East Africa Toolkit: Services & Supply
Integrated Family Planning Outreach
An integrated family planning outreach is a health service delivery activity done outside the facility with the aim of bringing health services closer to the community. The health services are provided at the community level within locally available venues, such as schools, social halls, community grounds, markets and religious facilities, etc.
This animated video describes the steps for conducting an integrated outreach.
The TCI Tutorial below features a webinar held in October 2019 to explain what an integrated outreach is, as well as considerations for holding a successful one.
Why Is Integrated Family Planning Outreach Important?
- Increase access to services among the under-served urban poor
- Eliminate barriers and associated indirect costs of accessing health facilities by bringing services closer to the community, in areas where facilities are far away or where there are negative attitudes towards the health facilities
- Serve as opportunities for closer interaction between heath facility staff and the community. Such interactions foster community dialogue and assist to initiate community action
- Provide an avenue for improving health facility competency through coaching and mentorship
According to Tupange Pamoja program data:
- There was an increased uptake of long-acting and reversible contraceptives (LARCs), attributable to integrated family planning outreaches in program areas. Outreach services contributed about 30% of LARCs services provided within supported sites in 2018/9.
Guidance: How to Conduct Integrated Family Planning Outreach
- Review the data to identify gaps in the catchment area to determine:
- Need for family planning services
- Areas with low access to services
- Types of services to be offered during the outreaches
- Involve the local city health managers and teams involved in mobilization activities while scheduling dates for the outreach.
- Seek all necessary statutory approvals and permits that are required from relevant government agencies before conducting mobilization activities.
- Conduct pre- and post-outreach meetings to plan and evaluate each outreach activity.
- Prepare and avail adequate supplies, commodities and equipment for the outreach based on services to be provided.
- Mobilize communities to be ready for outreach services through use of community health workers, the door-to-door approach, posters and flyers and announcements during community gatherings. Where budgets allow, announce on radio or TV to expand reach. This will ensure that the targeted communities are aware of the services to be offered.
- Identify and prepare the community venue that will host the outreach in collaboration with all stakeholders, ensuring cleanliness and safety. The venue should ideally be centrally located and easily accessible to community members. Use health wagons, where available, to enhance privacy and enable provision of services that require a high degree of infection prevention.
- Recruit and train competent staff to conduct integrated family planning outreach services.
- Ensure quality service provision during the integrated family planning outreaches. On the day of the integrated outreach, ensure easy registration and retrieval of records and short waits (and swift referral when necessary).
- Where several stakeholders are involved, it is advisable that county health staff carry out the actual implementation and service delivery while stakeholders provide technical assistance and resources.
- Ensure emergency preparedness. Outreaches offer multiple health services and as such outreach teams need to be prepared to manage basic medical emergencies.
- FP commodities and expendable supplies for outreach services need to be projected, quantified and procured in advance and should be part of the routine supplies for health facilities. Resource planning for outreaches need to be done at least three months prior to the activity.
- Maximize outreaches by integrating other related health services, such as child health, cervical cancer screening, prostate cancer screening, HIV testing and counseling, immunization and de-worming, without losing focus on family planning. The extent of integration is dependent on available resources (staff, supplies and commodities). Avoid including more than 3-4 integrated services in one outreach.
- Use of the Provider Initiated Family Planning (PIFP) job aid to ensure that clients coming for integrated services do not miss an opportunity for family planning. The number of clinical and community staff participating in integrated outreaches needs to be rationalized based on the scale of the integrated outreach.
- All integrated outreaches should be planned and managed strategically to avoid interfering with facility and other routine operations.
- Mobilize youth to be ready for services through the use of established youth groups and youth community health assistants.
- Increased uptake of FP/contraceptive services
- Reduced number of myths and misconception around FP services at community level
- Better client engagement
- Enhanced provider initiated family planning
- Monitor the level of integration to assess the extent of integration of services during outreaches
- Monitor the quality of integrated services through laid-down structures (ensure privacy, confidentiality and infection procedures are followed)
- Conduct post-outreach meetings to review quality and operational issues that may have arisen
- Monitor the level of family planning commodities and expendable supplies expended and remaining from the integrated outreach
- Ensure data from the outreach has been captured in the in the right tool and also entered into the Open Data Kit (ODK) online system before leaving the outreach site
- Number of integrated outreaches conducted within the catchment area
- Number of new family planning acceptors from integrated outreaches
- Proportion of clients reached through outreaches
- Resources needed to conduct an integrated outreach are listed in the outreach guidelines
- Consistent advocacy with city stakeholders to provide resources for outreach services
- Inclusion of integrated outreach activities in geography health plans by allocating budget for these activities
- Ensure planning, management, coordination and implementation of outreach activities are led by the geography health staff
- Cost reduction can be achieved through cost-sharing among stakeholders and leveraging of community resources such as venues, community staff and local leaders and structures for mobilization assists to minimize costs
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