Integrated Family Planning Outreach

• Mobile outreach services have played a critical role in contraceptive provision in Nepal. In 2011, 13% of all modern method users obtained their method from government mobile clinics, including nearly 20% of all female sterilization users and approximately one-third of male sterilization users (MOHP [Nepal] et al., 2012)
• In 2010, over half of all LARCs and PMs in Tanzania were provided through mobile outreach (Jones, 2011)
• Mobile services further enhance access because they are frequently offered free of charge in communities (Jacobstein et al., 2013)

Planning

• Conduct pre-outreach meetings with key stakeholders or community dialogue to effectively plan for the outreach. Ideally, all integrated outreaches should be planned and managed strategically to avoid interfering with facility and other routine operations. Plan to conduct the outreach depending on the FP demand in the area.
• Review the data to identify gaps in the catchment area to determine:
  • Need for family planning and other maternal neonatal child health (MNCH) and other related services in areas with low coverage
  • Types of services to be offered during the outreaches
• Involve the geography health managers, implementers and community mobilizers in the mobilization activities while scheduling the outreach. Seek all necessary approvals and permits that are required from relevant government agencies before conducting mobilization activities.
• Prepare and avail adequate supplies, commodities and equipment for the outreach based on services to be provided. 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.
• Use the outreach supply checklist to assist with the planning for the outreach event including supplies and commodities.
  TIP: Commodity quantification for outreaches is included within current commodity plans
• Mobilize communities for 1 or more days before the event and during the event, to be ready for the services. Use community health workers, youth champions, the door-to-door approach, posters, radios, TVs, flyers, and announcements during community gatherings for community mobilization.
  TIP: Consider the use of health wagons, and tents, where available to enhance privacy and enable the provision of services that require a high degree of infection prevention.
• 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.
• Identify competent staff with support from the geography teams to conduct integrated family planning outreach services.

During Outreach

• On the day of the integrated outreach ensure:
  • All the relevant staff are aware of their roles and duty stations
  • Easy registration and management of client flow

  Maximize the day through integrating other health services, such as child health, cervical cancer screening, prostate cancer screening, HIV testing and counseling, immunization and de-worming, without losing focus on provision of FP services.

• Ensure quality service provision during the integrated family planning outreaches that includes counselling for services, Infection prevention measures, privacy, availability of skilled staff and commodities etc.
• Use of the Provider Initiated Family Planning (PIFP) job aid to ensure that clients coming for integrated services do not miss an opportunity receive FP services or information. The number of clinical and community staff participating in integrated outreaches needs to be rationalized based on the scale of the integrated outreach.
  TIP: The extent of integration is dependent on available resources and needs. It is advised to include at least 3 to 4 integrated services in one outreach.
• Ensure the team is prepared with appropriate emergency care equipment and supplies to manage basic medical emergencies that may occur during the outreach.
• Documentation of the service statistic data is done in the relevant primary MOH data collection tools (e.g. family planning registers) for reporting and review of outreach outcomes.

Post-Outreach

• Conduct post-outreach meetings to evaluate the outreach and use the outcome for future planning.
• Ensure the activity is documented in the relevant summary and reporting tool.
  TIP: Use the HII outreach checklist to monitor the quality of implementation of the checklist

• Increased access to FP services
• Improved linkages between the community and the facility
• Red myths and misconceptions around FP services at the community level
• Improved knowledge on FP among the communities

• Monitor the number of services offered during the integrated outreach activity
• Monitor the quality of implementation of the outreach using the checklist
• Use the post-outreach meetings to review the implementation and quality of the outreach
• Monitor quality documentation of outreach services using appropriate tools

 
• Increase access to FP services
• Improved linkages between the community and the facility
• Red myths and misconceptions around FP services at the community level
• Improved knowledge on FP among the communities

• Allowances for health care providers supporting the outreaches
• Allowance for the community mobilizer (CHVs, CHWs, VHTs),
• Logistics and supplies cost(tent hire, non-pharmaceuticals )
• Transport cc for taking the commodities to the outreach venue

• Inclusion of integrated outreach activities in geography work plans, strategic policies, and guidelines and allocating budget for these activities in the geography Costed Implementation Plan.
• 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.
• Leveraging FP outreaches in other RMNCH mobile outreaches