Alex Namaala Lwasa is a nursing officer in Mukono, Uganda.

Tupange Pamoja is orienting health care providers using the WSO and there has been increased referrals within the facilities for FP/AYSRH services.

Intervention in Action: After Conducting Whole Site Orientations

“We have changed the way we offer our services. The capacity of health workers to provide quality family planning services has improved. Right now, everyone is confident to talk about the methods and counsel or advise clients on the method of choice. The moment you enter the health facility, everyone, starting with the askaris [security guards], cleaners, records persons and the health workers can talk about family planning. These people make sure that the clients don’t go without getting a family planning method of choice. Due to our family planning signage, people are now more interested in asking about family planning and any person they approach readily provides them with reliable information. When they ask at the gate, the Askaris direct them. Even mothers who bring their children for immunizations nowadays ask for family planning services and they are assisted, which was not the case before. Family planning services have been integrated in all service delivery points. At the moment, all the care points at this facility are able to provide short-term family planning methods, while clients for long-term methods are referred to the family planning clinic. The family planning clinic is open Monday to Friday every week. The attitudes and communication of the health workers has positively changed. Before they did not take it as an important issue to communicate about family planning. People now appreciate family planning and say it is a good service. Communication has greatly improved both at the facility and community where the village health teams (VHTs) give information. After giving them [clients] information about the advantages and disadvantages of the various family planning methods, they usually make an informed choice and they take what they see is good for them, which was not happening before. If you clear the misconceptions, give facts about the methods and assure them about your availability to help in case of any concerns, you will get many acceptors. We now provide a [more balanced] family planning method mix since the skills of the health workers has been improved. More health workers are now able to provide long-term family planning methods. Nowadays, IUD is the most preferred method followed by implants, not because they are new but because we now have the knowledge, skills and equipment for administering them. Ever since we started providing the long-term family planning methods, congestion at the family planning clinic has greatly reduced because few mothers come to the clinic. They come only when they want a method or when they have complaints or side effects which are really minor. So, we have reduced the frequency of the mothers’ visits to the hospital. – Alex Namaala Lwasa, nursing officer in Mukono, Uganda

1. Identify the facilitators from the facility who will take lead in planning and conducting the orientation. Establish the number of staff interested in the sessions; this guides the facilitator on the number of cycles that the facility requires. Ideally, a class should have a minimum of 10 participants and maximum of 25 participants.
2. Agree with the participants upon the most convenient time to conduct the sessions.
3. Determine the schedule for the orientation, including pre- and post-knowledge assessment tools, posters and other necessary materials. Orientation sessions should cover:
   • Overview of FP
   • Method Mix
   • MEC Eligibility Criteria
   • Myths and misconception
   • Infection Prevention
   • Post Pregnancy FP
   • Provider Initiated FP
   • Commodity management
   • Youth Friendly Services
   • Counseling
   • Communication with young persons
4. Organize with the facility in-charge the scheduling of the modules. Participants sign the whole-site attendance record or the whole-site attendance register form every time they attend the sessions
5. After completion, the facility, in collaboration with the city team organize a whole-site graduation where participants are recognized and certified.
6.  

• Knowledgeable clinical and non-clinical staff
• Decreased myths and misconceptions among staff
• Better client engagement and direction on FP/AYSRH services
• Increased intra-facility referrals
• Enhanced Provider Initiated FP 

• Topics covered to be monitored by the facility in-charge on a monthly basis
• Track integration in different family planning service areas by the facility in-charge on a monthly basis through the use of family planning integration tally sheets
• Monitor the knowledge gap during the whole-sites through supervision on a monthly basis using the supervision checklist
• Testimonials from the health facility staff

• Number of clients receiving family planning services from other service areas
• Number of staff who have successfully undergone whole-site orientation sessions to be monitored by the facility in-charge and tracked in the facility database
• Number of completed sessions to be monitored by the facility in-charge on a weekly basis

The cost elements include:

• Training materials, i.e., flip charts, marker pens, notebooks, pens, and copies of handouts
• Facilitation fee/honorarium for the trainer
• Refreshments
• Printing of certificates

• Integrate the module into the usual facility updates (Continuous Medical Education)
• Incorporate whole-site training into facility work plans
• Include whole-site training in QI teams’ responsibilities