TCI Global Toolkit: Service Delivery

Integrated Outreach

How TCI-Supported Geographies Operationalize this Approach

In Taraba and Bauchi states in NIgeria, the health facilities already have a robust structure for routine immunization outreaches. Leveraging onto this, TCI supported the governments to integrate family planning into the already existing outreach programs. First, an orientation meeting was organized for relevant stakeholders and participants with technical assistance from TCI. Key stakeholders included Director Primary Health Care (DPHC), State Reproductive Health/Family Planning Coordinator and relevant local government (LGA) Family Planning Coordinators. Then, TCI coached service providers and LGA Family Planning Coordinators on how to plan for family planning services within existing outreach programs, like maternal, newborn and child health services (MNCH) and immunizations. This includes coaching on effective strategies for integration including integrated health talks and counseling that covers MNCH and family planning and providing family planning service provision alongside other MNCH services. At the same time, state and LGA Health Educators, with TCI coaching support, train social mobilizers to mobilize people for family planning services ensuring collaboration between service providers and social mobilizers. All integrated family planning outreaches are linked to strong community-based social mobilization, ensuring high levels of community endorsement and support and complemented by partnership with religious and traditional leaders in TCI-supported LGAs.

How the Implementation Experience Differs between East Africa and Nigeria

In East Africa, there has been an increased uptake of long-acting and reversible contraceptives (LARCs) attributable to integrated family planning outreaches in TCI-supported geographies. Outreach services contributed about 30% of LARCs services provided within supported sites in 2018/9.

While, in Nigeria, integrated outreaches are more effective in promoting the uptake of short-acting reversible contraceptives (SARCs) than LARCs because of the challenges of getting a sterile environment for LARCs in community settings in Nigeria.

Evidence from the Urban Reproductive Health Initiative (URHI)

Between 2011 and 2015, Kenya’s Tupange family planning outreach services reached poor populations in urban centers. In the five Tupange-supported sites, outreach services contributed to about 30% of long-acting and reversible contraceptive services provided by the project. By the end of 2013, more than 50,000 clients had received family planning through the integrated outreach of family planning, reproductive and child health services.

Between 2011 and 2015, 425,974 women accepted new forms of contraception, thanks to passionate and dedicated community health workers who drove outreach efforts.

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