1. National stakeholders meeting on MNCH/HIV Giraffe Hotel, Sept. 24, 2014 Integration of FP in MNCH and other setting, experience in Health facilities in Masasi

2.  INTRODUCTION  CURRENT SITUATION  WHY FP INTEGRATION  INTEGRATION PROCESS  INTEGRATION APPROACH  ACHIEVEMENTS  CHALLENGES  WAY FORWARD Outline

3.  Masasi was one of the six districts of the Mtwara Region Bordered to the North by the Lindi region, East by Newala district, South by Ruvuma River and Mozambique and to the West by Nanyumbu District  Masasi have been geographically divided into Masasi Town Council and District Council INTRODUCTION

4. ---introduction--- DISTRICTMASASI D.CMASASI T.C POPULATION275,944 147,644 WRA65,64126,639 MMR258/100,00071/100,000 HEALTH FACILITIES 41 (1hos,3hc,37 disp) 13(1hos,12disp) HF providing RCH services 409 Health facility delivery 74%98%

5.  Maternal Mortality rate still high now stand at per 258/100,000 in Masasi district  FP is well recognized for its role in reducing maternal, child and newborn morbidity  Clients in need can only access services at RCH clinic in FP room  Missed opportunities for potential clients who visit the facility for other reasons Why integrated FP into other services?

6.  In March 2014, CHMT Masasi district in collaboration with MOHSW and EngenderHealth Piloted integration of FP into other units/services/departments in 4 Health facilities  These are: CTC, Immunization, ANC, OPD, in patient ( male, female, paediatric, gynaecological wards ) and labor and delivery Integration process

7.  Stage 1: Orientation meeting : RHMT,CMHT, Facility in charge and other RH/FP stakeholders partners in Mtwara Region  Stage 2: Facility assessment to determine which units can integrate FP and capacity gaps  Stage 3: Orientation of all staff at the facility about service integration-138 health staff and other supporting staff-mortuary attendants,watchmen --Integration process

8.  Stage 4: System strengthening  Skills training of 17 staff from other units on FP  Distribution of FP commodities in relevant units  Distribution of FP data collection tools in other unit ( MTUHA 8,  Referral for method not available at the unit/facility  Stage 5: Continuous monthly data collection – collecting FP data from all units Integration process

9.  A client/patient shows up at he facility for any reason  A provider attend the primary problem  Provider at CTC, OPD, IPD etc. informs a patient about availability of FP services  Interested clients are counseled and given FP method at the same unit ( Short-term methods and implants) Integration Approach

10.  For method not available ( IUCD and Permanent methods) a client is referred to FP unit or out side the facility)  Provider records – information in MTUHA  Monthly RCH coordinator collect data from all units and prepare monthly summary form for the facility Integration Approach

11.  Availability of Family Planning services in other units/department  Increased number of clients receiving family planning services.  Decreased waiting time and receiving comprehensive services at the same unit.  Reduction of working overload at RCH clinic.  Increased number of staffs trained on family planning in different sections/units. ACHIEVEMENT

12.  ‘’A watchmen who attended FP integration orientation meeting at Mkomaindo Hospital said; QUOTE; ‘’ I see many young girls who are pregnant passing at the gate going to the hospital and I really feel pity on them. The knowledge of FP I have obtained today I will make sure I talk to their parents and other people who also come to the hospital and my neighbours were I stay””.

13. S/N O METHODSJUNEJULYAUG 1.PILLS ( COC, POP)233212 2.DMPA301520 3.IMPLANTS10305 4.BTL, VASECTOMY000 5.CONDOM1218 6.PAC-FP126 7.REMOVING IMPLANON001 TOTAL769762 NEW FP CLIENTS AT MKOMAINDO HOSPITAL

14. S/NOMETHODSJUNEJULYAUG S/NMETHODSJUNEJULYAUGUST 1PILLS (COC,POP)134417 2DMPA241622 3IMPLANTS832 4BTL,VASECTOMY000 5CONDOM4362 6PAC000 7 REMOVING IMPLANON 000 TOTAL499943 REVIST FP CLIENTS SERVED IN OTHER UNITS MKOMAINDO HOSPITAL

15.  Inadequate knowledge on long acting family planning method to other service providers  Inadequate MTUHA books  Inadequate number of skilled/trained staffs.  Shortage of Family Planning commodities, e.g. POP, female condoms CHALLENGES

16.  To conduct On job training and mentorship  To conduct community sensitization on availability of FP services in other health sections/units.  To do correct forecasting and quantification of family planning commodities.  To ensure availability of MTUHA books for proper documentation  To scale up in other health facilities in the District WAY FORWARD

17. Trainee attending a client

18.  FP INTEGRATION WILL CAPTURE THE MISSED OPPORTUNITIES.

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