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Enabling Private Facility Provision of LARC/PM through an Integrated Model

Stephen Rahaim, Asia Regional Manager, BCC Advisor SHOPS Project April 2, 2014

SHOPS is funded by the U.S. Agency for International Development. Abt Associates leads the project in collaboration with: Banyan Global Jhpiego Marie Stopes International Monitor Group OHanlon Health Consulting

Barriers to LARC/PM Provision in Private Facilities


Rules, regulations, and operating context

Skilled Providers

Investment

Lack of LA/PM Available through Private Facilities

Commodities

Demand

Inconsistent application of regulations

The Case for an Integrated Service Delivery Model for Private Facilities in Bangladesh
52% modern CPR rate, 61% total 13% of total CPR is LARC/PM, down from 30% in 1991 Pre and post natal care offer a good opportunity for FP integration Pre and post natal care are increasing, private sector provides 43% of all ANC visits

The Case for an Integrated Service Delivery Model for Private Facilities in Bangladesh

Public: 4.2 percentage points increase

SHOPS Integrated Service Delivery Model


Reaches women where they are seeking services Lowers actual and perceived investments

SHOPS Integrated Service Delivery Model


Private for-profit hospitals and private medical college affiliated hospitals Providing 100+ deliveries per month Previously provided very few LARC/PMs but experienced with short-acting methods Assessed: 80+, 50 MOUs, 37 engaged in the integrated model and providing services Working with owners/chairs, senior administrators, department heads, senior Ob/Gyns, nurses and marketing staff
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Components of the Integrated Model


Adapted training to meet private provider needs
ObGyns, Graduate Docs and Nurses: method modules, infection prevention, balanced counseling

Community level marketing


Embedded agents and communication materials

Components of the Integrated Model


Supply
Ensured through interim social marketing source

Quality assurance
Focal point, integrated to facilitys existing systems

Reporting
Simplified reporting system to feed MOH/DGFP MIS

Business and management planning


To operationalize the model
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Lesson: Treat Each Facility as a Unique Health Business with Its Own Needs and Issues

Lesson: Operationalize the Model at All Levels

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Experience and Lessons


As of September 2013, 37 facilities are providing IUDs, implants, and tubectomies All facilities have made the necessary investments and are providing LARC/PMs Range of experience depending on time theyve spent with the model

Working through a customized approach is time consuming


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Challenges Going Forward


Reporting to GoB MIS Turn over of trained staff and training of new staff Consistent marketing of services

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Thank You
Stephen_Rahaim@abtassoc.com

SHOPS is funded by the U.S. Agency for International Development. Abt Associates leads the project in collaboration with: Banyan Global Jhpiego Marie Stopes International Monitor Group OHanlon Health Consulting