Study tour participants from Jharkhand visit the Lucknow Urban Family Welfare Center to gain insights from facility staff.
After attending a Mini University workshop facilitated by The Challenge Initiative (TCI) and master coaches from Uttar Pradesh (UP), state health officials from Jharkhand’s National Health Mission (NHM) decided to arrange a study tour to Lucknow and Ayodhya in UP. Both cities graduated from TCI’s direct support almost two years ago and were eager to share practical insights and proven strategies for sustaining health system strengthening.
The visiting team from Jharkhand was treated to a comprehensive regional healthcare excursion over the two-day visit, touring state and city-level government offices, Urban Family Welfare Centers, District Women’s Hospitals, and a private hospital.
The Jharkhand team observed several key practices implemented by the UP state government following the success of TCI’s fixed-day static intervention, which was expanded as “Antral Diwas” (Spacing Day) across all 75 districts in both urban and rural facilities. They noted how medical officers in charge held regular review meetings at Urban Healthcare Centers to assess the performance of Accredited Social Health Activists (ASHAs) and Auxiliary Nurse Midwives (ANMs). These meetings led to significant improvements and were subsequently incorporated into the program implementation plan, with government funds allocated for quarterly reviews.
The visiting team heard from Dr. Geetanjali Singh, Medical Office in Charge of Chitwapur, and Dr. Rumana, Medical Office in Charge of Rajendra Nagar Urban Family Welfare Centers, who both shared the factors that led to success. They said the ASHA and ANM’s WhatsApp groups were instrumental in the weekly planning of fixed-day static services and in ensuring real-time data reporting. Health facilities also improved their client retention and built stronger relationships through effective counseling provided to clients. They also noted that with TCI support, detailed slum area maps were developed for micro-planning, which significantly improved targeted service delivery. Additionally, each Mahila Arogya Samiti, which are local women’s groups, was connected with an ASHA worker to facilitate group meetings and enhance community awareness about health programs. Prior to routine immunizations, infants were screened, and parents received counseling on contraceptive options, they shared. And health awareness programs in schools successfully boosted adolescent participation during facility adolescent health days.
The Jharkhand team also observed how Chief Medical Officers adopted another TCI concept, creating a pool of city-level “master coaches” to foster capacity strengthening across various departments through high-impact practices and other interventions. Displaying family planning HMIS dashboards at health facilities allowed staff to assess their progress on a regular basis, enhancing data-driven decision-making, and government-funded condom boxes were installed at Urban Healthcare Centers providing expanded access.
They learned how the Family Planning Logistics Management Information System (FPLMIS) portal was instrumental in ensuring consistent supply chain management and how the City Health Coordination Committees facilitated cross-departmental collaboration to effectively address city-specific challenges.
While visiting the district hospital in Ayodhya, officials learned about the special attention directed toward antenatal and postnatal care clients to motivate postpartum family planning (PPFP) services. Priyanka, the family planning counselor at the district hospital, told the team:
The facility has developed an innovative approach: a stamp listing all modern contraceptive methods. This stamp is applied to [outpatient department] prescriptions of eligible family planning clients, and the client’s preferred method is ticked. This helps in identifying future clients easily.”
Dr. Manjusha Pandey, a gynecologist and obstetrician from a private facility in Ayodhya, added,
TCI brought the concept of public-private interface meetings, which serve as a vital platform where private facilities gain insights on government family planning programs, HMIS data reporting processes, and share challenges. Furthermore, the meticulous maintenance of data in family planning registers developed by TCI is imperative not only for reporting to the HMIS but also for reviewing data to make data-driven decisions.”
At the conclusion of their visit, Dr. Ranjit Prasad, Jharkhand State’s NUHM Nodal Officer, expressed appreciation for the learning tour:
The visit enabled me and my team to gain deeper insights from both Lucknow and Ayodhya, including how TCI interventions are driven by the government, how the UP government has benefited from TCI’s technical support, and how they have optimally utilized existing resources. Moving forward, we aim to streamline ASHA payment issues with learnings from UP and scale up HII/HIPs into non-intervention cities with support from TCI India.”
