Jhansi, a 38-year-old woman from Cuttack, Odisha, reflects a challenge shared by many women:
Household responsibilities often consume most of my time, leaving me unable to focus on my reproductive health needs. Visiting a health facility felt like a luxury I could not afford, as it would take away precious time from my daily duties.
The Challenge Initiative (TCI) – which began working in Cuttack under its Rapid Scale Initiative in April 2024 – took up a critical question: how could the city ensure that women like Jhansi have access to the full range of family planning choices closer to home? TCI worked with the Additional District Urban Public Health Officer and senior health officials to expand family planning services across all urban health facilities, including Urban Health and Wellness Centers known locally as Urban Ayushman Arogya Mandir (UAAM).
As a technical partner, TCI led a capacity-building effort. UAAM nursing staff, pharmacy officers, and Accredited Social Health Activists (ASHAs) received coaching and mentoring on counseling, service delivery, and client mobilization. Peer-to-peer coaching and cross-learning platforms were established, enabling Urban Primary Health Center staff to share practical insights with UAAM staff and strengthen their confidence. ASHAs were also equipped to identify and refer eligible clients from their communities to the nearest service points.
The results were tangible. Antara injectable contraceptive services were successfully rolled out across all UAAMs, giving women not just access, but the ability to choose what worked for them.
Jhansi’s own experience captures the impact:
As a mother of two, my days disappear into cooking, cleaning, and caregiving. After my second child, I started using oral contraceptive pills, but I often forgot to take them, and every missed dose filled me with fear. When ASHA didi visited me, she saw my worries and exhaustion. She told me there were other FP methods such as Antara available at the nearby UAAM and reminded that, ‘it is your right to choose what is best for your body and your family.’ That evening, I shared my fears with my husband. He understood and together, we went to the UAAM. The staff nurse heard us and explained all the FP choices. I finally chose Antara. The day I received my first dose, I felt carefree and a happier woman.
By bringing services closer to communities, building the capacity of frontline workers, and equipping health facilities, TCI is ensuring lasting health choices and dignity for women in India.
