Watch now: [26:09 – 38:00]
Srishti Shah presented on the USAID supported MOMENTUM Private Healthcare Delivery Nepal project implemented by FHI 360, Nepal CRS Company, and PSI Nepal. During the pilot phase engagement – started in October 2021 – the project worked with 105 private sector facilities and pharmacies across 7 municipalities and 2 provinces in Nepal.
The project improved technical capacity in adolescent sexual and reproductive health (ASRH) and FP counselling, initiated quality improvement approaches including a client feedback mechanism, and enhanced data collection and use from the private sector. To link improved quality FP service delivery to customer loyalty and improved business, they also implemented a business skills training that included demand generation skills, and implemented community mobilization efforts.
During the pilot phase, 158 private providers were trained in ASRH and received training on value clarification and attitude transformation to challenge harmful norms and stigma around providing adolescents with FP/RH services including contraceptives. In addition, 180 providers were trained in how to provide injectables to clients.
It’s also worth highlighting that at the beginning of the project, only 14% of providers had set aside counselling rooms or spaces. In response to monthly quality coaching that highlighted the importance of privacy, by the end of the pilot implementation period, all site owners had restructured their existing space to make private counselling rooms or spaces for all clients, including adolescents. In addition, during the pilot phase each site received more than 200 clients every month seeking short acting contraceptives, of which 20% were adolescents and 46% were young people.
The project is currently scaling up to 811 new sites across 64 additional municipalities and 6 provinces. In their shift to scale-up, the pilot sites are moved from intensive monthly support to a less intensive quarterly support to encourage them to be more self-reliant and to operationally enable the project staff to offer the same package of intensive support to the new scale-up sites. The project’s key scale up considerations include adaptive management for which the team uses the automated dashboards from the quality improvement and monitoring application as well as timely pause and reflects. Additionally, refining the approach to suit new geographies and context as well as approaches such as journey mapping and Human-Centred Design are used to tailor implementation for marginalised communities within the expanded catchment area during the scale-up. Lastly, sustainable linkages are built so that government authorities and private sector clusters take up ownership for the interventions that worked and continue quality improvement sustain gains made during engagement with the project.