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Integrating Family Planning in Community-based Maternal and Newborn Care in
Bangladesh
Presented by: Nazmul Kabir
Date:2nd December, 2011
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MaMoni: Integrated Safe Motherhood, Newborn Care and Family Planning Project
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1 2 3 4 5 6 7 8 9 p1 p2 p3 p4 p5 p6
D
IFA Supplementation
ANC1
TT
ANC2 ANC4
TT
ANC3
Pregnancy identification
Misoprostol
Clean delivery and immediate
newborn care
PP maternal care, Vit A and management of
complications
Essential newborn care/KMC
Management of newborn
complications
Immunization
Postnatal session promoting LAM, spacing, PoP, FP, transition
ARI, CDD, EPI
Supply of PoP, transition to modern method, Supply of
FP methods
Integrated maternal, newborn care, child health and Integrated maternal, newborn care, child health and family planning packagefamily planning package
Birth preparedness
HW counseling
AMTSL &
referral for
EmOC
Exclusive breastfeeding and
promotion of LAM/PPFP
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Capacity building
Govt staff NGO staff
Health staff FP staff
Training on integrated MNH-FP package including injectable contraceptive administration
A pool of trainers developed from both Health and FP department
Area of integration: Capacity BuildingArea of integration: Capacity Building
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Service delivery
Facility levelHousehold level
• customized MNH-FP counseling during bi-monthly visits and at facilities by Govt and NGO workers
• Short term method distribution
• Injectable administering
• 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
Area of integration: Service DeliveryArea of integration: Service Delivery
Administering of injectable Contraceptive by MaMoni CHW
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• Community Action Groups (CAGs) formed: 1904
Area of integration: Community MobilizationArea of integration: Community Mobilization
MN
H
FP
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Reinforced key behavior change issues at community Reinforced key behavior change issues at community level through community action groups . . .level through community action groups . . .
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Micro-planning meeting at unit level:
FP staff (FWA)
Health st
aff
(HA)
• Update info• Status check 100%• Reach vulnerables • Action planning
System Strengthening
Out put:
Increase coverage
Increase quality
Out put:
Increase coverage
Increase quality
Community
Volunteer
NG
O s
taff
(CH
W)
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MicroplanningMicroplanning
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Source: BDHS, 2007Baseline survey, Sep’10Progress Assessment’ April’11
CPR in Sylhet - Modern Method
Progress measure …
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Percentage of pregnancy status at Sylhet
Source: Baseline survey, Sep’10 Progress Assessment’ April’11
Progress measure …
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Trend of LAPM Performances
MaMoni (Before 8 months)CYP=30785, Average= 450
MaMoni (After 8 months)CYP=57875, Average= 1000
Source: GoB District report, MIS-5, Sylhet
Progress measure
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Issues and Challenges: 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
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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
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Birth Spacing picture cardBirth Spacing picture card
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Birth Spacing picture cardBirth Spacing picture card
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Thank You