As Jhansi Matures, Other Cities Take Notice of Its Success and TCI’s High-Impact Approaches
The Challenge Initiative (TCI) has been supporting the local government in Jhansi (Uttar Pradesh, India) since June 2018. Jhansi’s Chief Medical Officer, Dr. Anil Kumar, said TCI’s unique and inclusive partnership approach along with coaching and high-impact approaches are leading to additional family planning clients in his city.
Unique and Inclusive Partnership Approach
Dr. Kumar said he was excited by TCI’s approach from the very beginning when TCI invited him and other local government stakeholders working in the urban health system to take part in a ‘Know Your City’ exercise. As a result of this exercise, he immediately reached out to the District Quality Consultant and staff mentor for maternal health and conducted a gap analysis of all urban primary health centers (UPHC). With gaps identified, they developed and executed on a mitigation plan.
Coaching and High-impact Approaches
TCI shared with Dr. Kumar and other city officials the success other cities have seen with TCI’s high-impact approaches. When TCI began to coach them and UPHC staff on how to implement the high-impact approaches, they immediately began to see how these approaches could help Jhansi. Their first step was to roll out the fixed day static (FDS) service approach. Before engaging with TCI, only two facilities had started FDS. By August 2018, all 12 UPHCs in Jhansi were providing assured quality family planning services on FDS days. With continued coaching from TCI, Dr. Kumar issued a training calendar for service providers on the new contraceptive method, Antara. By January 2019, the UPHCs were offering Antara, having expanded the methods of choice to poor urban women.
Results from Engagement with TCI
Dr. Kumar shared how TCI’s coaching support around reviewing, using and sharing data with stakeholders has not only demonstrated the success of TCI’s high-impact approaches but has caused a ripple effect:
We had understood the power of data. We regularly presented our work in urban family planning at DHS reviews and this grabbed the attention of Superintendents of Community Health Centres (CHCs), other block level functionaries. With regular reviews, we had good programmatic insights to inform us of the change that was visible through data. A favorable environment for prioritizing family planning had been created. But it was in a divisional review meeting that I was handed over the CMO series. This particular event and afterwards, I received much applause and recognition, which was the game changer in catching the attention of other two districts, Jalaun and Lalitpur in the divisions.”
Dr. Kumar invited the CMOs of Jalaun and Lalitpur for a divisional diffusion workshop. Dr. N.D. Sharma, CMO of Jalaun, readily accepted the invitation and said the progress made by Jhansi was impressive, noting how the high-impact approaches contributed to improvements in family planning services. Dr. Sharma shared:
I find the following in particular of tremendous importance: coaching availability through TCI University, the role of a functional CCC [City Coordination Committee], sustainability of antral diwas [FDS] and strengthening ASHAs. I am pleased to share that Dr. Jain, Nodal Officer of Jhansi, his team at Divisional Urban Health Consultant and the Divisional Program Manager have all extended their support in coaching our geography teams so that we too can scale up these high impact approaches in Jalaun.”
Jhansi is now well-positioned to take on the role of a mature TCI city and support diffusion and capacity transfer of the high-impact approaches to Jalaun.