TCI University Toolkit: Services & Supply
Mobile Service Delivery
What Is It?
Dispatching a team of trained family planning service providers, along with the necessary equipment, supplies and commodities to deliver family planning services, to areas in greatest need. Mobile service delivery models address inequities in access to family planning, broaden the contraceptive method mix available to clients and can help reduce unmet need for family planning.
This approach is beneficial in:
- Facilities with limited trained staff or resources
- Settings where providers do not have the knowledge or skills to administer certain types of contraceptive methods
- Rural or hard-to-reach areas where travel times to health facilities can be extensive
Mobile services can be offered at existing health facilities or in schools, community buildings, tents or even in a mobile van.
What Are the Benefits?
- Serves communities that lack access to family planning service providers, commodities and supplies
- Expands the range of contraceptive methods offered so clients can choose a method that meets their needs
- Increases reach to underserved populations by bringing services closer to where they live and work
- Can increase contraceptive use
How to Implement?
Recruit and train a team of mobile outreach providers
Mobile outreach providers of course need to be skilled in counseling and provision of the methods offered during mobile outreach events. Mobile outreach teams often provide long-acting and reversible contraceptives (LARCs). The Tupange project developed several relevant resources that can be used to train providers to provide LARCs, including on counseling, medical eligibility criteria and infection prevention. In addition, the Nigerian Urban Reproductive Health Initiative (NURHI) developed a training poster on infection prevention.
Coordinate with community leaders to identify appropriate locations
Ensure selected sites are clean, safe and private
Schedule each site’s mobile service dates
Conduct client mobilization and outreach prior to each scheduled service date
Send all commodities and supplies with the mobile outreach team
Routinely review each site
What Is the Evidence?
- In 2012, the Nigerian Urban Reproductive Health Initiative (NURHI) began dispatching mobile outreach teams to hard-to-reach urban slum areas. The contribution of outreach visits to total family planning users served by NURHI-supported facilities increased from about 15% in 2012 to 31% in 2013. By May 2013, outreach visits were contributing nearly half of total clinical services provided by NURHI (Krenn et al., 2014).
Family Planning Users Served by NURHI-Supported Clinics and Through Associated Outreach Visits
January 2011–May 2013
- Mobile services expand method choice by improving access to long-acting and reversible contraceptives and permanent methods. Service statistics from an international NGO show that a substantially greater share of clients of their mobile outreach services switch from short-acting to long-acting or permanent methods than clients of their social franchises or static clinics (for example, in sub-Saharan Africa 39% of mobile outreach clients switched compared with 17% each of social franchise and static clinic clients) (HIP Brief on Mobile Outreach Services).
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Mobile service delivery–whereby a team of trained family planning service providers are dispatched to areas in greatest need–addresses inequities in access to family planning, broadens the contraceptive method mix available to clients and can help reduce unmet need for family planning.
Where is the mobile service delivery approach to family planning most beneficial?
Mobile outreach teams are particularly helpful in improving access to long-acting and reversible contraceptives (implants and intrauterine devices [IUDs]) and permanent methods, which are less accessible in many settings.
Strong systems must be in place to provide adequate follow-up care, including access to removals of implants and IUDs between mobile outreach team visits. Strategies that have worked in different settings include working with community health workers to assist with follow-up and referrals and using mobile phones or hotlines for follow-up messaging and advice.
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- Mobile outreach teams are particularly helpful in improving access to long-acting and reversible contraceptives (implants and intrauterine devices [IUDs]) and permanent methods, which are less accessible in many settings.
- For sites that lack privacy or procedure rooms, or in remote areas with no facilities available at all, a mobile van, motorized auto-rickshaw or an inflatable tent can be used. See how this innovation was piloted in Tanzania.
- Link mobile outreach programs with community health workers, who often have strong local networks, to help communicate to community members the location and dates of mobile outreach visits and to help generate demand for services.
- Mobile outreach programs often struggle with staff retention because of travel demands and time away from family. Rotating staff to travel to the field, setting travel dates in advance and supporting transportation expenses and overnight accommodation when needed can help.
- Strong systems must be in place to provide adequate follow-up care, including access to removals of implants and IUDs between mobile outreach team visits. Strategies that have worked in different settings include working with community health workers to assist with follow-up and referrals and using mobile phones or hotlines for follow-up messaging and advice.
- Sustained communication through community channels is critical to the success of mobile outreach programs to ensure potential clients know about the services offered. Many clients frequently report they first heard about mobile outreach programs through word-of-mouth, community health workers, loudspeakers, radio and community events (High Impact Practices [HIP] Brief on Mobile Outreach Services).