The Challenge Initiative (TCI) recently expanded its reach to Jharkhand state in India in response to their request for technical support to advance family planning efforts in five cities: Ranchi, Bokaro, Dhanbad, Deoghar, and East Singhbhum.
Jharkhand’s capital city of Ranchi had an almost stagnant family planning program before implementing TCI’s high-impact practices and other interventions (HIPs & HIIs). Almost all urban Accredited Social Health Activists (ASHAs) had not had a specific family planning orientation for many years. Urban primary health centers (UPHCs) also needed capacity strengthening to improve documentation.
In collaboration with TCI, city government officials and UPHC staff were promptly coached on HIPs & HIIs. Through early mentoring support, the medical officer-in-charge (MOIC) conducted a facility needs assessment of UPHCs to find gaps, and then develop an action plan to resolve them and start delivering quality family planning services.
Among the gaps identified during coaching discussions were low awareness of modern family planning methods in the community and poor visibility of family planning at UPHCs. Dr. Rachit Bhushan, MOIC of the Urban Community Health Center (UCHC) Risaaldar Nagar, noted:
The majority of my FP clients are women. However, they are hesitant to discuss FP with a male doctor. As a result, when a woman arrives at the clinic seeking FP information, she looks for a staff nurse.”
In seeking solutions to these gaps, the idea emerged to establish “FP Counseling Corners” at UPHCs, which complied with the government’s privacy guidelines. All seven MOICs showed interest and inquired about the requirements of establishing such a corner. They discussed the idea with their staff as well.
The TCI team supported them in creating a prototype layout of an FP Counseling Corner and listed the required materials. The MOICs determined that all the commodities and IEC materials listed were available. All that was required was a “sacrosanct space,” with a table, chairs, and a display featuring family planning commodities, job aids and IEC material. The MOICs made auxiliary nurse midwives (ANMs) responsible for managing the FP Counseling Corner, where they counsel eligible clients and help them make an informed choice when selecting a family planning method.
FP Counseling Corners are being noticed and appreciated by other government officials. The Public Health Manager of Ranchi, Mr. Shishir Roy, stated:
We are noticing the benefits of this concept because people who were previously hesitant to ask for FP commodities now take condoms or OCPs from the FP corner. As a result, FP data is increasing. We are now planning to focus on community mobilization and outreach activities, and I am confident that with TCI India’s assistance, we will achieve even better results in the near future.”
Dr. Rachit is equally happy as he reported that in his UCHC, women are no longer hesitant as they visit the FP Counseling Corner to clarify their doubts, seek answers to their family planning questions and receive counseling as well. He now wants to have a female gynecologist scheduled on particular days at the UCHC to support the provision of both maternal and child health and family planning services.
The successful demonstration of this approach drew the attention and interest of the government. TCI shared this in review meetings and advocated scaling it up in other TCI-supported cities. As a result, the FP Counseling Corner concept has now been adopted by all the remaining four intervention cities in Jharkhand, including Bokaro, Dhanbad, Deoghar and East Singhbhum.