Avances en la medición de la escala y el alcance de las HIP: resumen de la serie de seminarios web

Sessions and Speakers

Fondo

The conversations about measuring HIPs started during the early days of creating the HIPs themselves and continue to this day. In the Accelerating Access to Postpartum and Postabortion FP meeting that took place in Nepal in October 2023, stakeholders from 16 Anglophone countries came together to assess their progress on scaling up Immediate Postpartum FP (IPPFP) and Postabortion FP (PAFP). During the meeting, participants discussed measurement, referring back to these four recommendations developed in 2018 to understand what is and is not being routinely collected via national Health Management Information Systems (HMIS). They shared challenges around data collection, alignment of definitions and indicators, and gaps in what is currently being measured and what is desired. This webinar expanded this discussion to even more participants by presenting additional country experiences and perspectives collecting data about IPPFP and PAFP through national HMIS and implementing partner information systems. The webinar also facilitated discussions about the recommended indicators, including what is feasible and can therefore be retained and what may need to be changed.

For the most part, the discussions illustrate support for the globally recommended indicators. Participants agreed to maintain the uptake indicators for both IPPFP and PAFP, and also agreed that having disaggregation by method for both is very important. Many participants also felt that having disaggregation by age was relevant for IPPFP, but cautioned against this for PAFP given concerns about stigma. When it came to capturing data on counseling, many participants felt that this is a helpful process indicator that should be collected at the level of facilities but that it may not need to be reported up into national HMIS. However, participants from Francophone countries did want to capture data on counseling for IPPFP (especially counseling during antenatal care), which they noted as critical to build demand.

While participants were generally supportive of these globally recommended indicators–and suggested that the PAFP indicators, in particular, need to be shared more extensively–they also clearly stated that countries should be able to prioritize for themselves what information to extract from registers and report up the national HMIS, given that limited time and resources likely means they cannot collect and report everything.

Links

• Recopilación de conocimientos de FP of resources relevant to this webinar series
• Meeting recording
• Presentation
• Speaker bios
• IPPFP HIP brief
• PAFP HIP brief
• PPFP Steering Committee Recommendations

Sessions and Speakers

Fondo

This webinar focused on advancing measurement of the scale and reach of two HIPs–Community Health Workers (CHWs) and Pharmacies and Drug Shops. The overarching objective of these discussions was to identify how to improve routine monitoring of scale and reach of HIPs through national HMIS and implementing partner information systems. These two HIPs are essentially community-based and present unique challenges for integrating data into broader systems, and unlike IPPFP and PAFP, neither have a set of globally recommended indicators.

During the webinar, speakers presented on the landscape of indicators that are currently in use, by partners and within national HMIS, to monitor the scale and reach of these two HIPs. The presentations demonstrated that CHWs in the countries covered in this webinar collect information on the family planning services they provide to clients but that information is aggregated in summary forms and reported up the HMIS to varying degrees. In contrast, there is essentially no consistently available data captured about family planning provision via pharmacies and drug shops in HMIS, despite some variable indicator collection by partners.

There seemed to be general agreement on the way forward for measuring the scale and reach of CHWs, including:

• Indicators focused on family planning uptake are high priority, with interest in disaggregations by age and by method.
• Options for indicators may vary depending on how data flows in a country work (in particular, whether CHW data are collected separately or combined with facility data).
• Challenges with tracking referrals makes this type of indicator a lower priority.

For Pharmacies and Drug Shops, participants noted that the challenges to collecting data from these institutions are numerous and significant, which requires serious thought about what is essential to collect–such as limiting to an indicator about uptake–and how to think creatively about incentives and reporting structures to best enable data collection. More discussion will be needed.

Links

• Recopilación de conocimientos de FP of resources relevant to this webinar series
• Meeting recording
• Presentation
• Speaker bios
• CHW HIP brief
• Pharmacies and Drug Shops HIP brief

Sessions and Speakers

Fondo

This second set of webinars, following the first set related to measuring the scale and reach of HIPs, focused on advancing measurement of the calidad of HIP implementation. Quality can be examined from multiple angles, including client-provider interactions—for example, whether the client was treated with respect and whether the client was told about all of their options, without the provider swaying them to one choice or another—and outcomes of care—such as client knowledge, satisfaction, and continued use of contraception. These dimensions are more often what people think of when they think of quality, and they have more established measures associated with them (such as the Índice de información del método). But quality can also be examined from the structural angle, which is about the intentions and readiness to put all necessary resources, inputs, and structures in place to support a given practice. The definition, and measurement, of this dimension of quality as it relates to HIPs has received relatively little focus, although it is essential for understanding and improving HIP scale-up.

The goal of this two-part series was to support systemic, harmonized measurement of HIP implementation by  sharing two new approaches—one developed by the Data for Impact (D4I) project and the other developed by the Research for Scalable Solutions (R4S) and SMART-HIPs projects—that define the quality of HIP implementation as “the extent to which a HIP is implemented in accordance with key implementation components.”  The Key Implementation Components are derived from HIP briefs and describe the specific aspects of a HIP that must be implemented in order to ensure that it is high-impact.

Links

• Recopilación de conocimientos de FP of resources relevant to this webinar series
• Meeting recording
• Agenda
• Speaker bios
• More information about the Key Implementation Components can be found aquí.
• This brief provides more information about the D4I self-assessment checklist methodology for assessing quality of HIP implementation, and este resumen includes the checklists themselves.
• You can listen to our previous webinar on measuring the scale and reach of IPPFP and PAFP aquí.

Sessions and Speakers

Fondo

This second set of webinars, following the first set related to measuring the scale and reach of HIPs, focused on advancing measurement of the calidad of HIP implementation. This two-part series introduced participants to two approaches for assessing whether HIPs are being implemented in accordance with established guidance—referred to as Key Implementation Components. One tool, developed by the Data for Impact (D4I) project, can be used by implementers to qualitatively self-assess the extent to which they are implementing each key implementation component. The second tool, developed by the Research for Scalable Solutions (R4S) and Smart-HIPs projects, seeks to quantitatively evaluate each key implementation component at the point of service using a set of readiness standards. The webinars focused on how these approaches were developed and tested and how they could be applied to measuring the quality of HIP implementation. The webinars also generated feedback about how these approaches could be used in a variety of contexts. Participants saw opportunities to use both tools and offered suggestions for how to further contextualize their use.

Links

• Recopilación de conocimientos de FP of resources relevant to this webinar series
• Meeting recording
• Agenda
• Speaker bios
• More information about the Key Implementation Components can be found aquí.
• This brief provides more information about the D4I self-assessment checklist methodology for assessing quality of HIP implementation, and este resumen includes the checklists themselves.