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Making Family Planning More Available in Manyara Region, Tanzania
Tanzania's unmet need for family planning—including for people living with HIV—remains high, hovering near 25%. URC recognized that integrating HIV and family planning services would likely improve service uptake and therefore led efforts to do so at five hospitals in Manyara region early last year.
Before integration, people needing both HIV and family planning services had to start at the care and treatment center (to get HIV services) and then go to the reproductive and child health clinic (for family planning services). One hospital official told us, "Most clients didn't like this process because . . . they had to waste more time queuing for one service before they went to queue for another service." Many clients gave up before receiving family planning services.
With guidance from URC, hospital management and staff focused on the systems that provided HIV and family planning services and merged the path carrying clients needing both types of services. The USAID-supported Health Care Improvement (HCI) Project advised staff/ management of how to apply quality improvement methods to integrate both types of services for those who needed both. Work begun by HCI was carried forward by its successor project, the USAID Applying Science to Strengthen and Improve Systems (ASSIST) Project.
For example, at the Mbulu District Hospital care and treatment center, the project helped staff/ managers identify changes that would make it easier for people living with HIV to access family planning services. A major change was to alter the patients' flow pattern so that both services were available at one stop.
Other changes included training providers at the center on family planning methods, having registers to record information on clients, introducing family planning counseling services, and educating clients about family planning.
The proof, however, is in the numbers. In one year (January–December 2012) the center raised the percentage of HIV clients having a family planning method to 88%, well above the national average. The other four project facilities experienced similar levels.
November 06, 2013