After The Challenge Initiative (TCI) began its engagement with Dhanbad, Jharkhand, in July 2022, an internal review of family planning HMIS data revealed that two urban facilities were not providing postpartum intrauterine contraceptive device (PPIUCD) services despite being delivery points.
TCI then met with the district urban health manager (DUHM) for a coaching session and noted the lack of PPIUCD service at the Sindri urban primary health center (UPHC) and the Gaushala Sindri urban community health center (UCHC). In a subsequent coaching session, the DUHM and TCI team conducted a deep dive to identify the potential reasons and next steps for getting PPIUCD services into both facilities.
According to the DUHM, family planning services were in poor shape prior to Dhanbad’s engagement with TCI because of a lack of trained professionals and community health workers, as well as poor UPHC infrastructure. Both facilities were offering delivery services and temporary family planning methods, but not PPIUCDs.
With TCI support, providers were already receiving training and the medical-officer-in-charge was considering ways to improve the existing UPHC infrastructure. Because the time was ripe for the facilities to also start offering postpartum family planning services, a plan was presented to the Civil Surgeon (CS) and Dr. Sanjeev Kumar Prasad, the District Reproductive and Child Health Officer (DRCHO), in a family planning review meeting in November 2022.
The CS and Prasad both had questions about the readiness of these facilities and the staff, but after a few additional meetings, the DRCHO approved the plan. He then directed the medical officer-in-charge (MOIC) to initiate PPIUCD services as soon as possible and report back to the CS office.
Prasad said he appreciated the coaching that the UPHC and UCHC staff and the entire district health team were receiving from TCI as it was making all the difference. He noted to the medical officer and DUHM that:
Infrastructure, equipment, trained providers, uninterrupted FP supplies, and commodities must be ensured and then only the community will accept and acknowledge the services.”
Prasad also wanted to ensure PPIUCD clients received follow-up care and instructed the MOIC and DUHM to seek the support of the district quality assurance team to improve the quality of family planning services.
After PPIUCD services began at the Sindri UPHC and Gausala Sindri UCHC in November and December 2022, HMIS data has since recorded 20 new PPIUCD clients.