Integrating Family Planning in Communitybased Maternal and Newborn Care in
Bangladesh
Presented by:
Nazmul Kabir
Date:
2nd December, 2011
MaMoni: Integrated Safe Motherhood, Newborn Care
and Family Planning Project
PP maternal care, Vit A and
management of
complications
Management of
newborn
complications Essential newborn
care/KMC
Clean delivery and
immediate
newborn care
Misoprostol
Pregnancy
identification
ARI, CDD, EPI
Supply of PoP, transition to
modern method, Supply of
FP methods
Postnatal session
promoting LAM, spacing,
PoP, FP, transition
Birth preparedness
HW counseling
Immunization
IFA
Supplementation
TT
ANC1
1
2
3
TT
ANC3 ANC4
ANC2
4
5
6
7
8
9
p1
p2
p3
p4
p5
D
AMTSL
&
referral
for
EmOC
Exclusive
breastfeeding and
promotion of
LAM/PPFP
Integrated maternal, newborn care, child health and
family planning package
p6
Area of integration: Capacity Building
Capacity building
Govt staff
Health staff
NGO staff
FP staff
Training on
integrated MNHFP package
including
injectable
contraceptive
administration
A pool of
trainers
developed from
both Health and
FP department
Area of integration: Service Delivery
Service delivery
Household level
• customized MNHFP counseling during
bi-monthly visits and
at facilities by Govt
and NGO workers
• Short term method
distribution
• Injectable
administering
Facility level
• Community Clinic- Health
staff (HA) preserve FP
commodities of FP staff
(FWA) and distribute to the
clients.
• EPI session- HA promote
EBF/LAM
• Sub District and District
health complex- Health staff
also provide FP services
Administering of injectable
Contraceptive by MaMoni CHW
Area of integration: Community Mobilization
FP
MNH
Issue
identification
and set
priorities
Organize
community for
action
Evaluate
together
Plan together
Act together
• Community Action Groups (CAGs) formed: 1904
Reinforced key behavior change issues at community level
through community action groups . . .
System Strengthening
• Update info
• Status check
100%
• Reach
vulnerables
• Action planning
Microplanning
meeting
at unit
level:
Out put:
Increase
coverage
Increase
quality
Govt
staff
NGO
staff
Joint
visit
Microplanning
Progress measure …
100
CPR in Sylhet - Modern Method
75
%
50.8
50
34.0
25
24.7
0
DHS 2007
Baseline 2010
Source:
7 months after baseline
BDHS, 2007
Baseline survey, Sep’10
Progress Assessment’ April’11
Progress measure …
14
Percentage of pregnancy status at Sylhet
12
10
11.5
9.4
8
6
4
2
0
Precentage of pregnant women during Percentage of pregnant women after 7
baseline survey Sep'10
months of base line
Source:
Baseline survey, Sep’10
Progress Assessment’ April’11
Progress measure
1600
Trend of LAPM Performances
1400
MaMoni (After 8 months)
CYP=57875, Average= 1000
1200
1000
800
MaMoni (Before 8 months)
CYP=30785, Average= 450
600
400
200
0
Source: GoB District report, MIS-5, Sylhet
Issues and Challenges:
• In practice limiting emphasized rather spacing
• Male involvement is minimum
• Record keeping and MIS system
• PoP is not in Govt supply channel
Adopting PPFP
•
•
•
•
Adapted early HFS experiences of PPFP
EBF, LAM Incorporated in MNH-FP package
Added IYCF-Peer approach
Promoting HTSP through community action groups
Birth Spacing picture card
Birth Spacing picture card
Thank You