrated program (MCHIP) for feedback. The software will be used for database management instead of Excel spreadsheets.
Project Monitoring Plan (PMP) for FP/RH sent for review: The M&E team developed a first draft of the FP/RH Project Monitoring Plan. The PMP draft is being reviewed by the project’s senior management team.
Helpline
During the reporting period, the helpline provided counseling/information (65% of total calls), referrals (19% of total calls) and side-effect management (16% of total calls) information to its callers. Outbound call facility contributed to 14% of total calls, indicating that the call back service is vital to the platform. The number of calls related to reproductive health increased during the reporting period. The main queries were about the human immunodeficiency virus (HIV), sexually transmitted infections (STIs), menstrual cycles, and infertility.
7,210 62% 22% 63% 15% callers served this quarter
of callers under the age of 30
referred via helpline cards
consented to being contacted back via
helpline
Male callers
Promotional activities to stimulate call volume were conducted during Q2:
Competence-building trainings
Refresher training –March 15, 2016 USAID compliance training by HSD – March 21, 2016
M-Heallth initiative
Helpline generates three messages a day, weekly to FHEs
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Helpline promotion partner guidelines
Standardization guidelines for MCH partners Guideline presented to health communication working group (HCWG) – February 25, 2016
Leveraging strong on-ground presence
A ‘one call per FHE per day’ strategy – FHEs encouraging clients to avail MCH Helpline Demo calls and helpline promotion cards Regular field visits by program management
Helpline message handling compliance
Helpline has developed ‘guides’ to ensure compliance with USAID requirements, including US abortion and FP guideline compliant scripts.
Communications
Branding and Marking
To ensure compliance with USAID’s branding and marking policies, the FP/RH Technical Services Department (TSD) developed the Branding and Marking checklist for the project, regional and district offices. This checklist ensures that USAID-funded items are branded and marked according to USAID guidelines. To ensure the visibility of USAID’s brand and to acknowledge the assistance “From the American People,” TSD developed a dashboard to identify, monitor and address branding and marking compliance issues. Subsequent action plans will be guided by the dashboard results.
Behavior Change Communication (BCC)
Behavior change communication is an evidence-based, collaborative process. It consists of working with individuals, communities, and societies to develop communication strategies for positive behavior change and to create a sustainable environment for positive behaviors. Field teams and FHEs reach communities through door-to-door visits, Mohalla, and Mashwara meetings to mobilize MWRAs. One FHE supports each provider who serves a catchment population of around 25,000. For the FHE, coverage is a major challenge. Social mapping and formation of CRG and community social volunteers (CSV) were introduced to tackle this challenge.
Social Mapping
Social mapping is the division of a district into smaller, more manageable ‘zones’ for improved coverage and better monitoring.
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Community Resources Groups (CRGs)
CRGs Are groups of influential volunteers which act as a link between the community and FP/RH teams. CRGs also provide logistic and communication support to the FP/RH teams.
Community Social Volunteers (CSVs)
CSVs are volunteer change agents within each zone. They help the FHEs with their insights into the community.
Family Planning Interpersonal Communication Toolkit (FP IPC Toolkit)
FP IPC toolkit was brought to its final stages of development after multiple revisions and consultations with PWD and the National Program for Family Planning and Primary Healthcare Sindh.
Community Mobilization (CM) trainings
The Kirkpatrick model for training evaluations is being applied to the CM trainings on a pilot basis. The model includes training evaluation at four levels i.e. Reaction, Level, Behavior and Results Level.
Program Management
People and development
The FP/RH people and development function hires, supports, and retains high-quality human resources. This quarter, 95 new people were hired to strengthen the program, especially in operations (92% of all Q2 hiring). An extensive performance-appraisal exercise was carried out in February, 2016, to ensure individual performance evaluations and to stay competitive. This was followed by the rollout and training of the human resource (HR) checklist to ensure pre- and post-hiring compliance.
In line with focus areas identified during the appraisal process, and as part of the P&D mandate of capacity-building, multiple trainings were conducted during the reported quarter. These included Microsoft Excel intermediate skills training, effective communication training, and time management training. FP/RH takes pride in its human resources, ensuring that they are empowered and trained to meet high project standards.
Information Technology (IT)
Tax Management System application: A tax management application was designed by IT mainly for procurement. Certain payments (above a set value) require additional authorization/ tax verification. The tax management application isolates these transactions within the system and notifies the procurement function to ensure appropriate treatment.
Technical assistance from MSI Marie Stopes International (MSI), as a sub-awardee to MSS for the Family Planning and Reproductive Health Project Component 1, funded by the USAID, is tasked with providing technical assistance to MSS. MSI brings to MSS its international wealth of experience through its staff who provide technical assistance remotely and in person as well as guidelines, systems and toolkits to further enhance the quality of MSS’s delivery of the FP/RH project.
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During the reporting quarter, the regional research advisor visited Karachi and provided remote and in-country assistance for research activities including the willingness to pay study and the outreach continuation study. Support was provided to hire the new IT manager and MSI rolled out the ‘Success Models’ workshop, which will support implementation of good practice and sharing of best practices across projects.
Procurement & Logistics
Guidance on selection, sourcing, and procurement of rapid diagnostic tests that meet USAID quality requirements for Restricted Commodity Approval and facilitated final USAID approval for this.
Information Technology & Services
In January, a new IT Manager was hired to support all MSS projects including FP/RH. An induction was provided and together with MSI’s Chief Information Officer (CIO), they initiated a review of MSS’s IT organization design and identified priorities to be addressed. The CIO provided technical assistance for the implementation of an IT helpdesk and continued support for the Enterprise Resource Planning (ERP) system. This included its implementation in remote offices and integration with the corporate finance ERP which will support better visibility and control of the supply chain, particularly for inventories. In March, the CIO developed options to capture social franchise data utilizing local applications (Flame) and emerging global solutions (DHIS2) to improve the visibility of services provided by franchisees.
Security Management
The global security manager held weekly meetings with the GM security on context updates, traveler schedules and feedback. Three traveler briefings were conducted and four security incident reviews. Support was provided for the visitor standard operating procedures (SOP), the Proof of Life system and the Employee Travel Monitoring System.
Medical Development and Quality
Working closely with MSS, terms of reference have been developed for a training systems workshop to be held in Y3 Q3, and to plan all content for co-delivery by the global training lead, MSI’s regional medical adviser and members of MSS’ training team. The objectives of this workshop are: a) for six candidates from MSS's training team to receive instruction on how to conduct training of trainers and support the ongoing development of quality assured clinical trainers, and b) to agree a process and system-design by which candidates receive and act on the results of competency assessments carried out during continuous supportive supervision meetings. The workshop will include an interactive debrief session with FP/RH staff to plan their participation and cascading of the training.
Social Franchise and Health Financing
Support continued for the domestic diversified health financing strategy and work began on a voucher scoping study which will provide a comparative analysis between current practice and MSI’s voucher management standards. This will help guide improvements and technology innovations in the voucher management system.
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A continued focus on sustainability has been supported through input into a video detailing the value proposition of the Suraj Social Franchise network and a technical review of FP/RH’s sustainability framework which builds upon MSI’s ‘sustainable health market for choice’ strategy to strengthen supply, consumption, support, and regulation of health care. Work has begun on provider behavior change and support was provided for the development of the IPC toolkit.
Research, Monitoring and Evaluation (RME)
MSI reviewed the methodology and liaised with potential partners for the willingness to pay study; reviewed the protocol before submission to the MSI and national Ethics Review Committee for the outreach continuation study; and reviewed the concept note and methodology for the safe motherhood (SMH) voucher study. The willingness to pay study will help teams understand how to make programs more sustainable while maintaining equity and the outreach continuation study will assist with understanding problems faced by clients to continue or discontinue a method in an outreach setting. At the end of March, an in-country technical visit provided in-person support for these studies and other ongoing research activities including mothers-in-law, never users and provider studies. The RME advisor and the FP/RH TSD team, conducted a review of the department structure and drafted a new organogram. Support was provided for M&E processes, including information analysis and dissemination, the helpline and social franchise data for the M&E working group.
Finance and Audits
Support was provided in valuation of donated stock, its associated clearing costs, and developing the accounting treatment for these costs to improve clearing cost attribution to the project. Technical assistance was also provided for the global audit, financial reporting, and financial compliance.
Other Technical Assistance
Technical assistance in USAID compliance included reviewing contract modifications, project reporting, and sub-awardee management was provided. In February 2016, the newly recruited Head of Program Support (for the MSI sub-award) received an induction in MSI’s London head office. This included meeting all technical teams, clarification of roles and responsibilities, and the ongoing development of MSI’s sub-award work plan. Unfortunately, the incumbent resigned shortly after her return to Karachi. Recruitment for a replacement is underway. In March, MSI held a ‘Success Models’ workshop in Bangkok. The FP/RH Director of Operations attended this workshop aimed at developing and sharing best practices to improve delivery through the social franchise and outreach channels. Workshop participants were challenged to identify key areas to improve implementation which will be tracked throughout the year.
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Liaison
Government Liaison
One of the Sustainable Millennium Development Goals is to achieve a contraceptive prevalence rate (CPR) of 55% in Pakistan by 2020. FP/RH is working towards meeting these goals through partnerships with government and private stakeholders.
During the reporting quarter, a major victory was the achievement of a consensus on the FP messages drafted by Johns Hopkins University Center for Communication Program (JHU-CCP). With minor revisions, endorsement was received from the PWD, LHW program, and the MNCH program for the FP Messages. These would serve as the guiding principles for the FP IPC toolkit which is under development in close coordination with the LHW Program.
Technical Advisory Group meeting on Development of FP IPC Toolkit:
FP/RH hosted a meeting on January 20, 2016, to share developed content and insights with stakeholders. The meeting was attended by representatives from PWD-Sindh, MNCH Program, National Program for FP & PHC, and MCH partners.
Consultation Workshop with LHW Program on revising the content for the FP Curriculum: The project team met with the LHW program on January 20 to discuss the FP curriculum and IPC toolkit. A consensus was developed regarding toolkit approach, content, and layout.
Workshop with MNCH Program on Gap analysis for the FP IPC Toolkit from CMW Perspective: A meeting with the MNCH on January 21 further reviewed the FP IPC Toolkit from the perspective of its potential use by the CMWs.
Consultation Workshop with LHW Program on identifying the gap in the FP IPC Toolkit: With a high level of cooperation by the NP for the FP & PHC coordinator, a follow-up workshop was held in Hyderabad on February 29. LHS insights were helped in finalizing the content of the FP IPC toolkit. Some remarks by LHSs during the consultative workshops: “Previously we were just given material and trained on it, but for the first time we are getting to put forth our experience and integrate it into something that we will utilize in the field.”
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IRMNCH visits OMU in Ahmed Pur East (Bahawalpur)
The OMU team was visited by the Deputy Program Manager Integrated Reproductive Maternal Newborn Child Health (IRMNCH) at Basti Kotana, Ahmed Pur East (Bahawalpur) on January 29, 2016 and was introduced to the working of OMU, the project, and overall MSS operations.
MCH Partners
The Bright Star Design Workshop: FP/RH participated in “The Bright Star Design Workshop,” conducted by the Johns Hopkins University Center for Communication Program (JHU-CCP) in Karachi from March 15–18, 2016. FP/RH has committed to assisting JHU-CCP identify Bright Stars in its program and communities of influence in order to promote talent within the organization and the sector.
After months of collaboration
and technical consultations, the
National Program for FP & PHC,
PWD and MCH partners finally
developed a consensus, with the
government turning into strong
proponents of the FP toolkit and
its messages.
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Creating Exponential Impact: Maulana Siddique (’maulana’ is the reverential term for a senior cleric), resides in the village of Moluvi Haji Khaskheli, near Mirpur Khas. The village mainly comprises clerics who follow a conservative interpretation of Islam. His approach to family planning was also quite conventional. Traditionally, this village was very resistant to any family planning messages and as such, did not entertain FP teams in the district.
Clerics, almost always male, are influential in their communities. Their beliefs and approaches guide the whole community and determine many practices. Maulana Siddique would tell FP teams to leave immediately and not to come back again. But all that changed after a soul-searching dialogue between the FP/RH FHE and the cleric:
“They had a unique way of communicating with me. Despite my initial stance, they requested I listen to them and if I didn’t like
what they said, they’d go away and never bother us again. Then they asked if my wife was just as religious as I was, and if she
prayed five times a day and fasted during Ramadan? I said no, she doesn’t because she looks after our five children, does the
housework, and helps me in farming. And she cannot fast because she is very physically weak. And that is when I realized that
because our way of living was not healthy it was not only affecting her quality of life but was also hindering with her religious duties
as well. I am really thankful to them, if they hadn’t made me realize this, I would have never known.”
He further added, “This meeting has opened my eyes to the benefits my family can have by adopting family planning services. Now, not only have I helped my wife get a service (IUCD), but I have spoken to many people in the community and encouraged them to look after their families in a similar manner... I like the way they work, they listen to us and take their time in answering our questions and have never pressured us into making a decision.”
Changing the perspective of Maulana Siddique, a major influencer in his community, is likely to create a lasting impact. The village of Moluvi Haji Khaskheli is already on its way to a healthier future with greater access to FP resources and methods.
CHAPTER 6
IMPACT STORIES
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Sharing Hope: Chandan Bhagwani (wife of Achar) is a resident of the village of Qurban Mangrio. Aside from being a housewife, she also helps out her husband, a tenant farmer. She has eleven children (six girls and five boys) and has taken a voluntary TL service from the FP/RH project. Chandan has lived all her life at Qurban Mangio and has very little exposure to the outside world. There are no healthcare facilities and hardly anyone from the nearby towns or city comes there. Her village is one of the few far-flung areas where the FP/RH project provides family planning services through its OR services. Previously, their village rarely had anyone visit for health-related matters.
“I thought that they would just provide the service and they would never come back, but their support has been
consistent. I now have a chance to live a much healthier life and look after my home.”
In the past, Chandan had very little knowledge of FP and would get pregnant frequently, resulting in her poor health and financial difficulty in looking after so many children. She states, “We had no information about this (FP methods), and my health suffered a lot because I had babies very frequently. This also compounded our financial problems, since we have meager resources and so many children to look after. But thanks to them (OR team), I was able to get the services I need.”
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Terath - a Bright Star: Terath is a one of the few male community mobilizers working for the FP/RH project. He is a part of the OR team from Mirpur Khas in Sindh. His community comprises of mostly tenant farmers residing in remote villages, largely populated by a minority (Hindu) community. These villages are cut off from the main city and have a poor health and FP infrastructure. A further challenge is that these communities are miles away from any public or private healthcare facilities. In addition to the distance, village residents are further disadvantaged by a lack of transportation and inadequate funds to pay for transportation. The FP/RH project reaches out to these far-flung areas through Terath. As the district’s male mobilizer, his duties include talking to the male members of his community to tell them about family planning. He answers the queries they have and also refers them to the project’s OMU team in case of more technical questions. He takes pride in counseling people in his community, especially the males.
“Ours is a patriarchal society. The number of children a woman will have is mostly decided by the man, and, sadly, they too (like the women) have very little knowledge of FP
methods. Furthermore, this is a topic that is hardly ever discussed between them, and because of the social set-ups, it
is very difficult for them to admit that they have very little knowledge of such things, despite having a genuine need for
family planning methods. And since hardly anyone comes out here, getting the right knowledge and accessing services is
also very difficult.”
He further added. “But things are different now, thanks to them (FP/RH’s OMU team), we have managed to reach out and benefit so many people in my village and the areas near it. They are happy that someone out there cares for them, provides them a service of their choice, and has the patience to answer all the questions they have. I am extremely grateful to them, they took their time, trained me, made inroads into my community, and now people have an option of good quality services and healthier lives.” The FP/RH project is proud of the contributions Terath is making towards improving family planning and reproductive health access to underserved populations. Terath is a bright star.
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ANNEX-1:
Key Performance Indicators (To-date)
Indicators
Year 1
(Through
Sep 14)
Year 2
( Oct 14 to
Sep 15)
Year 3 ( Oct 15
to Dec 15) Qtr.
1
Year 3 (Jan 16
to Mar 16)
Qtr. 2
Total to
date
Family Planning Clients Served
SSF Network 103,808 198,105 73,675 85,316 460,904
Outreach 38,898 40,389 18,382 23,363 121,032
OMU 0 2,205 2,038 2,974 7,217
HANDS 0 908 545 0 1,453
MCH 0 782 200 114 1,096
Total 142,706 242,389 94,840 111,767 591,702
CYPs Generated
SSF Network 212,863 419,001 182,376 214,604 1,028,844
Outreach 126,159 168,437 57,049 62,575 414,220
OMU 0 1,632 1,951 2,215 5,798
HANDS 0 1,432 2,414 0 3,846
MCH 0 1,662 270 238 2,170
Total 339,022 592,164 244,060 279,632 1,454,878
Maternal Deaths Averted
SSF Network 133 197 60 68 458
Outreach 85 90 19 20 214
Total 218 287 79 88 672
Unintended Pregnancies Averted
SSF Network 95,552 164,699 63,469 74,791 398,511
Outreach 64,404 75,806 21,966 23,577 185,753
OMU 0 518 565 594 1,677
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HANDS 0 525 955 0 1,480
MCH 0 607 98 84 789
Total 159,956 242,155 87,053 99,046 588,210
Number of USG Supported Service Delivery Channels
SSF Network 135 165 +4(-24) 37 (-20) 300
Outreach Teams 12 6 0 0 18
Number of People Trained
FP Clinical 1,454 532 25 79 2,090
FP Counseling 288 2,058 188 659 3,193
Community Mobilization 162 162
SMH Clinical 0 19 0 0 19
SMH Counseling 0 43 0 0 43
Other 263 242 0 0 505
Total 2005 2,894 213 900* 6,012
Number of Calls on MCH Helpline
No. of Calls Received 72,010 36,512 9,806 7,210 125,538
*The total number trained includes 802 service providers and 98 project staff
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USAID/PAKISTAN’S MATERNAL CHILD HEALTH PROGRAM
FAMILY PLANNING/REPRODUCTIVE HEALTH COMPONENT
Marie Stopes Society
5th Floor | Clifton Diamond Building | Block V | Clifton | Karachi | Pakistan
Tel: 92-21-35205596 | Fax: 92-21-35291049 | Web: www.mariestopespk.org
________________________________________________________
24 Hour Free Helpline – 0800 22333 Online Advice – www.srhmatters.org