Leveraging Existing Resources to Upgrade Urban Primary Health Centers in Mathura, India
Contributors: Meenakshi Dikshit, Dharmendra Kumar Tripathi, Parul Saxena
When scaling up its signature Fixed Day Static (FDS) services /Family Planning Day (FPD) approach in Mathura, India’s seven urban primary health centers (UPHCs), the TCIHC team noticed the facilities themselves needed some improvements. A number of issues needed to be addressed, including poor water supply, improper seating arrangements in the patient waiting area, no family planning counseling area and a lack of family planning informational materials and supplies. But the UPHCs’ regular administrative budget apparently did not cover these types of improvements.
After the TCIHC team raised these issues, the Additional Chief Medical Officer (ACMO) and Nodal Officer of the National Urban Health Mission (NUHM) agreed the problem needed to be addressed as it was hampering the quality of family planning services being offered. While everybody agreed on an improvement plan, no one knew how to fund the plan given the budget constraints.
TCIHC analyzed the budget more closely and discovered an underutilized fund in a category devoted to patient welfare called “Rogi Kalyan Samiti” (RKS). Under the guidance of the ACMO, TCIHC developed a detailed report describing what was required to transform the UPHCs into family planning-friendly centers for clients and the benefits of doing so. The district magistrate was impressed after receiving the report and approved the RKS budget expenditure as requested.
In addition to painting the walls, the RKS budget was used for condom boxes, fire extinguishers, LED bulbs, ceiling fans and chairs in the client waiting areas, refrigerators, pin/information boards, complaint boxes, water filter repairs, IUCD room slippers and caps, doormats, curtains for counseling areas to maintain privacy, mattresses, tables, blankets and family planning education materials. As a final touch, family planning/FDS themed wall paintings were done alongside a large poster displaying family planning methods.
The transformed UPHCs lifted the confidence of facility staff. The posters and new materials piqued the interest of clients who wanted to know more about family planning methods. ASHAs in the area also were inspired to reach out to clients and refer them to the upgraded facilities.
“This has become easy for us to initiate dialogue on FP now that there is a huge basket of choice poster. Many clients themselves ask questions referring to the poster,” said Ms. Bushra, a nurse in the UPHC Haiza Hospital. “However, sometimes we do ask, ‘have you seen that huge poster’?”
As a result of the facility makeovers, client volume for family planning services has increased 13% across Mathura’s seven UPHCs in the first quarter of FY 2019-20, when compared with the same period last year.
ASHAs in India are building relationships with family decision-makers to promote family planning among young first-time mothers.
In Nigeria, TCI set out to bridge the gap between just making referrals to family planning services and successfully completing those referrals.
Malam Mukhtar, a scholar of the Qu'ran in Nigeria, works to change the narrative and understanding of child birth spacing in his community.
TCI Youth Champion stands up to community misconceptions about implants and teaches adults about the benefits of contraceptives.