Nioro Health Facility Continues to Implement TCI’s Universal Referral Intervention Even After Graduation

Contributor: Adama Seck

Ms. Safiétou Kanouté, a midwife at the Fass HLM facility in Nioro, Senegal, received TCI coaching in universal referral.

After experiencing a health worker strike in 2018, Senegal saw a decline in its contraceptive prevalence rate, particularly in Fass HLM, a health facility in Nioro, Senegal. The family planning needs of clients were not being met during general consultations, deliveries, prenatal and postnatal consultations or even during childhood immunization visits. Counseling on family planning was nearly nonexistent during this time period. As a result, women were not seeking family planning services and rumors about family planning were not being addressed by providers.

According to Ms. Safiétou Kanouté, a midwife at the Fass HLM facility, the training and coaching she received from The Challenge Initiative (TCI) on the universal referral intervention (Identification Systématique des Besoins du Client or ISBC) provided an opportunity to turn the situation around:

In 2018, the health district in collaboration with the Nioro townhall and the TCI platform organized trainings on universal referral of client’s needs and this has been an asset for the Fass Hlm health facility.”

According to Kanouté, this training enabled her to talk about family planning and improved her counseling skills and ability to introduce family planning during health visits unrelated to family planning. The use of ISBC and these newly found skills combined with additional training on contraceptive technology updates made it possible for Kanouté to offer and provide women of reproductive age long-acting reversible methods, expanding the method mix at the facility.

In addition to capacity building, the facility benefited from technical coaching on other TCI high-impact service delivery interventions as well as community outreach. This resulted in the health facility meeting the unmet family planning needs of more new users, as illustrated in the bar chart on contraceptive prevalence rate for the health post from 2019 to 2021. Nioro graduated from TCI’s direct support in September 2021. 

Contraceptive prevalence rate trends for the Fass HLM health facility, from 2019 through 2021.

According to Kanouté:

Achieving our objectives in terms of contraceptive prevalence rate was made possible with ISBC (universal referral). By discussing family planning with women, we can remove many gray areas, and sometimes it is due to lack of knowledge or because of rumors that they are not using family planning. By talking with their partners, you can convince them. Even with the graduation of the city of Nioro after more than three years of partnership with TCI, we continue to organize special days for free family planning services with city hall and with other partners and implement ISBC. We also update the registers accordingly, use community actors to search for those lost to follow-up through household mapping and finally disseminate family planning programs on the community radio to overcome rumors and raise awareness of family planning services.