MOMENTUM PRIVATE HEALTHCARE DELIVERY
Since May 2021, CRS has been implementing the MOMENTUM PRIVATE HEALTHCARE DELIVERY (MPHD) in 2 Provinces of Nepal. The MOMENTUM is a part of a suite of innovative awards funded by the U.S. Agency for International Development (USAID) to holistically improve maternal, newborn and child health services, voluntary family planning, and reproductive healthcare (MNCH/FP/RH) in partner countries around the world. The project helps to expand public and private partnerships to strengthen the enabling environment for MNCH/FP/RH in support of the MOMENTUM suite of awards.
The MOMENTUM project in Nepal supports the advancement of 105 selected private sector facilities along a pathway to equitable and profitable delivery of high-quality, client-centered FP services.
THE GOAL of the project is to start a successful business model for the private sector to provide quality FP services to adolescents and young people in Nepal.
1.Improve technical capacity to deliver quality, client-centered FP services, including counseling, contraceptive methods and referrals to young people that include adolescents (15 to 19 years) and emerging/young adults (20 to 29 years)
2.Improved managerial and overall institutional capacity towards offering services in an equitable, profitable and sustainable manner.
THINGS DONE UNDER MOMENTUM
After the province and palika level kickoff meeting, the field team for the MOMENTUM project were mobilized and various field work were initiated starting with primarily identification of health facilities and pharmacies in both the project provinces.
A client feedback mechanism tool was prepared in order to collect and use actionable client feedback for continuous quality improvement efforts to make selected private sector health facilities and providers more adolescent friendly. The client feedback mechanism tool was prepared and pretested and revised based on the findings and recommendations from the pretest and is set up on SurveyMonkey with tailored data dashboards to be able to share with specific facilities as well as make aggregate analysis.
HCD is an integral part of the MPHD approach as it provides perspectives of the different groups of people involved such as providers, facility owners, adolescents and emerging adults to inform the various components of MPHD Nepal.
MPHD Nepal conducted HCD user group assessments in Province No. 2 and Karnali Province in October 2021 with different sub-groups of adolescents and youth namely unmarried, newly married, married with at least one child, and married with absent spouses or migrant partners to comprehend their perspectives for delivering quality, client-centered and equitable FP services to adolescents and youth. Based on the findings from these assessments with user groups and private sector providers and owners, a co-design workshop was planned among the user group and providers/owners that would help to inform the project interventions, for instance PBCC, business skills training, client feedback mechanism and other interventions as appropriate. Similarly, various user group assessments with providers and owners in the project provinces was also conducted for the same.
ASRH Basic Training to Private Sector Providers/Owners
MOMENTUM Nepal has conducted 6 batches of ASRH basic training to a total of 101 private sector providers/owners private sector providers/owners from pharmacies, clinics/polyclinics and private hospitals from both the project provinces in collaboration with the National and Provincial Health Training Centers to enhance their skills to provide adolescent-responsive FP and RH services. The findings from user group assessment of clients and providers as part of HCD conducted by MPHD Nepal were also woven into the delivery of the training to adapt to the private sector providers.
REPORTING AND RECORDING
A two-day MEL training to the field staff that helped them to understand MPHD project recording and reporting tools, data reporting mechanism, data flow chart, reporting indicators, baseline and target for each indicator including learning agenda. The trained field staff will transfer these skills to the providers in their respective municipalities. The sessions on Health Information Management System (HMIS) 3.2 and 9.3 were also covered to orient the field staff on the government reporting system, especially reporting on FP services from private sector health facilities and pharmacies. Later, all the private sector providers received orientation on the recording and reporting tool and facility level data recording has also been initiated by the private sector facilities in the project intervention areas.
A three-day training on PBCC was conducted in January which was tailored to adolescent contraceptive provision and FP counseling specifically to adolescent and young clients, and provider bias against providing contraception counseling.
PBCC skills are used to interact with providers/owners during QA/QI visits including monitoring visits to the health facilities and pharmacies for client feedback and recording and reporting mechanism. The field staff will use a PBCC provider strategy planner to plan the visits with specific objectives. The PBCC training was also followed by a refresher training in July.
Whole site orientation
ASRH whole site orientation was provided to the private sector providers in both the project Provinces with the aim to enhance their capacity to deliver quality and client-centered FP services to adolescents and young adults as well as to brief them about the project overview and key interventions. The whole site package was designed to orient all providers of respective health facilities so that they can provide adolescent-friendly services.
Sangini (DMPA) Basic Training to Private Sector Providers
Besides the general Sangini Training that Nepal CRS provides outside the MPHD project, as a part of strengthening the technical capacity of the private sector providers/owners to deliver client centered quality FP counseling and services, a three-day Sangini (DMPA) basic training was conducted for the Health Facilities. A total of 7 Sangini Training covered all the health facilities that were non-Sangini outlets.
Quality Assurance and Quality Improvement
MPHD Nepal plans to tailor, streamline, and adapt the existing Quality Assurance Mobile Application of Nepal CRS Company, a locally developed and used mobile application to monitor the quality of FP services provided by private sector health facilities. The QA/QI approach in MPHD Nepal is supplemented by an adolescent client feedback mechanism, PBCC training and findings from the HCD. The monthly QI review sessions support reviewing the action plan, client feedback and monitoring the progress using the quality measurement parameters.
COMMUHNITY YOUTH ENGAGEMENT MEETING
Community youth engagement is a part of FP demand generation activity targeted among adolescents and young adults in the age group of 15–29 years and conducted 51 events in different settings such as community, youth clubs and schools. Under MPHD, Nepal CRS continues to carry out these activities with adolescents and young adults in both provinces that reached a total of 1945 (796 male and 1149 female) participants. These activities aimed to provide them knowledge on adolescent sexual and reproductive health services, informed choice including physical, social and physiological changes during the adolescent period and improve linkages with the project supported service sites.
Value Clarification and Attitude Transformation (VCAT) Training to Project Field Staff
A two-day VCAT training tailored to the project context was organized with the aim to enhance capacity of the project field staff to clarify their own values on FP and equip them with evidence and skills to carry out value clarification and attitude transformation of private sector providers and owners. The training was mainly focused on understanding and respecting values related with FP using effective techniques and exercises for attitude transformation and was tailored for private sector context with data and evidence. The trained project field staff will cascade this training to the providers/owners in their respective municipalities using the same materials and methods.