Hold a city consultation committee (CCC) meeting as soon as possible after you set foot in a city. This becomes the first platform of marketing TCIHC to a group of stakeholders and encourages rapport building among all of the stakeholders working for urban health in the same city, who may be meeting each other for the first time given their varied expertise and points of entry/interventions within urban health. This platform helps identify critical gaps in urban health, family planning, maternal and child health, etc. It also helps produce a city health plan, which serves as a common reference document for everyone to follow in subsequent CCC meetings.

The following pre-planning steps are required for organizing a CCC meeting:

• Mapping and validation of stakeholders
• Finalizing date and time in consultation with stakeholders
• Ensuring invitations are issued from the CMO’s office and any necessary follow-up required
• Finalizing the agenda and activities for the day-long meeting
• Making logistical arrangements

Timeline: Ideally within two months, City Managers should hold the CCC meeting.

 Immediately, City Managers should visit each urban primary health center (UPHC), gather its details related to family planning (refer facility readiness checklist) and assess it against government of India’s quality assurance parameters for family planning. Based on this, identify ‘ready-to-start’ facilities where the Fixed Day Static (FDS) approach can be started immediately with minimum input.

Timeline: Simultaneously initiate this exercise while doing the ‘know your city’ exercise.

By doing city consultation and further assessing gaps in the UPHCs, City Managers gain a better understanding of what is required to move family planning uptake in the city. While you identify gaps, also provide solutions to overcome them. So, having a good grasp and knowledge of the HIAs is imperative since they can be the solutions required for fulfilling the identified gaps of the city. Always keep a copy or two of key HIAs handy with you.  

Make a ritual of meeting with the CMO/CMHO/CDMO, Nodal Officer, and other key stakeholders and identify at least two stakeholders who are key to getting the work done. Brief them regularly about the family planning work done in slums through UPHCs, FDS, outreach camps (ORCs), urban health and nutrition days (UHND), etc. Also, understand the dynamics between the CMO/CMHO/CMDO and his/her team. Sometimes, including the Nodal Officer hastens the process for approvals.

Use data to advocate for improving family planning services. This may entail data regarding the status of needed equipment, supplies, health care provider trainings, the status of human resources, recent family planning uptake in UPHCs and role of TCIHC in supporting them, etc. Do a simple time series or trend analysis and present it in key forums, such as urban health review meetings, family planning review meetings,  District Health Society Meeting, District Magistrate Meeting and urban local body meeting, among others.

Share important daily happenings related to family planning work in the social media platforms of the city government, such as National Urban Health Mission (NUHM) group, Uttar Pradesh (UP) Technical Support Unit (TSU) group, etc. This updates the CMO, and sharing progress of work builds credibility of TCIHC but also of the CMO and his/her team. This platform can trigger discussions, which can help in convergence with various other departments.

Participate in every urban family planning review meeting, urban health review meeting, and MoIC monthly meeting, and at least one or two ANM/ASHA meetings every month. Facilitate the ASHA/ANM meeting, and bring out challenges and gaps in reaching out to and counseling women on adopting modern family planning methods. Address these issues by doing joint field visits yourself and through the field team. Gradually, ANMs should be able to hold review meetings with ASHAs in a similar manner, and the City Manager can focus more on district-level meetings.