Improving Quality Family Planning Service Delivery in Plateau State through TCI Coaching
Contributor: Winifred Kwanknat
Rhoda Kushi – the Reproductive Health (RH) Coordinator of the Bassa local government area (LGA) in Plateau State, Nigeria – believes the coaching she received from The Challenge Initiative (TCI) has improved her service delivery skills.
As a stakeholder in Plateau State family planning space, I have experienced a change in the way I provide services to my clients, resulting from the several online and offline capacity strengthening (opportunities) I received from TCI from 2018 up until now. TCI has built my capacity which has made me (more) knowledgeable and enhanced my skills to coordinate activities to ensure quality health care services. Before TCI started its intervention, I was used to donor-funded training as the only platform for capacity building and most capacity building exercises were partner-led. This affected my ability to provide coaching to frontline service providers as I didn’t have the confidence and the knowledge to do so. I also was not aware that there were high-impact interventions that, when implemented, can improve uptake and provide an enabling environment for family planning services.
With the coming of TCI, I was coached and mentored on various skills relating to family planning service provision, in particular communicating better with my clients, providing informed choice services and ensuring that there is confidentiality for all information received from clients and as well provision of quality service. My skills have improved. As a result, I have coached other FP providers as peer coaches to step-down to other providers and staff on standard gloving, counseling using the balanced counseling strategy tools and job aids. In addition, institutionalizing of infection prevention and other control measures, including instrument processing, are now routine in the facilities under my direction. My increased competence in LARC insertion has also helped me to provide family planning supportive supervision (FPSS) to providers and correct them, where necessary. TCI has also improved my capacity to collect and validate data which has informed decision-making and helped me plan for FPSS to really address areas of weakness in FP service provision. I have received coaching through platforms like WhatsApp and Zoom, which has helped me coordinate activities even amidst the COVID-19 pandemic. With my new skills, there is now no need to depend solely on partners to fund training.”
In addition to equipping Rhoda with the skills and confidence to coach others and provide quality family planning services, Rhoda’s attitude towards adolescents and youth also changed following TCI coaching. She explains:
Another very important area of change is my attitude towards service provision for adolescents and youth (AY). AY clients are now treated without bias and I now believe and understand that they have the right to information. They are free to choose and have the full options of family planning methods. Their privacy and confidentiality is protected, which has improved the influx and uptake of FP services which is evident by data generated from facilities’ national health information management system registers and the Commodity Logistics Management System.”
Of all the benefits Rhoda has derived from her relationship with TCI, she considers her ability to coordinate and implement the high-impact interventions to be the most significant.
My ability to coordinate and implement service delivery (SD) approaches in my LGA is the most significant thing that has happened to me. This is because the TCI high-impact approaches provide a sustainable platform for the delivery of quality family planning services, which was previously partner-led and -driven. As a member of the LGA PHC team, I can effectively initiate the implementation of SD approaches, utilizing local and available resources of the LGA. I have learned that quality improvement team formation improves community participation. I have introduced FP integration, in-reaches, whole site orientation in my LGA and these strategies have improved access and utilization of FP services.”
Before Rhoda became the RH Coordinator in Bassa LGA, she worked in Jos South LGA of Plateau state. There she recorded remarkable improvements in family planning as a result of TCI high-impact interventions, including an 88% increase in additional long-acting reversible contraceptive (LARC) client volume from the baseline (July 2018) to date. The following high-impact interventions were implemented in Jos South:
- 16 whole-site orientations, reaching over 200 people (trained and untrained facility staff and community stakeholders)
- On-the-job training for 17 service providers (11 community health workers and six nurses) from 17 facilities out of the 63 facilities in the LGA
- Supervised and supported 11 in-reaches within the LGA
- Supported the inauguration of seven quality improvement teams and conducted three 72-hour facility makeovers
- Supported performance improvement plan in 10 facilities, utilizing the resources of the LGA
Rhoda concluded by sharing what TCI has meant to her personally:
TCI has made tremendous impact in building my capacity to deliver quality family planning services to women and young people. I wish that TCI will scale up to other LGAs and all non-TCI supported health facilities to enable them to benefit from all the life-changing skills we have acquired from TCI.”