Interventions and Approaches
The priority audiences of the project are;
The project took into cognizance the amount of time a woman spends in the private health facility to develop strategies that will generate her interest and prompt questions about family planning during her clinic visits. This intervention spurs the women to ask questions, seek clarity, and be referred to a trained FP provider. The waiting area within the facility also creates the right avenue for the social mobilizers to approach clients waiting to be attended by skilled health workers with comprehensive FP information.
The PPFP project’s structural approach aims to integrate quality family planning information and referral into the facility’s structure through the following actions:
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Orientation of facility health workers to provide Family Planning information
Health providers ranging from medical doctors, nurses, midwives, community health extension workers and lower cadre health workers are equipped with the resources to adequately incorporate FP messaging into routine health talks provided during MCH clinics. The orientation focuses on how to conduct FP talks using developed talking points. The social mobilizers work within the clinic structures to support health talks, whilst ensuring screening of media materials in the waiting areas.
Supporting facility staff members to take ownership of in-clinic social mobilization activities
As part of the sustainability plans, the project developed and distributed how-to guides on in-clinic social mobilization activities across all the 236 supported facilities. This will ensure facility staff take ownership of the demand generation activities.
Satisfied post-pregnancy clients share positive experience of family planning during immunization clinics
To reinforce the return to fertility and demystify the safety of FP immediately after delivery, the project encouraged satisfied users to share their experiences with other women during immunization clinics. The users iterated the benefits and addressed various biases identified by the women.
Health facilities create an improved waiting room experience that generates discussions on family planning.
The Project worked with private health providers to improve the waiting room experience through the modified 72-hour clinic makeover, which ensured the availability of family planning information and services in the facilities. The Project also adapted and developed materials that addressed the needs of the post-pregnancy women and initiate family planning conversations during MCH clinics.
Conversation starters initiate discussions on family planning
Research had shown that many women believed that they were not at risk of pregnancy if they were breastfeeding (not necessarily exclusively). To address this, the project designed a tagline that asked the provocative question “Do you know you can get pregnant soon after delivery”.
This generated discussions on FP and led to numerous referrals within the facilities and surrounding communities.
Materials addressing concerns about exclusive breastfeeding
The project developed materials to address concerns around exclusive breastfeeding, return to fertility and the switch to another modern family planning method. The materials addressed the safety of FP use immediately after delivery and timing in the post-pregnant period to strengthen self-efficacy, promote couple communication and method use.
Displaying SBBC materials in the private health facility
To address the structural limitation of the private health facilities and the inability to display and mount materials, the project utilized roll up banners and magazine racks for the display of FP information. The materials are strategically located in the waiting areas and locations with high flow of the project’s target audiences.
Screen media materials in the waiting areas
The project provided media materials with entertainment-education content on family planning for screening in the waiting areas. The media materials include the Get-It-Together family planning songs, Newman Street TV, Wise Woman’s Diary video and a FP provider’s video.
One key challenge was how to ensure the facility staff routinely show the media materials. This was addressed by integrating the edutainment videos as part of the health talks provided during clinic days.
Ensuring prompt referral for family planning during MCH clinics
Antenatal and Immunization clinic days are a great avenue to refer post-pregnancy clients for family planning services. These mobilization activities, most especially during immunization clinics, lead to completed referrals and sometimes immediate FP method uptake, as most of the women are now aware of the risk of another pregnancy soon after delivery. These women are provided with the referral cards, which are collected after the visit to the trained provider.
Key Life Events (KLEs)
Celebration of key life events, such as baby naming ceremonies creates an avenue to engage the newly delivered mother, family and guests in discussions about family planning/modern contraceptives. The event is used to reach prospective clients with the right information about FP, dispel myths and misconceptions and explain the different FP methods and their benefit.
Attendees also receive information about where to access FP services. Social and behavioral change communication (SBCC) materials are distributed during the events with the presentation of branded gift materials to the couple.
KLE at Agege LGA
KLE at Oshodi-Isolo LGA
KLE at Alimosho LGA
Facility-initiated outreaches are conducted to create awareness on family planning services with technical support from the project. The facility staff go into the communities to educate people about FP and refer for balanced counselling. SBCC materials are distributed during the community activity. The project also developed how-to-do guide to support facilities to independently conduct outreaches.