Family Planning Workforce
The health workforce includes personnel who provide health services, such as doctors, nurses, and community health workers (CHWs), as well as those who support health services, such as hospital managers and supply chain managers. The family planning health workforce is a key to ensuring that everyone has access to the health care and contraceptives they need to plan their families and lives. The health workforce is essential to helping countries increase contraceptive prevalence rates, reduce unmet need for family planning, and meet their FP2020 commitments and other national and global goals, including the Sustainable Development Goals.
Continue reading to learn about the family planning workforce:
Challenges that plague the health workforce, or human resources for health (HRH), include the following:
- Health worker shortages
- Uneven distribution between urban and rural areas
- Imbalances in the skills mix of health workers
- Training that is misaligned with population needs
- Bias and misconceptions among health workers and clients about family planning
- Poor health worker supervision and management
- Lack of health workforce data to inform policies and strategies
The good news is that stakeholders have found some solutions to mitigate HRH challenges. These include improving education and training for health workers, task-sharing, increasing access to and use of data, and promoting gender equality.
Improving health worker development
- Strengthening pre-service and in-service training for health workers can improve the quality of family planning service delivery. Health training institutions need up-to-date curricula, well-trained faculty, and sufficient resources to ensure that the current and future health workforce is well prepared to provide high-quality services.
- Access to and training on the latest reproductive health and family planning guidelines is essential to making sure health workers are able to offer clients a comprehensive range of contraceptives to meet their needs.
- Digital learning provides flexible and expanded opportunities for improving learners’ family planning and reproductive health knowledge. For example, an eLearning platform program in Kenya capitalized on the expansion of mobile phones to offer health workers refresher training on family planning and reproductive health.
Task sharing to expand service delivery
- Expanding the roles of health workers, such as nurses and clinical officers, to offer some clinical methods traditionally offered by physicians, like intrauterine devices (IUDs), implants, and sterilization, can increase the availability of these methods.
- Supporting community-based distribution programs and community health workers has been successful in extending family planning services to clients who might not otherwise seek or have access to health services.
Increasing access to and use of data
- Tracking health workforce data using health information systems can help illustrate health worker shortages, training needs, and other information that can be used to improve service delivery.
- Using high-quality data and evidence from user testing to inform HRH and family planning activities can improve interventions and strengthen family planning referrals and services.
Promoting gender equality
Addressing the gender norms and inequalities that influence both the operations of the health workforce and the provision of family planning services can improve service quality and access to family planning.
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Most modern methods of family planning require an interaction with a health worker, and studies consistently show that people are more likely to trust health information provided by a health worker than any other source. A well-trained, qualified, and motivated health workforce is needed to provide family planning counseling and services at all levels of the health system.
- Health workers make family planning possible.
- Frontline health workers can be a driving force behind increasing the use and acceptability of family planning.
- To increase contraceptive prevalence, countries need to strengthen their family planning health workforces.
- Task sharing, supported by adapted national guidelines and government commitments, can make family planning services more accessible and efficient.
- Cadre: A category of health worker or group of health workers specially trained for a particular purpose or profession: physicians, midwives, registered nurses, nurse practitioners, clinical officers, laboratory technicians, etc.
- Human resources for health (HRH): Also known as the health workforce, HRH includes all people primarily engaged in actions with the primary intent of enhancing health.
- Task sharing: Sometimes called task shifting, task sharing involves training cadres of health workers—such as clinical officers, auxiliary nurses, and CHWs—to deliver some services typically offered by cadres with longer, more intensive training—such as physicians—in order to further the reach of a limited health workforce.
The Global Health eLearning Center offers several courses on strengthening the family planning workforce:
- Human Resources for Health (HRH): Principles and Practices This course introduces concepts and solution-focused examples that aim to support the existing health workforce and build the future health workforce through site-level interventions, policymaking, data use, and other evidence-based initiatives.
- Health Workforce Productivity: An Approach for Measurement, Analysis, and Improvement This course offers useful descriptions of a quantitative, formulaic approach for measuring productivity at the facility level; suggests possible underlying causes of low productivity and methods to measure them; and explores potential interventions to improve productivity and strengthen health services.
- Gender and Health Systems Strengthening This course examines gender considerations for each of the six health systems components described in the World Health Organization’s health systems model, including the health workforce.
- A Total Market Approach to Family Planning Services This course encourages learners to focus the total market approach lens on nurturing a healthy market for family planning services and understanding the roles of different sectors within that market. It includes a session on overcoming staffing challenges.
Tilahun Y, Lew C, Belayihun B, Lulu Hagos K, Asnake M. Improving Contraceptive Access, Use, and Method Mix by Task Sharing Implanon Insertion to Frontline Health Workers: The Experience of the Integrated Family Health Program in Ethiopia. Glob Health Sci Pract. 2017;5(4):592-602. In 2009, the Ethiopian Federal Ministry of Health launched an Implanon scale-up program with the goal of improving the availability of long-acting reversible contraceptive (LARC) methods at the community level. The Integrated Family Health Program (IFHP) supported the ministry to train Health Extension Workers (HEWs), a cadre of frontline health workers, on Implanon insertion. It proved to be a successful model for increasing access to contraceptive methods in the community, and the program supported the integration of Implanon services into the existing public health service delivery system.
Gueye B, Wesson J, Koumtingue D, Stratton S, Viadro C, Talla H, et al. Mentoring, Task Sharing, and Community Outreach Through the TutoratPlus Approach: Increasing Use of Long‐Acting Reversible Contraceptives in Senegal. Glob Health Sci Pract. 2016;4 Suppl 2:S33-S43. Mentoring, task sharing, and community outreach at 100 rural facilities in Senegal led to an 86% increase over 6 months in the number of women choosing long-acting reversible contraceptives (from 1,552 to 2,879). Concurrent improvement of facilities and provider skills, coupled with the application of Senegal’s task-sharing policy, are increasing the range of contraceptive methods available to women throughout the country.
Charyeva Z, Oguntunde O, Orobaton N, Otolorin E, Inuwa F, Alalade O, Abegunde D, Danladi S. Task Shifting Provision of Contraceptive Implants to Community Health Extension Workers: Results of Operations Research in Northern Nigeria. Glob Health Sci Pract. 2015;3(3):382-394. With training and supportive supervision, male and female Community Health Extension Workers (CHEWs) in Nigeria safely and effectively provided contraceptive implants, and virtually all clients said they were satisfied. Most CHEWs achieved competency after 5 client insertions. However, the CHEWs provided only an average of 4 insertions per health facility per month. Realizing the true potential of providing implants calls for a context with dedicated providers and robust outreach.