Bowen fp mch
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CORE Group Fall Meeting 2010. Family Planning Integration: Overcoming Barriers to NGO Programming. A Presentation of Preliminary Results from the CORE Group CBFP/MCH Integration Survey. - Paige Anderson Bowen, CORE Group Consultant
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Bowen fp mch
- 1. Family Planning Integration: Overcoming Barriers to NGO Programming A Presentation of Preliminary Results from the CORE Group CBFP/MCH Integration Survey Paige Anderson Bowen, MPH CORE Group Consultant CORE Fall Meeting; September 15, 2010
- 2. Survey Objective To generate a set of recommendations directed to the CORE SMRH Working Group and USAID on information, tools and other publication resources, and guidance that is needed to mobilize and support organizations to integrate CBFP into community-focused MCH programs
- 5. Key themes identified in open-ended questions using content analysis techniques
- 7. 132 individuals invited to participate; at least one HQ and one field representative invited from each target organization
- 8. 51 respondents (39% response rate); 38 complete surveys
- 9. Respondents…
- 10. Evenly distributed among HQ (35%), country head office (37%), and field office (28%)
- 11. Primary role of almost half of respondents (45%) is program design/management
- 13. Barriers to CBFP Integration
- 15. Elements of Integration Elements of integration, as defined by respondents… Expanding access (11%): “To take the opportunity offered by a service already delivered, often in routine, to ‘’vehicle’’ the delivery of another new service.” Affordability (9%): “Collaboration and combination of all activities related to health promotion and diseases prevention to obtain optimum coverage and cost effectiveness.” Improving Quality (7%): “Incorporation of one element into another (FP into HIV, FP into MCH, HIV into FP etc) so that the resulting combination is an improved, more accessible service package for the user.”
- 17. Less Effective Entry Points Sick child visits (53%): “When a child is sick, mothers are too upset to be able to understand or retain FP messages, plus the child is upset and likely crying - not a constructive environment for counseling.” PMTCT (71%): “PMTCT is primarily to ascertain pregnant mothers HIV status and ensure she can access appropriate services if HIV positive. FP should be discussed after HIV status is determined…” VCT/HCT (73%): “HIV/AIDS counseling and testing is usually a tense and stressful moment for many people. Adding in issues of FP may not be the most appropriate time.”
- 19. Effective?
- 20. Less effective?
- 22. Respondents ranked barriers on a scale of 1-5
- 24. Helpful Resources to Facilitate Integration
- 27. Frameworks: Postpartum FP Framework (Access FP, JHPIEGO), 7-11 Framework (World Vision), Birth Preparedness and Complication Readiness matrix (JHPIEGO)
- 28. Job Aides: CHW flipcharts, GATHER counseling tools, service checklists
- 29. Training curricula: CHWs, TBAs, CORPs, community health agents, pictorial
- 30. Books: FP Global Handbook, Where Women Have no Doctor, Helping Health Workers Learn
- 31. Guides, modules, case studies published by WHO, USAID, FHI, local MOH , and other partners
- 33. What tool or guidance document would help reduce largest perceived barriers (clinical, health systems/policy) and encourage FP integration?
- 34. Should any existing tool(s) be adapted and disseminated?
- 36. USAID/Washington
- 37. USAID Missions
- 40. Recommendations for USAID Missions
- 41. Recommendations for CORE Group
Notas del editor
- % of respondents including the element in their definition of “integration” is noted in parentheses. These %s were determined by a content analysis of all responses (n=46).
- % of respondents including the element in their definition of “integration” is noted in parentheses. These %s were determined by a content analysis of all responses (n=46).
- Of note, 100% of HQ respondents felt “CHWs trained in FP methods and counseling” and “Postpartum FP” are effective entry points for integration.Additional effective entry points suggested included:Nutrition and IYCF counselingPACFamily health promotion
- Other barriers discussed by respondents included:Poor infrastructure limiting access to populationCulturalReligiousPoliticalLinked health products/services damaged due to assumption that all products/services are FP
- These %s were determined by a content analysis of all responses (n=41). Only those suggestions with at least 4 responses (7%) included here.Interestingly, the resource predominantly requested by respondents is training resources, yet the main barriers to integration (clinical and health systems/policy) included commodity stock-outs and lack of budgeted government resources for CBFP. The requested resources does not match up with the identified barriers.
- n=38#1 recommendation – increasing mandate for FP in program designs, e.g.FP integration included in RFAsA portion of a project budgeted earmarked for FPFP included in MCH, CS, and nutrition proposalsOther recommendations mentioned:-Support scale-up of CBFP-Be flexible/open to FP-Strengthen supply chains-Health systems strengthening
- n=38#1 recommendation – increasing mandate for FP in program designs, e.g.FP integration included in RFAsA portion of a project budgeted earmarked for FPFP included in MCH, CS, and nutrition proposalsOther recommendations mentioned:-Strengthen local health systems-Train service providers/NGOs in integration-Be open/flexible to FP-Facilitate NGO/government collaboration-Scale up successful integration programs
- n=38#1 recommendation – facilitating/sharing resources, e.g.Devote sessions (Elluminate, Spring/Fall Meeting) to integrationFacilitating experience sharing between countries and between NGOsDisseminate successful (and failed) models, lessons learned, tools, etcOther recommendations mentioned:-Pilot integration programs-Scale-up successful integration programs or strategies-Mobilize resources for integration-Coordinate/harmonize interventions
- n=38Other recommendations mentioned:-Pilot integration programs to demonstrate feasibility-Scale-up successful integration programs or strategies-Coordinate with partners in-country to maximize resources-Promote integration internally – initiate dialogue, emphasize integration in mission, encourage project coordinationNote: Less than one-quarter of survey respondents have conducted any “implementation research” on FP