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Case Study

Photo: USAID/Virginia Foley

"The Sidhauli Community Health Center displays a "star" award for its service and facility improvements. "Our trust has improved because now all the services are available and the fees are affordable," said community leader Raj Yadao.

Challenge

With 170 million people living in an area the size of Oregon, Uttar Pradesh is India's most populous state - and it is growing at the rate of 2.3 percent a year. It is a place where traditions are so strong that in some cases women leave their homes only twice: once when they marry and once when they die. Information about family planning and access to quality health care are limited. Mothers often dictate health and family planning decisions to their sons' wives, and many couples believe that they need to have two sons to care for them in old age. With teeming waiting rooms and unpredictable costs, many Indian medical facilities are not attractive to couples seeking help in family planning, giving birth — or even solving minor medical problems.

Initiative

As part of its effort to raise the quality of health services in Uttar Pradesh, USAID supports the 30-bed Sidhauli Community Health Center, funding facility improvements, management training and day-to-day operations. Sidhauli provides diverse patient services, including a complete range of family planning methods, birth spacing counseling and family health services for women and children. Counselor Shael Gupta was hired to talk to couples about family planning and contraceptive decisions.

Results

USAID's partner, the State Innovations in Family Planning Services Project, has awarded Sidhauli a distinctive "star" award for its service and facility improvements, and the center now prominently displays the award, listing its accomplishments. The health center now serves about 100,000 people. Ninety percent of the drugs provided by its pharmacy are free, and patients pay 1 rupee — about 2 cents — per 15 days of medical and emergency care, including childbirth services. According to a 2003 survey of Uttar Pradesh, use of modern contraceptive methods has increased significantly faster in areas where USAID has supported similar projects than in areas where USAID is not yet involved.

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