Something for Everyone FP and MNCH Integration

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Something for Everyone! FP and MNCH Integration

• Catharine McKaig, Director, ACCESS-FP,
• Elaine Charurat, Senior Program Officer,
  ACCESS-FP

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Session Outline

• Brief overview of MNCH/FP Integration
• Assessment objectives and methodologies
• Group work report out
• Results from Afghanistan and Nigeria
• Discussion

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MNCH/FP Integration

• ACCESS-FP mandate of addressing unmet family
  planning need among postpartum women through an
  integrated approach
• Traditionally, FP is often provided within MCH
  units but not fully integrated, often provided as
  a separate service

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Literature Review

• Rationale for integrated services
• Womens perceptions
• Client satisfaction
• Service quality
• Providers time
• Provider skills
• Negative effect on other services

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Assessment of MNCH/FP Integration

• To identify, analyze and synthesize lessons
  learned in MNCH/FP integration in Afghanistan and
  Nigeria through
• Interviews with policy influential
• Interviews with providers
• Participatory exercises and guided discussion
  with women and community members

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Group Work Instructions

• Based on your interest, please select one of the
  three groups
• Policy makers or influentials
• Health care providers
• Community members
• You will be expressing your point of view as a
  policy maker, health care provider, or community
  member when participating group exercise (15 min)
• Each group will report briefly on discussion (5
  min total)

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Program Profiles
Nigeria EmONC, FP, ANC, and postpartum care
using a household-to-hospital continuum of care
approach

• Afghanistan basic health services focusing on
  service utilization and quality

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In Afghanistan

• Policy makers
• Importance of FP varies by position
• FP contributes to MDG4 5
• Strong MOH commitment to support integration
• Providers
• ANC ranked high as protective, as a gateway
• FP seen as well integrated with PNC, but not with
  ANC, delivery care or child care (immunization)
• Staff workload and misconceptions affecting
  service provision
• Community members
• Newborn care is largely unknown
• Barriers to service use religion, family
  gatekeepers (mostly mother-in-laws),
  misconceptions, political interpretation, distance

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In Nigeria

• Policy makers
• ANC as most important as gateway to other
  services
• FP contributes to MDG4 5, also it is important
  for maternal and child health and economic
  benefits
• Positive reactions to integration
• Providers
• ANC as most important as gateway to other
  services
• FP is well integrated in MNH services and women
  react positively
• Benefits of integration are frequently mentioned
• Community members
• ANC as most important because it leads to safe
  delivery
• Pregnant and breastfeeding women do use and are
  familiar with relevant services
• Some preferred receiving services in different
  days due to long queues
• Cost and transportation are main barriers for
  labor delivery services

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Takeaways

• Association between FP and maternal/infant
  mortality was somewhat acknowledged
• ANC is often ranked the most important, but
• It is limited in terms of mortality reduction
• Experience indicates its limitations to other
  service use
• Priorities appear to be reflective of services
• None of the respondents drew any link between FP
  provision and non-use of other services
• Clandestine use was reported, although difficult
  to quantify strong argument for integration
• Methodology could be improved, but needed for
  discussing integration in concrete terms

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WE NEED TO LEARN MORE

• Suggestions/comments
• Reports and tools can be found on ACCESS website
• http//www.accesstohealth.org under Tools and
  Resources