CORE Group Fall Meeting 2010. Family Planning Integration: Overcoming Barriers to NGO Programming. A Presentation of Preliminary Results from the CORE Group CBFP/MCH Integration Survey. - Paige Anderson Bowen, CORE Group Consultant

1. Family Planning Integration: Overcoming Barriers to NGO Programming A Presentation of Preliminary Results from the CORE Group CBFP/MCH Integration Survey Paige Anderson Bowen, MPH CORE Group Consultant CORE Fall Meeting; September 15, 2010

2. Survey Objective To generate a set of recommendations directed to the CORE SMRH Working Group and USAID on information, tools and other publication resources, and guidance that is needed to mobilize and support organizations to integrate CBFP into community-focused MCH programs

5. Key themes identified in open-ended questions using content analysis techniques

7. 132 individuals invited to participate; at least one HQ and one field representative invited from each target organization

8. 51 respondents (39% response rate); 38 complete surveys

9. Respondents…

10. Evenly distributed among HQ (35%), country head office (37%), and field office (28%)

11. Primary role of almost half of respondents (45%) is program design/management

13. Barriers to CBFP Integration

15. Elements of Integration Elements of integration, as defined by respondents… Expanding access (11%): “To take the opportunity offered by a service already delivered, often in routine, to ‘’vehicle’’ the delivery of another new service.” Affordability (9%): “Collaboration and combination of all activities related to health promotion and diseases prevention to obtain optimum coverage and cost effectiveness.” Improving Quality (7%): “Incorporation of one element into another (FP into HIV, FP into MCH, HIV into FP etc) so that the resulting combination is an improved, more accessible service package for the user.”

17. Less Effective Entry Points Sick child visits (53%): “When a child is sick, mothers are too upset to be able to understand or retain FP messages, plus the child is upset and likely crying - not a constructive environment for counseling.” PMTCT (71%): “PMTCT is primarily to ascertain pregnant mothers HIV status and ensure she can access appropriate services if HIV positive. FP should be discussed after HIV status is determined…” VCT/HCT (73%): “HIV/AIDS counseling and testing is usually a tense and stressful moment for many people. Adding in issues of FP may not be the most appropriate time.”

19. Effective?

20. Less effective?

22. Respondents ranked barriers on a scale of 1-5

24. Helpful Resources to Facilitate Integration

26. Tools being used:

27. Frameworks: Postpartum FP Framework (Access FP, JHPIEGO), 7-11 Framework (World Vision), Birth Preparedness and Complication Readiness matrix (JHPIEGO)

28. Job Aides: CHW flipcharts, GATHER counseling tools, service checklists

29. Training curricula: CHWs, TBAs, CORPs, community health agents, pictorial

30. Books: FP Global Handbook, Where Women Have no Doctor, Helping Health Workers Learn

31. Guides, modules, case studies published by WHO, USAID, FHI, local MOH , and other partners

33. What tool or guidance document would help reduce largest perceived barriers (clinical, health systems/policy) and encourage FP integration?

34. Should any existing tool(s) be adapted and disseminated?

36. USAID/Washington

37. USAID Missions

38. Individual organizations

40. Recommendations for USAID Missions

41. Recommendations for CORE Group

42. Recommendations for Organizations