Transcript Country Team Action Plan

Country Team Action Plan
Bihar, INDIA
Where are we now?
Current levels of accomplishment/Progress
and challenges since Bangkok 2007
Health
India
Indicato (Present)
r
CPR
47% total,
Tracks 1 & 2
Bihar
(Present)
Goal 2011
28% total, 31% total
24%
26%
limiting, 4% limiting,
spacing
5% spacing
2
Where do we want to be?
GOAL
Increase CPR from 28% to 31% by 2011
• Increase birth limiting from 24% to 26% by
2011
• Increase birth spacing method use from 4% to
5% by 2011
• Total case load expected: Approx. 2 million new
clients
Tracks 1 & 2
3
What are the gaps (1)?
Current Situation
– Space constraints prohibit retaining
women after delivery
– Shortage of trained Human resources
– Supervisory limitations
– Govt. service providers not trained in
PPIUD
– Provider prefer to deliver permanent
Track 1 methods
4
What are the gaps (2)?
Current Situation
–Low level of rapport and trust in
client-provider interaction
–Lack of male/family involvement
–Non involvement of RMPs
–Inadequate monitoring and
supervision
–Less use of data for feedback in
Track 1
monitoring
5
What are the gaps (3)?
Current Situation
– Misconceptions about “delay” of first
pregnancy versus “spacing” and “limiting”
births
– Breaks in service delivery due to floods
every year
– Limited involvement of private sector
providers
–1Issues in supply chain management
6
Track
What interventions
can we use to close the gap?
• Task shifting/Task sharing
• Increased involvement of private
sector in service delivery
Track 1
7
Task shifting/Task sharing
Track 1
8
Action steps for
Task shifting/Task sharing
• In service training on Contraceptive
Updated counseling to
ANM/ASHA (Volunteers)/AWW
• Review and revise job description
for ASHA/AWW/ANM
• Provide supportive supervision
• Post-Partum Home visit to be
mandatory by AWW/ASHA and
monitored by ANM
Track 1
9
Action steps for
Task shifting/Task sharing (continued..)
• Incentivise post partum home
visits by ASHA and AWW
• Include and prioritize FP in
VHND agenda
• Training of ANM on post
partum IUCD insertion
• Utilize opportunity for
counseling for IUCD/other
modern methods in institutional
deliveries.
Track 1
10
What are the possible challenges
to the intervention?
Challenges
Government approval for job
revision
Solution
Advocacy, Sharing of evidence
Resistance from govt. providers on
task sharing /shifting
Reward, Award & Recognition to
providers
Exposure Visits
Ensuring supplies and distribution
Logistics Planning and Supply chain
management
Quality maintenance at scale
IP training and supply.
Operationalize QAC
Track 1
11
Who are the possible partners,
allies, and stakeholders?
Sl Areas
#
1 Policy and
Funding
Partners
2
Technical
Assistance
3
Services
Development Partners( JSK,
UNFPA,Path finder, PFI,
PACKARD,BMGF,DFID,
B TAST ,CARE, PSI)
CARE, Janani, PSI, Path finder,
other NGOs, MOHFW,MOWCD
Track 1
MOHFW, MOWCD (Center &
State), UNFPA,DFID, BMGF,
PACKARD, WHO, Unicef
12
Involvement of Private Sector
Track 1
13
Action steps for
Increasing involvement of private sector
• Advertisement in local and national news papers
and media during June (State Directorate).
• Stake holders consultation( IMA/FOGSI) DGFW –
State IMA/FOGSI President.
• Provision of Funds in PIP.
• Approval from GOI for resource fee for Pvt.
Service providers
• Competency Assessment of providers/training
• Empanelment of selected providers (DGFW).
Track 1
14
Action steps for
Increasing involvement of private sector, cont’d
• Contact government in other states (state PS) to
facilitate empanelment of service providers.
• TOR (Government and FOGSI).
• Target 38 district/534 blocks (CMO).
• Operational Plans (# of clients, support staff,
equipments, supplies)
• Design mobile teams for FDFS (fixed day fixed site)
service
Track 1
15
What are the possible challenges
to the intervention?
Challenges
Existing GOVT doctors might
complain about involvement of
outsiders
Solution
Sensitization of government
doctors
Physical verification and payments Third party verification/ on
spot verification
Adequate number of clients
Strengthen BCC
Compliance with Government
norms regarding standards and
practice
Training programs
Private providers’ expectations
Counseling
Track 1
16
Additional points for involving pvt.
sector
• Pvt. Sector involvement for birth spacing methods
– Injectible contraceptives
– IUCD
– Oral Pills
– Condoms
– SDM/LAM
• Action plan to be determined
Track 1
17
Thanks
Track 1
18