Repositioning in Action E-Bulletin
August 2006
The e-bulletin was developed to provide a forum for the exchange of information, experiences, and lessons learned as we work to improve sustainable access to quality family planning services and commodities.
Table of Contents
Mainstreaming Best Practices to Boost Family Planning Programs
USAID has identified some key best practices that it would like to see integrated into its family planning/reproductive health (FP/RH) programs. These practices and interventions have been carefully researched and evaluated across many different settings and have been shown to boost results and improve program effectiveness. USAID is supporting efforts to use these research results in more of its programs globally.
The following criteria determine USAID’s selection of key practices in reproductive health:
- Cost: Key practices are inexpensive to implement and do not require significant additions to the existing program in terms of capital or human resources or long-term technical assistance.
- Potential impact: They have high potential for impact on increased use of contraception or other RH interventions.
- Evidence of effectiveness: There is solid evidence that they work and also experience with replicating them or bringing them to scale.
This issue of the E-Bulletin discusses four clinic-based key best practices; the next issue will address community outreach practices.
The clinic-based practices are:
- Using simple provider checklists for pregnancy detection and helping clients choose oral contraceptives, injectable contraceptives, or intrauterine devices:
- Where pregnancy tests are unavailable, health providers often deny contraception to nonmenstruating clients. Studies have found that in developing countries, approximately 10 to 20 percent of women are refused family planning services until they have menstruated. Using the pregnancy checklist can reduce this barrier and has been validated with 99 percent effectiveness.
- Medical barriers can be reduced through accurate screening of clients for their method of choice using simple checklists.
- Available at: www.fhi.org/en/RH/Pubs/servdelivery/checklists
- Systematically screening clients to improve integrated health:
- To improve the impact of integrated programs, health providers can be trained to provide or refer clients to a wider range of services. A simple algorithm called Systematic Screening guides the provider in assessing a woman’s health needs and ensures that she receives all the appropriate services for herself and her children.
- In pilot studies, Systematic Screening increased uptake of a variety of services between 15 and 25 percent; it has been shown to be cost-effective from the client’s point of view and has helped clinics improve their rate of service utilization.
- Available at: www.popcouncil.org/pdfs/frontiers/pbriefs/Sys_Scrn_brf.pdf [PDF, 337KB]
- Expanding the method mix to include natural family planning methods such as the Standard Days Method (SDM) using CycleBeads, the Lactational Amenorrhea Method (LAM), and other lesser used methods:
- SDM is an effective natural method of family planning developed through scientific analysis of the fertile time in a woman’s menstrual cycle.
- Women who correctly use LAM are more likely to become regular contraceptive users.
- Emergency contraception (EC) occupies a unique niche in terms of contraception; EC counseling should be readily available as part of family planning counseling.
- Adding contraceptive methods increases the number of contraceptive users; many natural and emergency methods “bridge” clients to other methods.
- Adding natural methods meets the needs of couples who desire to use a natural method of family planning and provides low-cost methods to the contraceptive mix; natural methods improve a couple’s dialogue about family planning.
- Following four simple ways to improve hormonal contraceptive provision:
- In order to remove unnecessary medical barriers and improve access to, compliance with, and use of hormonal contraceptives, providers can employ four easy strategies:
- The Quick Start method for oral contraceptives (OCs) – initiating OC use in the provider’s office
- Providing multiple packs of OCs to clients
- Following the newly developed WHO instructions regarding missed pills
- Knowing the DMPA grace period – two weeks before and two weeks after the appointment date
The above practices are acknowledged as important to any FP/RH program but have not been widely applied. USAID is disseminating information and tools about these practices to Missions and partners and facilitating actions by Missions to incorporate them. A recent assessment in Madagascar by USAID, the Ministry of Health (MOH), Sante Net, the Adventist Development Relief Agency, and Family Health International determined that many of the above practices, if brought to scale, could improve the provision of public health services. As a result of USAID’s recommendations, MOH norms and guidelines have been changed to include many of these practices, and USAID’s partners are collaborating to provide the MOH with technical assistance for training and monitoring these practices.
USAID plans to improve the available materials about these practices and link Missions and partners with assistance in adding them so they become a mainstream part of all quality FP/RH programs.
For more information, please contact: Elizabeth Warnick: ewarnick@usaid.gov
Religious Leaders Meet to Discuss Family Planning & Reproductive Health
Religious leaders from Mali, Ghana, Senegal, Mauritania, and Uganda have met to talk about family planning and reproductive health. The forum for religious leaders and scholars, with a theme of “Repositioning Family Planning,” provided an opportunity to discuss best practices, identify challenges (educational, social, cultural, and political), and reinforce each others’ efforts to engage members of their respective religious institutions in promoting family planning and reproductive health.
For the full story: www.usaid.gov/stories/afr_regional/ss_afr_famplan.html |
