When Dr. Ajay Jha, the Medical-Officer-In-Charge (MoIC) at the Hussainabad Urban Primary Health Center (UPHC), shared on a local WhatsApp community of practice his success with intrauterine contraceptive devices (IUCD) being offered at the UPHC, it created quite a stir in Bhagalpur. Word spread quickly and Dr. Umesh Sharma, the Civil Surgeon in Bhagalpur, asked Dr. Jha along with The Challenge Initiative’s (TCI’s) India team to share their experience.
Dr. Jha highlighted TCI’s coaching model for local governments implementing high-impact practices and other interventions (HIPs & HIIs), in particular the fixed-day static service (FDS) approach. He said at first he didn’t believe the positive results shared by the TCI team from cities in Uttar Pradesh (UP). But to his amazement, he witnessed firsthand increased traffic for family planning services as well as increased demand for IUCDs after FDS was introduced.
The Civil Surgeon wanted more details about the HIPS & HIIs and asked TCI’s India team to provide technical coaching support so all eight UPHCs in Bhagalpur could provide long-acting reversible contraceptive (LARC) services. TCI followed up and began coaching the staff at all the UPHCs along with demonstrating the relevant HIPs & HIIs.
Meanwhile, Dr. Jha also submitted a request to train his staff members on LARCs as some were out of practice and others lacked confidence. After learning about TCI’s HIPs & HIIs and being convinced about the potential benefits and positive outcomes, the Civil Surgeon issued a letter not just for Dr. Jha’s UPHC but all eight UPHCs in Bhagalpur.
This case in Bhagalpur demonstrated that sharing successful experiences from one UPHC, combined with effective coaching, can result in an organic horizontal scale-up of the TCI model.
Steps taken by the Hussainabad UPHC to implement FDS
- Assess the facility using a checklist
- Identify a dedicated room for the IUCD procedure
- Organize and properly store adequate FP commodities and IUCD kits
- Arrange and procure additional equipment from the district hospital and other higher order facilities
- With TCI’s support, train auxiliary nurse midwives on IUCD insertion and other skills (i.e., autoclave use and biohazard waste management)