Mayer Hashi Family Planning Project in Bangladesh (MH-II) QUARTERLY REPORT
Reporting Period: January 1– March 31, 2016
Project Year 3, Quarter 2 Report
Submitted to: Office of Population Health, Nutrition and Education United States Agency for International Development USAID/Dhaka
By MH-II Project
Associate Cooperative Agreement No. AID-388-LA-13-00002 Under Leader Award No. GPO-A-00-08-00007-00
Date of Submission
April 30,2016
Table of Contents Acronyms and Abbreviations ...... 2 Executive Summary ...... 5 Appendix 1. Activity Description and Achievements by IR ...... 16 Appendix 2: Indicator Tracking Table ...... 137 Appendix 3: Findings from QA and FP Compliance Monitoring Visit...... 141 Appendix 4: Number of districts coverage with MH-II key Intervention in Q2 ...... 143
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Acronyms and Abbreviations
ANC Antenatal care AUFPO Assistant Upazilla Family Planning Officer BRAC Bangladesh Rural Advancement Committee BCC Behavior change communication BCCWG Behavior Change Communication Working Group BEPZ Bangladesh Export Processing Zone BGMEA Bangladesh Garment Manufacturers and Exporters Association BKMI Bangladesh Knowledge management Iniative BMRC Bangladesh Medical Research Council BSR Business Social Responsibility CAR Contraceptive Acceptance Rate CC Community Clinic CCSDP Clinical Contraceptive Services Delivery Program CHCP Community health care provider CHW Community health worker CLP Chars Livelihoods Programme CMES Centre for Mass Education in Science CSBA Community Skilled Birth Attendants CTU Contraceptive technology Update CYM Court Yard Meeting CYP Couple-years of protection DD Deputy Director DG Director General DFID Department for International Development DGFP Directorate General of Family Planning DGHS Directorate General of Health Services DQA Data quality assessment ECP Emergency contraceptive pill EdM Enfants du Monde EHB EngenderHealth Bangladesh EH NY EngenderHealth New York EH HQ EngenderHealth Headquarters FAQ Frequently Asked Questions FGD Focus Group Discussion FP Family planning FPCST Family Planning Clinical Supervision Team FSDP Field Services Delivery Program FWA Family Welfare Assistant FWC Family Welfare Center FWV Family Welfare Visitor GOB Government of Bangladesh HEU Health Economics Unit H&FWC Health and Family Welfare Centre HQ Headquarters ICV Informed choice and voluntarism ICT Information Communication Technology iDQA Internal Data Quality Assessment IPC Interpersonal communication IEC Information, Education, Communication
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IEM Information, Education, and Monitoring ILO International Labor Organization IR Intermediate Result IUD Intra-uterine device KM Knowledge Management LARC Long-acting reversible contraception LD Line Director MAB Municipal Association of Bangladesh MCWC Maternity and Child Welfare Center MEC Medical Eligibility Criteria (of the World Health Organization) ME&R Monitoring, evaluation, and research MIH Marketing Innovation for Health MIS Management Information System MH-II Mayer Hashi Family Planning Project in Bangladesh MNHI Maternal and Neonatal Health Initiative (UNFPA) MO Medical Officer MOHFW Ministry of Health and Family Welfare MOLGRD&C Ministry of Local Government and Rural Development and Cooperatives MOU Memorandum of Understanding MOY Ministry of Youth MR Menstrual regularization MSD Merck Sharp & Dohme MSDCT Mobile Service Delivery Care Team NGO Nongovernmental organization NHSDP NGO Health Service Delivery Project NSV No-scalpel vasectomy NTC National Technical Committee Ob-Gyn Obstetrics and Gynaecology OGSB Obstetrics and Gynecological Society of Bangladesh QAT Quality Assurance Team OJT On-the-job training Q1 Quarter 1 OP Operational plan PAC Postabortion care PM Permanent method (of contraception) PNC Postnatal care POC Person of collaboration PPFP Postpartum FP PPIUD Postpartum IUD PPBTL Postpartum bilateral tubal ligation PSTC Population Services and Training Center PY Project year Q Quarter QA Quality assurance RHSPO Reproductive Health Service Promotion Officer RTMI Research, Training, and Management International SACMO Sub-Assistant Community Medical Officer SHOPS Strengthening Health Outcomes through the Private Sector SIAPS Systems for Improved Access to Pharmaceuticals and Services Program SMC Social Marketing Company SOP Standard Operating Procedure 3
SSN Senior Staff Nurse TA Technical assistance TOT Training of trainers UHC Upazilla Health Complex UP Union Parishad UPFO Upazilla Family Planning Officer UPHCSDP Urban Primary Health Care Service Delivery Project UNFPA United Nations Population Fund USAID United States Agency for International Development VPKA Voluntary ParibarKallayon Association VSC Voluntary Surgical Contraception WHO World Health Organization YMC Young Married Couple YPSA Young People in Social Action
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Executive Summary
Mayer Hashi II (MH-II) is a follow-on project to Mayer Hashi, a four-year family planning (FP) project in Bangladesh (October 1, 2013—September 30, 2017) Leader with Associate Cooperative Agreement awarded by the United States Agency for International Development (USAID). MH-II aims to advance the use of reproductive health (RH) and FP services with a focus on informed and voluntary use of long-acting reversible contraception (LARC) and permanent methods (PMs). MH-II provides in-country capacity development to strengthen RH service delivery by providing support to Bangladesh’s National FP and Maternal Health (MH) program and other FP implementing partners in the country.
This progress report covers the reporting period of quarter two (Q2) of project year three (PY3); January 1– March 31, 2016. During this reporting quarter, MH-II continued its ongoing collaboration with the Directorate General of Family Planning (DGFP) and the Directorate General of Health Services (DGHS) of the Ministry of Health and Family Welfare (MOHFW), Government of Bangladesh (GOB). MH-II has formed new partnerships and consolidated and strengthened existing partnerships with various non-governmental organizations (NGOs) and international, national, local, and private sector entities to provide quality FP and RH services, particularly LARC and PMs.
Overall, the project is ahead of target for three indicators, on target for one, and behind target for six performance benchmarks. The MH–II Performance Tracking Table (Appendix 2) and summary of district coverage with key interventions and its follow-up (Appendix 4) provides information on 14 indicators (two USAID standard indicators and 12 project-required indicators or custom indicators and overall coverage of districts.
By the end of Q2, MH-II performance indicators reflect the following:
• Against USAID standard indicator F:3.1.7.1, the couple-years of protection (CYP) the project achieved 81% of the quarterly benchmark and 39% of the annual benchmark, and 63% of the overall project benchmark. (BEHIND) • Of the project’s remaining 13 indicators, the performance is noted as following:
o For USAID standard indicator # F:3.1.7.3 (% of USG-assisted service delivery sites), MH-II achieved 96%. The total number of sites was 3483 and the project target for PY3 is 3,642. (AHEAD) o For custom indicator 2, mobile teams achieved 44% of the benchmark. The total number of clients who received services were 56,891 against the total clients targeted for PY3 is 127,977. (BEHIND) o The project achieved 43% of custom indicator 3 on postpartum FP (PPFP) uptake (6397 clients). The total project target for PY3 is 15,010 clients. (BEHIND)
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o For custom indicator 5 (providers receive training/or on-the-job training, orientation or mentoring) MH-II achieved 93%. The total number of service providers trained were 13911, The total project target for PY3 is 15,009 clients. (AHEAD) o For custom indicator 6 (% of MH-II trained service providers who performed at the national standard), 73% were found to be performing at national standard. (BEHIND) o For custom indicator 7 (# of service providers trained regional training center established by USG funds) achieved 84% of the benchmark of PY3 target. (BEHIND) o Gender indicator -3 (The proportion of service providers who report increased clear understanding on gender after the USG supported training) was finalized and added to the MH-II Tracking Table in September 2015. In Q2, 88 participants have received orientation on gender issues. The participants were from the DGFP, DGHS, and NGO clinical staff. The main objective of this training is to increase service providers’ awareness on providing gender sensitive services. The result from the post- test after the orientation showed that from the 88 participants 93% understood gender concepts achieving a score of more than 80%. o For custom indicator 8 (# of supported sites that received at least one supervisory visit) MH-II achieved 74%, the total number of visit was 156 and the total project target of PY3 is 210. (BEHIND) o Indicator 11a and 11b (communication materials developed and distributed), MH-II reached 73% and 20%, respectively. (BEHIND) o For custom indicator 15 (# of organizations/agencies including other ministries that incorporate FP messages and activities into their training programs, and the nature of the work) MH-II achieved 50% of PY3 target. (ON TARGET) o In custom indicator 16 (# of policies and guidelines related to injectable, LARC & PMs updated, adopted or revised through USG support and nature of changes), MH-II achieved 200% of PY3 target. (AHEAD) o Project interventions to meet custom indicator 17 planned for PY3; and setting of the benchmarks for sub-IRs 2.2 and 2.3 is contingent upon findings from the baseline survey undertaken by MEASURE, which has not yet been officially released. (TBD) Achievements of Service Delivery and Training (IR1) for Quarter 2, Year 3
Following are the highlights of IR Team 1 activities:
During Quarter 2 Service Delivery and Training Team finalized the acceleration plan and started its implementation. During the quarter MH-II has has provided skill-based traini g on PPFP for 76 providers, did clinical orientation on PPFP for 291 participants of 18 bfacilities, followed-up
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38 PPFP facilities. A job-aid on client counseling during all ANC, PNC, immunization visits for PPFP and FP after abortion care has been developed which is under final review by USAID. MH-II has also trained all 67 providers of five (5) MCWCs on ‘use of FP with PAC and after MR’. During the quarter MH-II has also trained 15 DGHS doctors on LARC and PM. As a part of changed policy MH-II has collaborated with DGFP to organize a TOT on Injectable for 31 trainers of DGHS and DGFP, and supported subsequent training of 772 providers.
In January 2016, a joint meeting was held together with a refresher training conducted by MH-II staff for all the field-based and headquarters (HQs) staff from the Research, Training, and Management International (RTMI) and Senior (Sr.) Quality Assurance (QA) & Compliance Officers from MH–II. The purpose of the workshop was to strengthen collaboration and coordination between Sr. QA & FP Compliance Officers and Mobile Service Delivery Care Teams (MSDCTs) from RTMI and to provide staff with a contraceptive technology update, and refresher orientation on infection prevention (IP), informed choice and voluntarism (ICV), counseling, and medical monitoring.
In order to improve low client attendance/low client flow at special FP service days, a behavior change communication (BCC) planning meeting was organized for all MH-II, RTMI, and HQ focal persons responsible for demand generation. During the meeting, it was decided that (i) RTMI’s MSDCTs would work closely with MH-II’s demand generation team while organizing special FP days and generating client demand, and (ii) that special FP service days should be conducted at facilities with greater client demand/client flow. The special FP service days should be conducted with adequate BCC activities undertaken in and around the special FP day service site.
During this quarter, onsite follow-up visits were conducted in 38 postpartum FP (PPFP) facilities from PY1 and PY2 districts by the consultant Ob-Gyn specialist. During the follow-up visits, trained provider’s (doctors, nurses and paramedics) knowledge and skills were assessed using a questionnaire and demonstrating the PPFP procedure on a model where clients were not available. When needed, hands on coaching and the latest PPPFP updates were provided. During these follow-up visits, it was noted that most of facilities are performing female sterilization along with a C-section with client’s informed consent; however, overall number of women accepting postpartum intrauterine device (PPIUD) compared to the number of facility delivery is low. Reasons for low IUD acceptance in DGHS facilities are multiple like: there is no specific person for family planning service delivery, there is almost no provision for counseling during ANC and PNC visits, non-availability of commodity (IUD) from DGFP, and sometime very busy schedule of the ob-gyn consultants, and clients mis-conception of chance of heavy bleeding after postpartum IUD insertion. To overcome these challenges/reasons for low acceptance of IUD, MH-II has reinforced PPFP information to the provividers, provided updated information, especially about their mis-conceptions about PPIUD, did advocacy with the DGFP to provide commodities on a regular basis, and during follow-up observed providers’ skills and demonstrated standard practice.
During this quarter, MH–II IR teams 1 and 3 organized special FP service delivery days at private facilities in Dhaka city in collaboration with DGFP. These service days are beyond which DGFP regularly organizes. During this quarter, 13 such special FP service days were organized in Dhaka, and 183 clients received FP services (148 no-scalpel vasectomy [NSV] procedures and
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35 implants). DGFP service providers were hired to provide FP services on these special days at the private facilities where they normally do not provide services.
Due to the policy change permitting the Family Welfare Assistants [FWAs) to provide the first and subsequent doses of the contraceptive injectable, and the Community Health Care providers (CHCPS) can provide the second and subsequent doses.MH–II provided technical support to the DGFP regarding training in the three districts namely B. Baria, Cox’s Bazar, and Dhaka. Injectable training for providers from B. Baria district was completed in Q4 of PY2. During this reporting period, 762 providers of various categories (i.e., Family Welfare Visitors [FWVs], Family Welfare Assistants [FWAs], community health care providers [CHCPs], and paramedics) from Cox’s Bazar (448) and Dhaka (314) received injectable training. Training for all Dhaka providers will be completed in Q3. During this quarter, 60 trained providers (36 Community Skilled Birth Attendants [CSBAs] and 24 CHCPs) from nine Upazilas in B. Baria district who received injectable training were followed-up. During follow-up visits, provider’s knowledge and skills were assessed and feedback provided as necessary. Most CSBAs and trained FWAs have started providing the first injectable dose and CHCPs are providing the second and subsequent injectable doses. Some of the trained CHCPs could not begin providing injectable services due to the unavailability of injectable contraceptive and the supplies that is required to give the injection. MH-II staff requested local managers to address these issues. DD(FP) of the concerned Districts has already taken some steps. Consent forms have been supplied and FWAs were instructed to provide Injectable to the CHCPs
During this reporting quarter, the Obstetrics and Gynecological Society of Bangladesh (OGSB) FP Training Center conducted eight batches of training for a total of 104 providers on the provision of IUDs, implants, FP counseling, and IP. OGSB has started to track the performances of the providers trained by them. From the next quarter performance numbers would be reported in the report. OGSB RH & FP Training center developed a draft marketing plan. The key elements of the paln are to develop a brochure about the Center and the trainings they offer, meeting with key stakeholders, communication with different NGOs and private entities through e-mail, organize seminars, and develop a Facebook page. The brochure has been developed and distributed through different programs and events.
MH-II Sr. QA & FP Compliance Officers conducted 72 QA visits to Maternity and Child Welfare Centres (MCWCs), Upazilla Health Complexes (UHCs), Health and Family Welfare Centers (H&FWCs), and NGO clinics. Of these, 58 were first time visits and 14 were follow-up visits. During this period, the Senior QA & FP Compliance Officers facilitated the orgazanition of 326 special FP service delivery days where trained providers were not available. In these special FP service days 6,242 LARC, PM, and injectable services were provided (460 female sterilizations, 488 NSVs, 4,792 implants, 161 IUDs, and 341 injectable) utilizing hired surgeons from the DGFP and DGHS at the district and Upazilla level.
During this quarter, three batches of DGHS doctors received the 18-day “Basic training on LARC and PMs” (15 doctors in total from Barisal, Chittagong, and Sylhet divisions). The trainings were conducted at the three regional training centers (Dhaka, Barisal, and Chittagong) of the DGFP using the regional trainers. MH-II Sr. QA & FP Compliance Officers working in Khulna region were closely involved in providing hands-on coaching to the doctors from the Barisal region. During follow-up of the trained DGHS providers, information from 11 providers
8 were collected and 4 have left on deputation for higher studies within the country. Out of the 11 providers 5 have started providing services and the remaining 6 are yet to start providing services due to lack of setting up of a system with the local UFPOs.
Challenges faced by IR Team 1:
During the reporting quarter, LARC and PM services by RTMI’s MSDCTs were lower than projected. The reason for this was non-availability of client counseling, disseminating the information about these days or lack of publicity of special FP service delivery days. To address the gap, two joint coordination meetings were conducted with RTMI roving doctors and paramedics, MH-II Sr. QA & FP Compliance Officers, and MH–II partners working on demand generation and client mobilization. The outcome has been better coordination across partner and improved client have access to the services offered on the special FP delivery days. The other reasons for low uptake were: resignation of two well performing surgeons of RTMI working in Rangpur and Rajshahi region; and not getting sufficient number of hired surgeons. RTMI sub- award budget was re-allocated so that they can recruit more full time surgeons and hire consultants when necessary. .
Community Health Care provider (CHCPs) working under DGHS are supposed to receive all logistics for the injectable services from FWAs (including injectable vials, gauze/cotton, antiseptic lotion etc.) and start providing second and subsequent doses of injectable immediately after training.
MH-II provides technical and financial support to train DGHS doctors to provide LARC and PM services, especially where no trained providers are available. Out of the 15 doctors trained, only five are performing. So far they have performed 28 procedures that include 17 Implant, 2 IUD, 7 NSV, 2 Tubectomy. Some of the trained doctors reported that they did not receive any positive support from the local Upazila FP Officers (UFPOs) in having their services utilized. Other MH- II-trained doctors have left practice to pursue higher studies or were transferred to other facilities having trained providers.
One of the responsibilities of MH-II Sr. QA & FP Compliance Officers has been to advocate with local level DGHS management to allow using the operating theater (OT) for the provision of LARC and PM services to ensure a clean separate space particularly for the IUD services. In 31 places (Upazilla Health Complexes), the local DGHS management has already handed over one of the OTs to the DGFP and allowed the FP staff to use the old OT for IUD insertions. However, in some places, this has not happened and as such the FP providers provide IUD services behind the Almirah/big cupboard put up in one corner of the room where the FWVs sit. MH-II staff continues to advocate for a separate space for IUD insertions at the Upazilla Health Complexes including getting a circular issued jointly signed by the 2 DGs.
Demand Generation (IR 2):
To increase demand for LARC and PM services, MH-II staff has enagaged a total of over 4,000 volunteers working with NGOs namely BRAC, the Population Services and Training Center (PSTC), Young Power in Social Action (YPSA), Mukti, the Voluntary ParibarKallayon Association
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(VPKA Foundation), and Sushilan. These volunteers referred 35,973 clients to the nearest health facility providing LARC and PM services. As a result, 32,046 clients have become a user of a modern FP method in this quarter which includes 25 emergency contraception pills/ECPs, 1,546 condoms, 2,162 oral contraceptive pills/OCPs, 20,957 injectible, 6,004 implants, 746 IUDs, 445 tubectomies, and 161 NSVs. Women referred by YPSA are garment workers or from the slum areas (BOTH). YPSA refers women from the garment factories and the slum areas
In Q2 of PY3, MH-II continued to provide support to the 10 private health facilities it’s been supporting since PY2. These facilities provided services to 1,262 clients during the reporting quarter using private sector/SMC contraceptives. To increase access to LARC and PM services for the urban population, MH-II signed a letter of agreement with additional 15 private facilities in Q2 those who would start functioning very soon.
To enahance the quality of FP counseling and to increase demand for LARC and PM services, MH-II distributed FP information, education, communication (IEC)/behavior change communication (BCC) materials to 633 facilities and oriented 2,507 facility and field-based staff on how to use these materials during counseling and interperpersonal communication (IPC). Team 2 developed a BCC plan for PPFP services in the Sadra Upazilla in PY3 districts and developed guidelines for staff on how to organize special FP service days. In addition, Team 2 conducted a 1-day orientation on how to organize these days, for partner NGOs so that they will be in a position to plan and organize the FP special service days by them selves.
Challenges faced by IR Team 2:
The unavailability/total absence of FWAs not communicating with the prospective clients is a major challenge in improving the performance of LARC and PM services. In this regard BCC partner NGOs of MH-II has been referring clinets to the DGFP facilities and other providers such as public/DGHS facilities, Smiling Sun, Marie Stopes, and Mamata run clinics to ensure better alignment between IR1 and IR2 and ensuring FP services are available and aligned with demand generation activities.
To dispel myths and misconceptions about FP, some BCC interventions are carried out which include one on one sessions, workshop with religious leaders, advocacy workshop/semniars with services providers, courtyard sessions with community people, male eneganement, and distribution of information leaflets etc. These are conducted by BCC partners (BRAC, YPSA and Shushilan) and the volunteers of some NGOs (PSTC, Mukti and VPKA).
Policy, Advocacy, and Enabling Environment (IR3):
In Q2 of PY3, MH-II’s Policy, Advocacy, and Enabling Environment Team accomplished most of its planned activities. As a part of local level advocacy, 10 workshops where held in 10 districts with DC (head of the local civil administration), CS, DD-FP, Upazila Chairmen, UNO, UHFPO, UFPO, Obs/Gynea Consultant, MO (MCH-FP), DD-IFB, President/Secretary of Imam Samiti, Journalists were conducted on the role service providers play in LARC and PM services, including PPFP. The specific objectives of the workshops were: discuss the current FP situation at national and local levels; analyze success, challenges and opportunities for strengthening LARC and PM including PPFP services; discuss the stakeholders’ (including service providers and program managers) critical roles in the LARC & PM and PPFP service delivery and get them more 10 engaged and discuss the next steps for strengthening of LARC, PM and PPFP services in the district. Ten workshops were organized and conducted jointly by MH-II and DGFP. These workshops were of advocacy and for sensitizing participants which includes DGHS, DGFP, local civil administration and NGOs. Key outcomes from the workshops included: commitment by the different stakeholders to disseminate information about the FP program specially LARC and PMs, commitment by the Civil Surgeon (CS) to allocate an OT to the DGFP for FP services at the Upazilla Health Complexes; commitment by DGHS providers to offer PPFP services; commitment by both DGHS and DGFP service providers to implement the changed policies related to PPFP counseling during antenatal care (ANC), postnatal care (PNC), and immunization services.
There has been good progress on the establishment of a cost center in DGHS facilities. The Chief Accounts Officer (CAO) from the MOHFW sent a positive letter to the Line Director (LD) of the Clinical Contraceptive Services Delivery Program (CCSDP) recommending that a cost center should be opened in DGHS facilities. The LD, CCSDP forwarded this letter of support from the CAO, MOHFW to the Secretary, MOHFW for their decision.
This quarter, the National Technical Committee (NTC) approved the implant and progestin-only pills (POPs) to be given PP. Now, implants and POPs can be provided to clients immediately after delivery irrespective of their parity. During the 65th NTC meeting, the decision was made to promote PPFP counseling during ANC, PNC, and immunization visits. A circular was jointly signed by the DG of the DGFP and DG of the DGHS supporting PPFP, and making short-acting FP services (pills, condoms, and injectable) available at immunization sites. The letter was sent to all relevant program managers and service providers working with DGFP, DGHS, NGOs, and the private sector.
In order to ensure that contraceptives are made available to garment factory workers, a tripartite Memorandum of Understanding (MOU) was signed between the DGFP, the Bangladesh Garment Manufacturers and Exporters Association (BGMEA), and MH-II.
To introduce monitoring (compliance culture: FWAs’ performance reporting should include indicators, other than the achivent againsts method wise FP performances, number of home visits, number of court yard meetings, number of client referrals, number of interpersonal communications, number of couple counselling, number of client follow-ups, number of monthly meetings along with the achievements of the contraceptive projections, etc.), MH-II, in collaboration with the DGFP, organized and conducted four regional workshops in Dhaka, Rangamati, Chittagong, and Comilla. A report was written and shared with the DG of the DGFP proposing piloting this initiative in one district.
The CCSDP of the DGFP has obtained approval from the MOHFW and Ministry of Finance (MOF) to recruit 500 newlywed couples to be trained as peer educators to work as volunteers for the young married couple (YMC) project. Based on a successful pilot activity in the previous MH project, this program will be implemented in 14 hard-to-reach Upazilas in seven districts by CCSDP of DGFP. Mayer Hashi-II will provide training and the UNFPA will fund the first year of renumeration to the peer educators, which will subsequently be paid by the DGFP.
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A booklet on ‘Why LARC and PMs’ targeting policy makers was drafted during this quarter and shared with MH-II staff for review and feedback.
Challenges faced by IR3 Team:
The main challenge faced by the team was to ensure that all of the updated and new FP policies are being implemented. During the reporting quarter a total of 79 DGFP service providers and program managers from 21 districts and 72 Upazilas were followed-up with by MH-II and Marketing Innovation for Health (MIH) team members. Monitoring findings reveaed that knowledge regarding all 12 modified/new policies is not well known and varied from 42% to 95% on different issues. Many of the program managers are not receiving the circulars and/or notifications from DGFP HQ, and therefore, circulars are not being shared with field staff. Some staff do not support some of the policy changes because of their personal opinions. There are also other reasons behind non-compliance withpolicy changes. For example, CHCPs are allowed to provide injectables, but as they are not DGFP service providers, they are not getting injectable supplies directly from the DGFP.
To address the mentioned challenges, i.e., to ensure that all changed policies are implemented MH-II has already taken several steps. The key steps are:
- Resending DGFP and DGHS issued circulars to over 4, 200 program managers and service providers of DGFP, DGHS, NGOs and private sector agencies across the country via regular surface mail - Sending to over 700 program managers and service providers of DGFP, DGHS via email - In the district advocacy meetings and any other field level events of MH-II, staff are disseminating the information and discussing the issue of policy changes - The Sr. QA&FP Comiliance Officers are discussing the issue in the districts and upazila level monthly meetings of the DGFP wherever they are attending - The District Maternal Child Health & Immunization Officers (DMCH & IOs), the WHO supported 32 local level staff of DGHS, will be oriented so that they disseminate the information and ensure that in each ANC, PNC and immunization services, PPFP counsling is done - A free of cost android based application is also under development to monitor the implementation of changed policies.
Monitoring, Evaluation, and Research (ME&R) Activities:
In Q2 of PY3, the ME&R team accomplished the majority of its activities according to the PY3 workplan, including the ongoing technical assistance (TA) and support to all MH-II IR teams using analysis od data for decision making particularly for PPFP and trend analysis of the performance of sub-awardees etc. To monitor progress and assess performance of some project activities, the ME&R team arranged monitoring visits to 69 upazillas under 14 districts. Staff from all IR teams did these monitoring visits and collected information using a structured checklist. Monitoring visits included: follow-up of LARC and PM trainees, special FP days already organized, monitoring of changed/modified polices between 2009 and 2015, and
12 monitoring the distribution and use of BCC materials. The findings revealed that in 62 facilities they have fixed days for LARC/PM services. More than half (36) of the facilities conducted 6 to 10 LARC/PM sessions in a month. Average client flow in each session is 12. UFPO of 26 facilities mentioned that other organizations such as Marie Stopes, Family Planning Association of Bangladesh and other local NGOs provided support to conduct special days for LARC/PM. These NGOs hired surgeons of DGFP and referred clients on the special service days. Findings from these monitoring visits were shared with the staff members of different IR Teams of MH-II for decision making for the interventions implemented by the Teams.
During Q2, one joint data quality assessment (DQA) and four internal DQAs were conducted. For the DQA, a team consisting of DGFP staff and ME&R staff visited different locations in Kushtia and Chuadanga districts. During the debriefing, the Director of the Management Information System (MIS) who was accompanying the DQA Team requested all staff working in these two districts to file-up consent forms properly. Currently all consent forms are available but they are kept in different places with different service providers. He also emphasized that postpartum bilateral tubal ligation (PPBTL) should be properly reported on a monthly basis particularly in Chuadanga district the service providers reported all tubectomies as interval BTL.
The MH-II ME&R team conducted four iDQAs at BRAC and YPSA in Chittagong, as well as a Reproductive Health Service Promotion Officer (RHSPO) intervention site at East West Medical College and Hospital and Shahid Monsur Ali Medical College. The iDQA at BRAC was conducted by a team comprised of ME&R team’s Program Manager and Program Officer along with BRAC representatives, and the Dhaka Divisional Manager and District Coordinator this team visited the BRAC Rangunia and Patiya office and their catchment areas on January 27-28, 2016. The team verified the data on training, client referrals, and and the number of referred clients who received services. There were some identified data inconsistencies and the ME&R team suggested revisions to their reporting format. BRAC revised their form and shared it with the ME&R team. Another iDQA was conducted at YPSA in Chittagong District on January 19, 2016. The team comprised of Ms. Caitlin Shannon, Director of Knowledge Management (KM) and ME&R, EngenderHealth New York; the Program Manager from the MH-II ME&R team, and a Program Officer from MH-II IR team 2. The team verified client referral data and did not identify any inconsistency. An iDQA was conducted at East West Medical College and Hospital on March 16, 2016 to review the reporting system on LARC and PM service data compiled by the RHSPO. During this visit, no data inconsistencies were identified in the reports submitted to EngenderHealgth Bangladesh (EHB) between October 2015 and February 2016. Another iDQA was conducted at Monsur Ali Medical College and no data inconsistencies were identified in the data submitted to EHB.
Development of a report on the study “Exploring menstrual bleeding among injectable contraceptive users and discontinuers” is ongoing. In addition, the MH-II KM Plan is now being developed. A consultant was recruited in mid-January 2016 for developing the KM plan of EHB. The consultant shared a draft outline of the Knowledge Management plan with the KM team of EHB for review. Before that two meetings with the relevant staffs were held. It is expected that by the next quarter the KM plan would be ready.
Challenges faced by the ME&R Team:
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Data collection from different entities including DGHS facilities, private sector hospitals, and NGOs remains a key challenge. Additionally, the quality of data submitted from NGOs and sub- awardees is often of poor quality such as data inconsistency and transcription errors. To address these challenges, ME&R staff are providing more hands-on coaching to relevant sub-awardee staff on record keeping, accurately completing MH-II forms, and checking for errors prior to submitting their reports to MH-II. To improve data collection MH-II is maintaining regular communication with different entities.
Program Management:
The project developed an accelared work plan by developing additional program activities during the year and to speed-up implementation of the already planned programs. To enhance program implementation capacity, 9 additional staffs were recruited during the quarter and further recruitment of couple of more additional staffs is under process.
Expanded workplace intervention and community engagement work using the volunteers enhanced visibility of the project. MOU with BGMEA, MAB and PSTC made the project further visible. The budget of the sub-grant with RTMI, BRAC and YPSA has been modified and suggestions has been provided to enhance their activities to increase community out reach and thus providing more LARC and PM services.
Quarterly progress review meeting between different IR Teams and Finance and Operation staffs has been conducted to enhance coordination between the program, finance and operations.
Efforts have been undertaken to enhance inter-team coordination, introduced quarterly progress review of the teams and financial monitoreing meeting with the teams. Team-wise budget monitoring has been introduced in this quarter.
MH-II staff has internally discussed the development of a legacy plan based on the outline developed by Paul Perchal, Vice President for Program Management, EngenderHealth, NY. Relevant MH-II staff has started developing the legacy plan. In this effort MH – II Consultant Joan Venghaus is providing a leadership support.
Financial Report Summary:
A review of the financial situation comparing with the past quarter was done. MH-II has advanced by 11% in spending. During the 2nd quarter, the project spent 90% of the quarterly accelerated workplan budget. The general expenditure trend shows overspending in most of the budget lines except Other Direct Costs and Program Activities. In Consultants line item 173% overspent due to hiring of consultant in place of Technical Director. Spending for creating Office facilities for new recruits contributed to overspending in Equipment and Office Supplies line item. Sub-awards overspent by 15% of the quatrely budget.
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Program Activities underspent by 24% of the quarterly budget while increased spening by 95% over the past quarter. Delay in start of some of the palnned interventions mostly contributed to underspending. However, general trend indicates program spending capacity has been significantly increased.
Cost Share Contribution
Until the end of 2nd quarter, MH-II collected $3.6 million cost share against the target of $2.22 million. Collected cost share is about 62% higher than the cost share required to be collected during the life time of the project. During the 2nd quarter, the project gathered $633,000 as cost share, against the target $181,000. This trend is expected to continue in coming quarters.
DGFP, local and international partners involved in implementation of the project mostly contributed to the cost share collection. Value of volunteer time, free office space, workshop venue, free FP logistics, cash contributions etc. to the project were counted as the cost share contributions.
15
Appendix 1. Activity Description and Achievements by IR
PY3/Sub-IR1 Workplan (October 1, 2015 –September 30, 2016) Activity Gantt Chart Achievements through Quarter 2
IR 1: Effective and High Quality FP Services Delivered Nationwide Partners/Collaboration RTMI, DGFP, NHSDP and selected Private Medical College Hospitals POC Khondoker Abu Jafar Md. Saleh and Mizanur Rahman Activity 1.1.1 INCREASE UPTAKE OF LARC & PM USING MOBILE SERVICE DELIVERY CARE TEAMS (MSDCT) This is an ongoing activity from previous year Workplan. This activity is to support RTM to expand services of LARC and PM in the DGFP and NGO/private sector sites where there is no trained providers using its mobile service delivery care teams (MSDCT) covering PY1, PY2 and PY3 Districts Sub-IR1.1 Capacity of public- and private-sector service providers to provide LARCs, and PMs increased
Implementation Time Quarterly Achievement of Inter-Team Task # Task Description Frame Benchmark/Deliverables Benchmark/Deliverables Collaboration Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 1.1.1 a Support RTMI in development of X X X Quarterly Workplan of
quarterly Workplan RTM developed
Done in Done Q1
1.1.1 b Have quarterly program review ME&R Four (4) program review
meetings with RTMI meetings held
meeting meeting
1 held meeting 1 held
1 meeting 1 meeting 1 meeting 1 meeting 1
1.1.1c Conduct joint field visit with RTMI’s RTMI management 6 follow-up visits
management staff to monitor quality of staff conducted as mentioned in
1 visit 1 visit 1 2 visits 2
RTMI MSDCT field level activities, visits 2 the different quarters
and to coach the management staff to covering PY1, PY2 and FU visit FU
conduct monitoring visits PY3 Districts
3 done visit FU 2 done
Page | 16
Implementation Time Quarterly Achievement of Inter-Team Task # Task Description Frame Benchmark/Deliverables Benchmark/Deliverables Collaboration
Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4
1.1.1d Support RTMI to review and analyze ME&R will support X X X X Through quarterly ,
RTMI’s monthly and quarterly LARC, to analyze the program review meetings ,
751 , performance report this support will be 2,494
PM and Injectable performances
1
provided. RTMI will be – including those at NHSDP facilities – undertaking 3750 special days conducted in areas where partner
organizations like BRAC, PM Male ,
Shushilan, YPSA and PM Male ,
804
,
941
1
BGMEA supported - activities are being carried - out including in the Districts of PY1 and PY2.
The mobile teams would . Female PM Female .
perform 73,143 LARC & PM Female .
218 ,
PM and Injectable services 926
1
according to the following – – estimation:
Implant – 47,963 IUD ,
IUD ,
877 ,
IUD – 3,726
414
,
11 8 - Female PM – 8,564 -
034
,
568 1
Male PM – 11,031
– –
Injectable – 1,860.
Implant Inj Implant Inj
Page | 17
Quarter-wise Narrative Description of Activity Q1 Achievement: Task # 1.1.1 b: In this quarter one program review meeting was held with RTMI to discuss field visit findings, current challenges faced by RTMI, and budget reallocation. Task # 1.1.c: Three field visits conducted with RTMI staff at Manikgonj, Khulna and Barisal. Based on field visit findings it has been decided that a joint program would be held in January in presence of all MSDCT members and MH–II Sr. QA & FP Compliance Officers. The purpose of the program is to build better coordination among the field staff of MSDCT and MH – II; to overcome the challenges faced to implement the program by MSDCT and to discuss on clinical monitoring, CTU, Infection Prevention, client mobilization from the community Task # 1.1.1d: The quarterly uptake of LARC & PM is mentioned below: The reasons for low performances has been mentioned in the challenges section of the narrative part of the report mentioned earlier. Method Yearly Projection Achievements (Q1) Female sterilization 8,564 1,804 NSV 11,031 2,494 Implant 47,963 11,877 IUD 3,726 926 Total LARC/PMs 73,143 17,101 Injectable 1,860 765
Page | 18
Q2 Achievement Task # 1.1.1b: One joint meeting and refresher training was held on January 17-19, 2016 where all field & HQ staffs from RTMI and the Sr. QA & Compliance officers from MH - II were present. The aim of the meeting and the refresher training was to build collaboration and coordination between the Sr. QA & FP Compliance Officers and MSDCT from RTMI and to disseminate the latest updates related to Family Planning Contraceptives, Infection Prevention, ICV, Counseling and Medical Monitoring. The decisions were: involvement of the Sr. QA & FP Compliance officers to monitor the quality of the FP services provided by the MSDCT and to provide support in organizing the services; assist in BCC activities for client mobilization during special day.
- A follow-up meeting was held on February 15, 2016 to review the progress of the decisions taken during the joint meeting held in January. To address issues related to BCC activities a planning meeting was organized on March 22, 2016 where all the focal staff working on the demand generation s from MH - II, RTMI field and HQ staffs were present. The key action steps are: MSDCT from RTMI will work closely with the demand generation partners of MH – II to organize special days and client mobilization activities
- Special day services will concentrate on high and medium performing facilities with adequate attention towards local level BCC activities
- RTMI will design and carry out activities for client mobilization involving the GOB field staff in collaboration with local DDFP and UFPO
Task # 1.1.1c: Two visits were conducted to support the MSDCT. One visit was conducted by the Advisor of Service Delivery and Training Team and another visit was conducted jointly by the AOR of USAID and MH-II staff. Both the visits were to Sylhet division in January 2016. The findings showed that the paramedics from RTMI were performing well in providing IUD but t the uptake for sterilization remains low. More collaboration with other organizations providing FP services NGOs (i.e NHSDP, UPHCSDP) might help to increase the number of clients wanting a sterilization. Task # 1.1.1d: The quarterly uptake of LARC & PM is mentioned below.
Method Yearly Projection Achievements (Q1) Achievements (Q2) Female sterilization 8,564 1,804 941 NSV 11,031 2,494 1,751 Implant 47,963 11,877 8,414 IUD 3,726 926 1,218 Total LARC/PMs 73,143 17,101 12,324 Injectable 1,860 765 1,034
Q3 Achievement Q4 Achievement
Page | 19
Activity 1.1.2 STRENGTHENING POSTPARTUM FAMILY PLANNING (PPFP) This activity is for expansion of PPFP services with emphasis on scale up of national PPFP action plan, strengthen follow-up Partners/Collaboration DGHS, DGFPOGSB, UNFPA, NHSDP, Marie Stopes and other NGOs, EngenderHealth Global Clinical Support Team Person of contact Dr. Sharmin Jahan and Fatema Shabnam Implementation Time Quarterly Achievement of Inter-Team Task # Task Description Frame Benchmark/Deliverables Benchmark/Deliverables Collaboration
Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4
1.1.2a Conduct joint follow-up visits with ME&R will support All 160 PPFP facilities of DGFP (CCSDP and FPCST officials) to identify low PY1 and PY2 followed-up and/or DGHS supervisory staff at physically as mentioned in
performing facilities
up visits up visits up visits up visits up
- - - -
PPFP service delivery sites where the different quarters.
PPFP services initiated during PY1 & Besides these all sites will
26 facilities 26
PY2 using structured checklist to be followed-up over -
strengthen their capacity. telephone at least two
30 follow 30 follow 52 follow 50 follow 28
other times. onsitevisits
38 telephone telephone facilities 10 site on
1.1.2b Develop an implementation X An implementation plan
checklist/follow-up card with PPFP and checklist/follow-up
messages to be used during counseling card with PPFP messages in all ANC and PNC visits and with developed and finalized
Immunization services
& reviwing &reviwing
Preparatory phage Preparatory Way of development development Wayof
1.1.2.c Support IR3 team to issue a joint IR3 team will take X A circular jointly signed
circular signed by DGHS and DGFP to lead for the issuance by DGHS and DGFP integrate PPFP counseling during all of the joint circular issued ed
ANC and PNC visit and with issu Circular Circular
Immunization services Inprogress
Page | 20
Implementation Time Quarterly Achievement of Inter-Team Frame Benchmark/Deliverables Task # Task Description Benchmark/Deliverables Collaboration Q1 Q2 Q3 Q4 Q1 Q2 Q Q4 3
1.1.2d Review follow-up cards (mentioned in X X X PPFP follow-up cards Not 1,1.2b) during FU and QA & FP reviewed during FU and yet
Compliance visits to see quality of QA & FP Compliance start started PPFP counseling conducted during visits in the PY1, PY2 and ed ANC, PNC check-ups and PY3 Districts.
Immunization services yet Not 1.1.2e Print PPFP participants handbook for X 2,000 copies of PPFP the providers involved with PPFP Participant books provided services which includes 1000 requested from CCSDP, DGFP t and 1,000 copies to be used by MH - II for
training of providers from
notcompleted 000 copies printed copies 000
NGO/private and USAID , 2
implementing partners. manual FP of Revision 1.1.2f Collaborate with DGFP/DGHS to X X X X 450 service providers facilitate clinical orientation on PPFP received clinical
in all the potential public facilities of orientation on PPFP
PY3 districts
73 291 1.1.2g Conduct clinical training on immediate IR 2 will support X X X X Out of 450 service Postpartum IUD in selected public BCC activities in providers as mentioned
facilities of PY1, PY2 and PY3 these facilities above 160 received
districts. clinical training on PPIUD
76 26
1.1.2i Monitor and analyze the performances ME&R will provide X X X X 15,010 immediate PPIUD
of immediate PPFP of supported sites support to compile and PPBTL performed
754 657
891
- – – (districts of PY1, PY2, PY3) and analyze the PP BTL – 11,844 –
performance report PP IUD – 3,166
Immediate PPFP 968
,
PPIUD PPIUD PPBTL 2 PPIUD performances monitored PPBTL
Page | 21
Implementation Time Quarterly Achievement of Inter-Team Frame Benchmark/Deliverables Task # Task Description Benchmark/Deliverables Collaboration Q1 Q2 Q3 Q4 Q1 Q2 Q Q4 3 and analyzed
Quarter-wise Narrative Description of Activity Q1 Achievement Task # 1.2.1a: ▪ Onsite follow up visit completed 10 facilities under PY1 and PY2 districts. Most of the facilities are performing female sterilization with C-section but less in IUD with C-section or normal delivery. ▪ 26 point persons at different facilities have been reached by telephone to understand the situation of their PPFP service provision using a structured checklist. Task # 1.2.1b: A job aid has been drafted with PPFP messages for counseling in all ANC and PNC visits and with immunization services. Task # 1.2.1e: 2000 copies of PPFP participants’ handbook sent for printing. Task # 1.1.2f : 73 service providers and facility managers received clinical orientation on PPFP at Rangamati & Manikgonj districts. Task # 1.1.2g: ▪ 26 service providers received clinical training on PPIUD and the participants were from Rangamati (15) and from Natore (11) ▪ PPFP services have been initiated in nine new facilities in this quarter.
Q2 Achievement Task # 1.2.1a: Onsite follow up visit completed in 38 facilities under PY1 and PY2 districts. Most of the facilities are performing female sterilization with C-section but less IUD are being insereted after normal delivery. Task # 1.2.1c: Integrate PPFP counseling during all ANC and PNC visit and Immunization services has been approved in the 65th NTC held on 02 December 2015 anda circular jointly signed by the Director General of DGFP and the Director General of DGHS was issued on the 16th March 2016. This circular states that the oral pill, Injectbale and condom will be made available at all EPI centers. Task # 1.2.1b &1.2.1d: A job aid with key messages on PPFP has been developed for providers to use during client counselliong for ANC, delivery at home and at health facility, PNC, during immunization visits and after abortion. This is now under final review by USAID/Dhaka. After receiving clearance from the USAID this will be printed and distributed.
Page | 22
Task # 1.2.1e: 2,000 copies of PPFP participants’ handbook has been printed and 1000 copies handed over to DGFP to be used for conducting PPFP training. From the 18 PY3 districts PPFP has been intiated in 8 districts during this quarter. The districts are Tangail, Rajbari, Faridpur, Feni, Khagrachari, Munshiganj, Narsingdi, and Netrakona. Task # 1.2.1f: Clinical orientations on PPFP for the service providers and facility managers was organized in 18t facilities, 291 participants attended. The facilities are MCWCs (8), District Hospitals (8), Medical College Hospital (1) and Upazila Health Complex (1) and these facilities are located in 9 districts (TangailFaridpur, Feni, Khagrachari, Munshiganj, Narsingdi, Rajbari, Netrakona, Gazipur) Task # 1.2.1g: A total of 76 different categories of service providers (FWV 39, Medical Officer 15, Paramedics 22) from the public and NGO sector received trainings on PPIUD. Public: 42 providers from Tangail and Faridpur NGO: 34 providers from different facilities under NHSDP (Sylhet, Chittagong and Rajshahi) Task # 1.2.1i: PPFP performances based on DGFP, MIS Method Yearly Projection Achievements (Q1) Achievements (Q2) PP BTL 11,844 2,310 2,968 PP IUD 3,166 462 657 Total 15,010 2,772 3,625
▪ 4 Mama U models and 4 Kelly Forceps distributed to the 4 DGFP regional training centers (Dhaka, Rangpur and Rajshahi) for use in demonstration of IUD insertion within 48 hours after delivery Q3 Achievement Q4 Achievement Activity 1.1.3 ADDRESSING USE OF FAMILY PLANNING METHODS WITH POST ABORTION CARE (PAC)/POST-MR SERVICES This activity is a continuation of PY2 with adding few components. Partners/Collaboration DGHS, DGFP, EngenderHealth Global Clinical Support Team Person of contact Dr. Shamima parveen Implementation Time Quarterly Achievement of Inter-Team Task # Task Description Frame Benchmark/Deliverables Benchmark/Deliverables Collaboration Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4
Page | 23
1.1.3a Identify PAC/MR service providers X X Identified 40 PAC/MR who need LARC & PM training and service providers through organize need based training of the FU visits, training and providers through OGSB RH & FP orientation on PPFP in the training center or DGFP training center PY1, PY2, and PY3
Districts, received new service
training on LARC & PM
86 service service 86 oriented providers 67 oriented providers Implementation Time Quarterly Achievement of Inter-Team Task # Task Description Frame Benchmark/Deliverables Benchmark/Deliverables Collaboration Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 1.1.3b Conduct follow-up of all of the X X All 40 providers followed providers trained as above. up through physical FU
visits or over telephone
oviders by by oviders
r
p
87 (FWV & (FWV 87
of
Not started activity started Not FU SACMO) telephone 1.1.3c Monitor and analyze family planning ME&R will provide X X X X 1000 LARC and PMs services with post abortion/MR support to compile provided by the 40 services of the trained 40 providers and analyze the providers during PAC/post performance report MR services. MH – II does
LARC
not collect MR statistics. -
Not started activity started Not (81) FP (15) Quarter-wise Narrative Description of Activity Q1 Achievement Task# 1.1.3a: ▪ 36 participants oriented on using of PAC during IUD training ▪ 50 participants oriented on PAC during PPFP training
Page | 24
Q2 Achievement ▪ MH – II has been implementing this activity focusing on the MCWCs with emphasis on FP counseling and the use of FP after abortion/MR.There is no separate reporting column for uptake of FP methods after MR in the DGFP MIS reporting format. MH – II will collect this information from the MCWCs where the activity would be intiated. Task # 1.1.3a: A detailed orientation on “use of FP with PAC and after MR” has been organized at 5 MCWCs: Tangail, Khagrachari & Feni (February 2016), Faridpur & Rajbari (March 2016) where 67 providers attended. Task # 1.1.3c: Report received from the 5 MCWCs showed 125 women came for MR services and 81 received a FP method post abortion. These are - Pill (41), Condom (22), Injectable (3), Implant (3) and IUD (12). As per providers’ opinion, some of the clients didn’t recive methods from the facility due to – (1) not decided at this moment (2) need to discus with their husband specilly for LARC (3) planned to visit within 7 days but not came. Another group of women came for abortion and use MM Kit (Medical Abortion) from MCWC. They take one medicine at MCWC and and another 4 medicine at home after 12 hours. Dispite being counselled to return to the clinic for a FP method many do not come back.. Q3 Achievement Q4 Achievement
Activity 1.1.4 STRENGTHEN LARC & PM AND INJECTABLE SERVICES IN THE URBAN AREAS This activity is to strengthen LARC and PM in Dhaka City through collaboration with the PNGOs of UPHCSDP, and strengthening/initiating LARC & PM in selected private facilities with DGFP and SMC logistic support. Second component of this activity is to work with some selected Pourashavas through collaboration with the Municipal Association of Bangladesh (MAB) for strengthening LARC and PM. Partners/Collaboration RTM, UPHCSDP, partner NGOs (PNGOs) of Urban Primary Health Care Service Delivery Project (UPHCSDP), Dhaka City Corporation, OGSB, MAB, selected Pourashavas Person of contact Khandoker Abu Jafor Mohammad Saleh and Dr. Murshida Rahman Implementation Time Quarterly Achievement of Inter-Team Frame Benchmark/Deliverables Task # Task Description Benchmark/Deliverables Collaboration Q1 Q2 Q3 Q4 Q1 Q2 Q Q4 3
Page | 25
1.1.4a. Organize special days at the PNGOs of IR 2 will provide X X X X 50 special days organized but UPHCSDP under Dhaka City support for demand and 3,000 LARC & PM Corporation to increase uptake of generation and performed LARC, PM and Injectable services of client mobilization Implant – 1,588 the facilities and adjoining slums around the facilities IUD – 618 and nearby slums Female PM – 176 ME&R will provide postponed Activity Male PM - 618
support & conduct postponed Activity DQA visit.
Implementation Time Quarterly Achievement of Inter-Team Frame Benchmark/Deliverables Task # Task Description Benchmark/Deliverables Collaboration Q1 Q2 Q3 Q4 Q1 Q2 Q Q4
3
1.1.4b Organize special days at identified IR 3 will collaborate X X X 24 special days organized ) 35 35 pure private 10 health facilities in with DGFP and at 10 private facilities in ( Dhaka having DGFP logistics and private sites for Dhaka and 500 LARC & imprest fund support meant for availability of PM performed
poor/ultra-poor population living in the DGFP logistics and Implant – 610 &NSV 148
13 S. days days S. 13 slums. imprest fund support IUD – 121 started yet Not Female PM – 34 lant
Male PM - 34 Imp
1.1.4c Collaborate with SMC to support X X X 20 selected facilities selected private health facilities/ started providing LARC & providers trained through non-MIH Injectable services using
project to initiate LARC and Injectable SMC commodities yet strated yet services using SMC commodities in
Dhaka facilities
Not 6 to work started
Page | 26
1.1.4d Collaborate with IR3 team and IR 3 team will X X 24 special days organized Municipal Association of Bangladesh collaborate with and 500 LARC &PM and (MAB) through an MOU with this MAB to select the Injectable services entity and DGFP to organize special four (4) Pourasavas, provided days to provide LARC & PM services and will also Implant – 300 using DGFP logistics and imprest fund collaborate with IUD – 50 in 4 Pourashavas in PY3 Districts to CCSDP to obtain test service delivery methodologies in approval for getting Female PM – 10 logistic and Imprest Male PM – 10 the urban areas. fund through the Injectable - 130 local DGFP Managers IR 2 team will support for demand generation/BCC activities in the selected
Pourashavas
Would be start next quarter next start be Would MAB with to work start to the way On Implementation Time Quarterly Achievement of Inter-Team Frame Benchmark/Deliverables Task # Task Description Benchmark/Deliverables Collaboration Q1 Q2 Q3 Q4 Q1 Q2 Q Q4 3 1.1.4e Monitor/track and analyze LARC, PM ME&R will provide X X X Special day performances
and injectable performances of the support for data through PNGOs and
ces ces
supported facilities analysis private facilities monitored
and analyzed
Performan Monitored Performances Monitored Quarter-wise Narrative Description of Activity Q1 Achievement Task # 1.1.4d: MH-II signed an MOU with Municipality Association of Bangladesh (MAB) to provide LARC & PM including injectable services through their existing facilities. IR 1 incollaborationwith IR3 conducted need assessment in five Pouroshovas. These are Sadar, Bera&Ishaawrdi of Pabna, Singra of Natore and Kaliakoir of Gazipur districts.
Page | 27
Q2 Achievement Task # 1.1.4a: The assigned activity was postponed because of the cancelation of the MOU by the UPHCSDP. MH–II has planned an alternate way to reach the urban population by providing a sub-grant to a local NGO, PSTC to work in the urban areas in 11 districts (Dhaka, Narayangonj, Gazipur, Mymensing, Jamalpur, Sylhet, Barisal, Jessore, Bagerhat, Rajshahi and Rangpur) through using volunteers. A resource pool was developed to orient and monitor the volunteers. IR1 team facilitated the training incollaboration with IR 2 team. The performances of the volunteers are covered in the activity # 2.3.5a Task # 1.1.4b: IR 1 & IR 3 team of MH–II in collaboration with DGFP has started to organize special days at private facilities in Dhaka. In this quarter 13 special days were organized in Dhaka.183 clients received the services. (35 implants and 148 NSV.) The service providers working at the DGFP performed the cases. Task # 1.1.4c: MH-II established strategic partnerships with private hospitals and/or clinics to provide FP services using SMC commodities. A letter of agreement was signed with 15 private health facilities. 6 out of 15 facilities have started offering service from March 2016. The facilities are involving the Reproductive Health Service Promotion Officers (RHSPO) to generate clients. IR1 staff in collaboration with IR2 organized a three daytraining on FP, Communication and Counseling for the RHSPOs. The performances of the facilities are mentioned in the activity # 2.1.2a above Task # 1.1.4d: The executive body of the Municipal Association of Bangladesh (MAB) has been changed after the elections. In collaboration with IR3 team, a start up meeting was organized to sensitize and orient the new MAB members on FP. (link activity # 3.1.3d) ▪ Accelarted Activity: In collaboration with SMC, 73 doctors working in the private sector received training on LARC and Injectable in this quarter. MH – II will start to follow up them over phone. SMC has taken the responsibility to collect their performances. Q3 Achievement Q4 Achievement Activity 1.1.5 STRENGTHEN LARC & PM AND INJECTABLE SERVICES IN THE BGMEA CLINICS/WORKPLACES This activity is to strengthen LARC and PM in Dhaka City through collaboration with the BGMEA, NHSDP and PNGOs of UPHCSDP, and strengthening/initiating LARC & PM in selected private facilities with DGFP and SMC logistic support. Second component of this activity is to work with some selected Pourashavas through collaboration with eth Municipal association of Bangladesh (MAB) for strengthening LARC and PM Partners/Collaboration BGMEA, NHSDP, UPHCSDP, Meridian Group International Person of contact Dr. Sayeeda Akhter Banu Implementation Time Quarterly Achievement of Inter-Team Frame Benchmark/Deliverables Task # Task Description Benchmark/Deliverables Collaboration Q1 Q2 Q3 Q4 Q1 Q2 Q Q4 3
Page | 28
1.1.5a Provide basic/refresher training/ hands X X 16 providers received
on coaching to selected BGMEA training/refresher
providers on Implant and Injectable training/hands on coaching
on Implant and Injectable
No training training No planned training No planned
1.1.5b Provide support to organize special Special days will be days in BGMEA clinics, and other organized in GOB/NGOs clinics around factory collaboration with IR 2 team
sites in Dhaka. The providers are paid special days special
by respective organizations and not by days special 15
20 special days special 20 days special 20 days special 20 days special 10 26 MH – II.
Implementation Time Quarterly Achievement of Inter-Team Frame Benchmark/Deliverables Task # Task Description Benchmark/Deliverables Collaboration Q1 Q2 Q3 Q4 Q1 Q2 Q Q4 3
Page | 29
1.1.5c Monitor/track and analyze special day ME&R will provide X X X X 1125 LARC & Injectable performances of BGMEA clinics, and support to analyze performed. the performances other GOB/NGOs clinics around Implant – 344 ondom
factories in Dhaka and Chittagong. IUD – 46 C
131, Condom Condom 131,
Injectable - 735 ,
2
727
1,486, 1,486,
,
-
– 4
Special days performance
–
Pills
Pill Pill
monitored and analyzed 2015) &Nov. (Oct
,
, ,
455
074
646
,
–
–
4
Inj Inj 1.1.5d Support Business for Social This activity will be X X FP integrated in the
Responsibilities (BSR)/Change organized in curriculum used by for for Associate on Family planning issues collaboration with BSR/Change Associate including training and service delivery. IR 3 team and their trainers/peer
MH – II will provide technical support educators received staff II - to update their curriculum related with orientation on family
FP issues and orient their trainers so planning methods to reach
BSR Curriculum Curriculum BSR
that they can deliver the correct out new garment factories
messages supported by BSR. the
BSR/Change Associate BSR/Change
Not yet started started yet Not of part FP MH by reviewed was rhe project. Quarter-wise Narrative Description of Activity Q1 Achievement: Task #1.1.5b: 10 special days organized in different garments and providers of BGMEA clinics organized these special days. Task # 1.1.5c: The BGMEA clinics served 1,486 clients who received 1 cycle of the pill and 4,074 clients received 6 pieces of condom eact and 455clients received njectable. (including special days at different garments factories) Task # 1.1.5d: Social Responsibilities (BSR)/Change Associate working at RMG factories on health & Hygiene issues. MH-II is working with BSR to incorporate FP issues in their curricula. For this purpose, MH-II signed an MOU with BSR. A planning meeting was organized with BSR for collaboration in IR3 The IR1 team will review their existing curriculum and incorporate updated information based on observation of the training.
Page | 30
Q2 Achievement Task # 1.1.5b: 26 special days organized in different garment factories. The service providers from the BGMEA clinics organized these special days. Task # 1.1.5c: During the period January – February 2016 FP Performance at BGMEA clinics (5) including special days organized by BGMEA.
Quarters Pill Condom Injectable Implant Q2 (Jan – March) 2,131 4,727 646
Both these tasks are linked with the activity # 2.1.3f Task # 1.1.5d: IR1 Team has been working in collaboration with team 3 in reviewed the existing curriculum used by BSR related to Family Planning and Maternal Health. Basic information related to all FP methods has been included. FP has been included in the maternal health section as well. A training has been planned for the trainers of BSR in the first half of April 2016. This activity is linked with activity # 3.1.5d. BSR, with funds from DFID working with three NGOs namely Awaz Foundation, Change Associates and Mamata in different garments industries.
Q3 Achievement Q4 Achievement Activity 1.1.6 STRENGTHENING IUD SERVICES This activity is for implementation of the policy decision for providing IUD by the female SACMOs that was ere approved by the National Technical Committee (NTC) during PY2. This is continuation of the activity initiated during PY2 adding new initiate to boost-up IUD services Partners/Collaboration DGFP, UNFPA Person of contact Dr. RushanAfroze and Dr. Shamima Parveen Implementation Time Quarterly Achievement of Inter-Team Frame Benchmark/Deliverables Task # Task Description Benchmark/Deliverables Collaboration Q1 Q2 Q3 Q4 Q1 Q2 Q Q4 3
Page | 31
1.1.6 a Conduct joint follow-up of female X X X X 119 providers followed up Sub-Assistant Community Medical PY2 - 87 SACMOs Officers (SACMO)s and Family PY3 – 32 FWVs Welfare Visitors (FWVs) received
refresher training (during PY2 & PY3)
on IUD using structured checklist
providers followed followed providers
41 FWVs 41 87 phone over up Implementation Time Quarterly Achievement of Inter-Team Frame Benchmark/Deliverables Task # Task Description Benchmark/Deliverables Collaboration Q1 Q2 Q3 Q4 Q1 Q2 Q Q4 3
1.1.6b Support trained FWVs, and female X X X X 80 special days organized, SACMOs to organize special days on and 800 IUD performed IUD to expand access to quality IUD
services
erformed
uring 22 Special Days Special 22 uring
13 special days (88 IUD IUD (88 days special 13 performed) p IUD 359 training receving after d 1.1.6c Support DGFP and conduct refresher X X 32 FWVs received
training for the newly recruited FWVs refresher training
working in MNHI districts including counseling, side (PY1/PY2/PY3) including counseling effect and complication
and side effect management. management
35 FWVs 35 training No planned
1.1.6d Monitor and analyze IUD ME &R will support X X X X IUD performances of
performances of trained female to monitor the trained female SACMOs, SACMOs and FWVs trained performances and FWVs monitored and
analyzed
Permonaces Permonaces monitored Permonaces monitored Quarter-wise Narrative Description of Activity Q1 Achievement
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Task # 1.1.6 a: 41 FWVs working at different upzilas of Chittagong who received training in PY2 received followed up this quarter. Follow up occurred at facility level. 88 IUD clients accepted IUD and another 33 clients rejected mostly due to cervicitis, pregnancy, cervical erosion. The clients who rejected were advised for another contraceptive as per their choice. Task # 1.1.6c: 35 FWVs from different upazila’s of Jamalpur districts received refresher training on IUD.
Q2 Achievement Task # 1.1.6a: As a part of training 63 FWVs and 24 female SACMOs recived training on IUD during PY2 and they were followed up over phone. The FWVs are performing but female SACMOs are infrequent performers. The reasons are: FWVs are the key person for IUD service delivery for the particular facility (FWC); FWV is known as the IUD provider in the community; female SACMO get chance to insert IUD whenever FWV is unavailable at the facility. Considering all of these issues IUD training for the female SACMOs have not been initiated in other districts. Task # 1.1.6d: Performances of IUD services (received through text message using mobile phones that was demonstrated to the female SACMOs and newly recruited FWVs during training). Below is their performance from January –March 2016
# Providers Districts # IUD inserted Period Received training # providers sent messages Chittagong (FWV) 24 out of 41 218 Jan – March 2016 Sunamgonj (FWV) 11 out of 22 102 Jan – March 2016 Bogra (SACMO) 12 out of 24 39 Jan – March 2016 Total 359 Q3 Achievement Q4 Achievement Activity 1.1. 7 STRENGTHENING INJECTABLE SERVICES This activity is for implementation of the policy decision that was approved by the National Technical Committee (NTC) during PY2. This include implementation of policy decision for injectable training for the CSBA, FWAs and CHCPs in selected districts (Dhaka, B. Baria and Cox’s Bazar) and follow up services at BGMEA clinics Partners/Collaboration DGFP, DGHS, BGMEA, BRAC, Person of contact Dr. Ifterkhar Alam and Sayed Anowar Hossain Implementation Time Quarterly Achievement of Inter-Team Frame Benchmark/Deliverables Task # Task Description Benchmark/Deliverables Collaboration Q1 Q2 Q3 Q4 Q1 Q2 Q Q4 3
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1.1.7a Support DGFP and organize TOT on X X 75 DGFP trainers received
injectable for the local trainers of TOT on Injectable DGHS & DGFP using GOB curriculum for 3 districts (B. Baria,
Cox’s Bazar, and Dhaka) according to personnel
a decision of NTC
32 TOT received personnel 31 TOT received Implementation Time Quarterly Achievement of Inter-Team Frame Benchmark/Deliverables Task # Task Description Benchmark/Deliverables Collaboration Q1 Q2 Q3 Q4 Q1 Q2 Q Q4 3 1.1.7b Support DGFP during cascade training X X X 1,700 providers (CSBA of CSBA trained FWAs and CHCPs trained FWAs, new FWAs on Injectable involving the DGHS & and CHCPs) received DGFP trainers training on Injectable trained by the 75 DGFP Trainers
Expected to provide:
Total doses - 1,295,353
1st dose - 14,503 by CSBA
training received Providers 762 training
trained FWAs received providers 556
1.1.7c Organize joint follow-up visits 12,00CSBA trained FWAs involving GOB supervisors which & CHCPs (the new 500
includes local MO-MCH, UFPO, MOs FWAs will be followed up
up visits up visits up visits up
- - of DGHS and UHFPOs - by their own supervisors) followed up which would
be 70% of the ones started
9 follow 9 follow 9
9 follow 9 trained. F/U will be done Follow up not yet yet not Followup through physical visit and and 24 CSBAs 36 phone calls. up followed CHCPs
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1.1.7d Monitor/track the performances of IR 2 team and X X Performance of CSBA
trained CSBA trained FWAs & CHCP ME&R will provide trained FWAs & CHCP
support to analyze monitored and analyzed
the performances
Not yet started the started yet Not activity started yet Not Quarter-wise Narrative Description of Activity Q1 Achievement: Task # 1.1.7a: MH-II started this activity in the last quarter of PY2 and developed 34 trainers for Brahmanbaria district. The trainers started upazila level field workers training since September 2015. Total CSBA, CHCP, FWA and FWV were trained on injectable while 516 were trained during this quarter. The providers breakdown is: CSBA trained FWAs-147, CHCPs-223, FWAs- 228, FWVs- 81) Task # 1.1.7b: This activity has been started at Cox’s Bzar district where 32 doctors and upazila managers under DGHS and DGFP received “Training of Trainers on Injectable” with an aim to conduct training for the FWAs/CSBAs and CHCPs. The trainers of Cox’s Bazar started cascade training and in this quarter 44 CSBA received training on injectable in two batches. Task # 1.1.7c: One follow-up visit done with local manager which was conducted at Kasba and Ashugonj Upazilla of Brahmanbaria.
Q2 Achievement Task # 1.1.7a: MH – II supported the Field Service Delivery Program (FSDP) from the DGFP to organize a TOT on Injectable for Dhaka district. 31 doctors and upazila managers including 14 managers under the DGHS and DGFP working in 7 different upazilas of Dhaka district received a TOT at the IEM conference room of DGFP. Task # 1.1.7b: The injectable training was completed in Cox’s Bazar district in February 2016 and since March the training has been started in Dhaka district. The trainers who received TOT are involved in conducting the cascade training with support from other DGFP trainers. MH – II provided financial and technical support based on need. In this quarter training has started in the Dhaka City Corporation in the two zones for FP service provision in Dhaka City Corporation. Below is the status of the training for this quater:
Categories of participants received training District # Batches Total FWV FWA CSBA CHCP Others (NGO) Cox’s Bazar 22 68 73 84 178 45 448
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Dhaka 13 81 126 - - 107 314
Orientation on record keeping and reporting was conducted on 31st January 2016 at the Upazila Family Planning Office, Sadar, Cox’s Bazar. A total of 46 (Forty- six) paticipantswere attended (UFPA – 10; Statistical Assistant-1; FPI-35) Task # 1.1.7c: Follow up visit was conducted in nine Upazillas in B. Baria district for 60 service providers (36 CSBAs and 24 CHCPs) who received Injectable training. Providers’ knowledge and skill were assessed and need based feedback provided. Most of the CSBAa are providing 1st doses of Injectable and the CHCPs a re providing the 2nd and subsequent doses. Some of the staff have not been able to start the services due to non availability of consent form and logistics. Local managers have been requested to address these issues.
Q3 Achievement Q4 Achievement Activity 1.1.8 STRENGTHEN LARC, PM AND INJECTABLE SERVICES AT NGOS (BRAC, NHSDP AND OTHER NGOS); AND COLLABORATE WITH FISTULA CARE PLUSPROJECT OF ENGENDERHEALTH This activity is to collaborate with the selected NGOs for capacity building of providers to initiate/strengthen LARC and Injectable services and this is a continuation of PY2 activities Partners/Collaboration NHSDP, BRAC, DGFP and DGHS Person of contact Dr. Murshida Rahman Implementation Time Quarterly Achievement of Inter-Team Task # Task Description Frame Benchmark/Deliverables Benchmark/Deliverables Collaboration Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 1.1.8a Provide support to the BRAC, NHSDP 60 providers received and other NGOs in training their clinical training on LARC
clinical providers including gender & PM and Gender
orientation to initiate/strengthen orientation (45 on only ived
LARC and injectable services spread LARC and 15 on both sions
over the Districts of PY1, PY2 and LARC and PM) from 45
1 session 1 session 1 3 ses 3 PY3 sessions 2 sites as requested by BRAC, NHSDP and other
NGOs
36 providers received received providers 36 trainings 6 providers rece providers 6 training 36
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1.1.8b Monitoring and follow up visits with X X X X All trained 60 NGO
NGO supervisors to strengthen LARC providers followed up & PM and Injectable services of the through physical visits and
selected supported facilities over telephone
Not yet yet Not planned 59 59 providers followed up 1.1.8c Monitor/track the performances of ME&R will provide X X X X 18,616 LARC& PM and
trained NGO providers support to analyze Injectable performed by
IUD IUD
the performances the supported 60 sites ,
11
-
Implant – 6,831
implant 9 9 implant
5
2,922 833,
, ,
,
IUD – 2,012 -
– 3
Female PM – 775 implant
n 355 n
, ,
–
Male PM – 1,758 – Implant Implant
Injectable – 7,240
Injectable Injectable IUD im Injectable 330 Implementation Time Quarterly Achievement of Inter-Team Task # Task Description Frame Benchmark/Deliverables Benchmark/Deliverables Collaboration Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 1.1.8d Collaborate with FC+ project team and FC+ team will share X X X X Need based support
provide support for training, event their proposed provided to FC+ project
conduction/facilitation on FP related activities and team issues as per need finalize the joint
action plan
Not yet yet Not planned yet Not planned Quarter-wise Narrative Description of Activity Q1 Achievement Task # 1.1.8a: In this quarter, 4 trainings on IUD and injectable were organized for 36 paramedics. The paramedics were from BRAC (30), RTMI (3), OGSB (1) and Shimantik (1). Among these, 2 training were completed in October 2015 and as per telephonic follow up it has been found that most of them are started to perform. Task # 1.1.8c: FP Performance from BRAC Injectable -2,922 IUD – 355 and Implant –9
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Q2 Achievement Task # 1.1.8a: 2 batches of 6 day long trainings on “IUD and injectable” were organized attebded by 11 paramedics. The paramedics were from BRAC (06), RTMI (05). 1 doctors recruited for RTMI received 18 days long training on LARC & PM. Task # 1.1.8b: A total of 59 providers (7 doctors & 52 mid wives/paramedics) service providers from BRAC were followed up in 5 batches. They had e received training on “IUD, Implant and injectables” during PY1 &PY2. Task # 1.1.8c: FP Performance of BRAC facilities: MH – II has been providing support such as refresher training, hands on coaching and follow up to BRAC to initiate FP services at their facilities including o PPFP. The perfomnces below are from the facilities where MH – II intiated FP services in (PY1 + PY2 + PY3). BRAC has been purchasing FP commodities from SMC. The uptake of Implant is low due to high price. BRAC is trying to get the affiliartion to get FP commodities from government.
FP methods October – December 2015 January – March 2016 Month Uptake of FP services Avarage # per facility Uptake of FP services Avarage # per facility Injectable 2,922 97 3,833 106 Implant 9 3 11 3.6 Interval IUD 293 11.7 249 8.3 Postpartum IUD 62 12.4 81 11.5
Q3 Achievement Q4 Achievement
Sub IR1.2 Training, support and performance improvement mechanisms institutionalized Activity 1.2.1 WORKING WITH MH – II SUB-AWARDEE “OGSB RH & FP TRAINING CENTER” TO STRENGTHEN ITS CAPACITY TO FUNCTION AS AN INDEPENDENT TRAINING CENTER This activity is to strengthen the capacity of the OGSB’s RH-FP Training Center with an added component of collaborating with DGFP and OGSB to set-up a Training Center Network involving MFSTC, MCHTI, and OGSB FP-RH Training Center. Partners/Collaboration OGSB, DGFP, MCHTI, MFSTC, NGOs, UPHCSDPs, Private sector facilities Person of contact Dr. Tahmina Akhter and Fatema Shabnam Implementation Time Quarterly Achievement of Inter-Team Task # Task Description Frame Benchmark/Deliverables Benchmark/Deliverables Collaboration Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4
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1.2.1a Support OGSB RH & FP Training X Yearly Workplan
Center in the development of a yearly developed
workplan, where cost of the training is
paid for by the trainees’ organizations.
Done Done
1.2.1b Organize joint meetings to support MFSTC, MCHTI, Two joint meetings held a
OGSB RH & FP training center to CCSDP Unit of as part of developing the
develop a training network involving DGFP training network
OGSB, MFSTC, MCHTI, CCSDP unit 1 meeting 1 of DGFP and other NGOs used for meeting 1
practical training sessions
Not yet planned yet Not planned yet Not
1.2.1c Support OGSB RH & FP training X X X OGSB RH & FP develops
center develop a sustainability plan a sustainability plan and n
and accordingly initiates the process of initiates the process of charging fee for different training sustainability through
courses charging fees for training
On the way to the way On development pla marketing A prepared hasbeen Implementation Time Quarterly Achievement of Inter-Team Task # Task Description Frame Benchmark/Deliverables Benchmark/Deliverables Collaboration
Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4
1.2.1d Organize program review meetings Grants and Finance 4 program review
with management of OGSB RH & FP team will participate meetings held training center to monitor the progress
of development of the training
1 meeting 1 meeting 1 meeting 1 meeting 1 meeting
network as per project goal
1 meeting 1 2 held
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1.2.1.e Monitor/track training performances ME&R team will Reviewed and analyzed
of OGSB RH & FP training center and conduct DQA performances of OGSB
follow up of activities as per project RH & FP Training center. (8
goal and workplan 5 batches 5
5 batches 5 192 providers as identified
5 batches 5 batches 4
Name of Batch x from PY1, PY2 and PY3 providers
Total
the training Participant Districts trained through 61
19 different batches Tr. received IUD 7 x 6 42 Implant 6 x 10 60
Counseling 3 x 15 45
5 batches & batches 5 providers
Infection 3 x 15 45
104 prevention batches)
Quarter-wise Narrative Description of Activity Q1 Achievement Task # 1.2.1a: With the support from MH - II, OGSB prepared the workplan for the period of October 2015 – September 2016 where cost of training conduction included Task # 1.2.1c: To organize training on IUD and Implant, OGSB contacted with NHSDP. They also organize practical session at the GOB facilities and also NGO facilities. Facilitator from DGFP participates in the facilitation of training organized by training center. Task # 1.2.1d: OGSB prepared their brochure to disseminate information about training center and participate in the scientific seminar organized by OGSB to search prospective organization with training need to develop sustainability of the training center. Task # 1.2.1e: OGSB organized following different training in this quarter. Name of the training # of batches # of providers received training Training on FP Counseling 2 36 Training on IUD and Implant 1 9 Training on IUD 1 7 Training on Implant 1 9
Q2 Achievement Task # 1.2.1c: OGSB RH & FP Training center developed a draft marketing plan. One of the focus of the plan is to develop a brochure,to distribute it at meeting with key stakeholders, communication through email, arrangement of a seminar, and development of a face book page. The brochure has been developed and distributed by OGSB through different programs and events. Task # 1.2.1d: Two meetings held in this quarter with the President, General Secretary, OGSB and Director, OGSB Hospital and other concerened persons were
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present. The key discussion points were how to increase the client flow at the hospital particularly Family Planning clients. Task # 1.2.1e: Training performances: 104 participants received different trainings organized by OGSB in this quarter. The participants were from different NGOs and private facilities. The trainings conducted by OGSB RH & FP training center is given below: Number of participants (batch) Name of the training Projection Q1 Q2 Total 1. Training on Counseling 45 36 10 (1 batch) 46 2. Training on Infection prevention 45 62 (3 62 batches) 3. Training on IUD 42 7 24 (3 31 batches) 4. Training on Implant 60 9 8 (1batch) 17 5. Training on IUD and Implant 9 9 Total 192 61 104 (8) 165
▪ The trainers conducted onsite follow up visit in 4 districts and 9 service providers from different facilities were followed up after they had received IUD training 3- 5 months earlier. All the participants are providing IUD services and following the standard technique, in Jamalpur (3), Panchagarh (3), Sylhet (2) and Dhaka (1) district. Q3 Achievement Q4 Achievement Activity 1.2.2 STRENGTHEN QUALITY ASSURANCE (QA) AND FP COMPLIANCE IN PUBLIC, NGO AND PRIVATE SECTOR FACILITIES This activity is to support the public, private and NGO sector to strengthen capacity of the clinical supervisors which would include CCSDP officials and FPCST to improve quality of care for LARC, PM services including PPFP and injectable services as well as QA & FP Compliance ICV through joint QA and FP Compliance visits. While working with the CCSDP officials and FPCST their capacity would be strengthened in terms of properly filling out FU visit checklists, providing feedback to the providers and providers finding the feedback to be helpful. Partners/Collaboration DGFP, DGHS, NGOs, private sectors facilities, EngenderHealth Global Clinical Support Team Person of contact Dr. S M Nizamul Haque and Dr. Rezaul Karim Implementation Time Quarterly Achievement of Inter-Team Task # Task Description Frame Benchmark/Deliverables Benchmark/Deliverables Collaboration Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4
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1.2.2a Support Sr. QA & FP Compliance X Monthly/yearly QA and
Officers of MH – II to develop their FP Compliance visit plan
monthly/yearly plan for QA & and plan for organizing Compliance visit and organization of special service days
special days developed Done Done in Q1 Done
1.2.2.b Sr. QA & FP Officers collect district X X X X District and Upazilla-wise
and Upazilla-wise monthly plan for monthly LARC and PM LARC & PM service delivery service delivery plan days/dates from UFPOs to make joint collected by the Sr. QA & plan for organization of additional FP Officers service delivery days for LARC, PM
and Injectable services.
Monthly collected Monthly collected Monthly Implementation Time Quarterly Achievement of Inter-Team Task # Task Description Frame Benchmark/Deliverables Benchmark/Deliverables Collaboration
Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4
1.2.2c Organize and conduct QA and FP DGFP and DGHS 100 QA & FP Compliance Compliance visits (100) and follow-up visits conducted in the
visits (75) jointly withthe DGFP PY1, PY2 and PY3 up
up up
-
up visits up visits up visits up visits up
-
- - - officials, FPCST & DGHS - Districts of which one counterparts with emphasis on third would be joint visits. problem solving. The joint visits will Out of 100 visits, 75 will build the capacity of the FPCST be follow up visits Supervisors in terms of filling the conducted.
checklists; providing constructive
feedback to the supervisees, supervisory visits would become more
of problem solving etc.
25 first visits + 15 follow 15 + visits first 25 follow 20 + visits first 25 follow 20 + visits first 25 follow 20 + visits first 25
84 (48 first visits & 36 follow & 36 visits first (48 84 done visits) follow &14 visits first (58 72 done visits)
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1.2.2 d Collaborate with the DDFP and 1,000 special service UFPOs to jointly plan and organize FP delivery days organized to
special days to be facilitated by the perform - 30,583 LARC,
QA & FP Officers for LARC & PM PM and Injectable and Injectable services at DGFP Male PM - -6,580
facilities Female PM - -3,395
300 special days special 300 days special 250 days special 200 250 special days special 250 Implant -16,830
IUD – 1,291
special days days special
Injectable - 2,487 doses 1 326 special days special 326
29
1.2.2.e Collaborate with the CS/DDFP and 12 DGHS/12 newly UH&FPOs to identify interested recruited DGFP doctors DGHS and /or newly recruited DGFP received on the job doctors in PY1, PY2, and PY3 training to develop skills Districts to build their skills on LARC on LARC and PM. Their
& PM under the direct guidance and performance would be
4 doctors trained doctors 4 trained doctors 6 trained doctors 6 trained doctors 8 supervision of the Sr. QA & FP followed-up through Compliance Officers physical FU visits and
over telephone.
Training not yet started yet not Training doctors DGHS 15 trained Implementation Time Quarterly Achievement of Inter-Team Task # Task Description Frame Benchmark/Deliverables Benchmark/Deliverables Collaboration
Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4
1.2.2f Collect client perception about the ME&R will do data X X X X Collected data analyzed to quality of LARC and PM on the processing and see quality of services
services received analysis provided and ICV
Not yet started yet Not started yet Not
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1.2.2g Support IR3 team to do advocacy with IR3 team will do X Circular issued by DG, the MOHFW through DG, DGFP.The advocacy to issue DGHS to all concerned to DG, DGHS will issue a circular to the circular allow existing OT of UHC
allow existing Operation Theater (OT) to provide LARC & PM of the Upazilla Health Complex services particularly IUD (UHC) to provide LARC & PM insertion and removal. A
services particularly for IUD insertion separate IUD insertion and and removal removal room may not be
obtained.
Distrcit based circular circular based Distrcit issued be would on based over handed 31 circular
1.2.2h Orient all new EHB staff and in- X All new EHB + in country
country partners/sub-awardees on partner + sub-awardee Done USAID statutory policies, regulations staff oriented on USAID Done
and FP compliance monitoring tools. statutory policies
1.2.2i Make sure that USAID e-learning X All EHB Staff completed
course on FP completed every year by e-Learning course on FP Done Done all EHB staff, collect & post and obtained certificates certificates to EH/BCO intranet page
and forward to USAID Dhaka
1.2.2j Develop an on-line file on FP On-line file on FP
Compliance visit findings in the Compliance visit findings Done homepage of EngenderHealth developed in the home Done Bangladesh according to the HQ page of EHB. And all requirements and keep all related compliance related documents in that file documents uploaded Implementation Time Quarterly Achievement of Inter-Team Task # Task Description Frame Benchmark/Deliverables Benchmark/Deliverables Collaboration Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 1.2.2k Conduct FP compliance review X X X X FP Compliance review
meetings with USAID staff as part of meetings held
the quarterly review meetings
Meeting Meeting held Meeting held s
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1.2.2l Take necessary actions for any issue Necessary steps taken and
that impedes the quality and FP documented in case of any
compliance and documentation done violation of quality and FP
compliance
N/A N/A 1.2.2m Monitor/track performances of QA & ME&R will Analyzed data available FP Compliance Officers collaborate for data
analysis and d
Monitotre analyzed and Monitotred analyzed Quarter-wise Narrative Description of Activity
Q1 Achievement: Task # 1.2.2a & 1.2.2b: During this quarter a District-wise plan for QA and FP Compliance was developed. Monitoring visits conducted in different DGFP and DGHS facilities of PY3 Districts, not including facilities of PY1 and PY2 Districts, and follow-up monitoring visits in different facilities of PY1 and PY2 Districts. This plan was shared with all the Sr. QA and FP Compliance Officers in an orientation session held at EHB on 29 November2015, in which advised them to follow the plan to implement the QA and FP compliance monitoring visits. In the orientation session, they were provided guidance on how to collect relevant data on QA and FP compliance monitoring visits and how to report it through the excel sheets in a better way. They were oriented on the organization of special LARC and PM service delivery days and using hired surgeons in the Upazilas where the post of MO (MCH-FP) is vacant. They were also oriented how to do MH-II follow-up activities including PPFP, BCC materials distribution, and the implementation of changed policies. Task # 1.2.2c: According to PY3 workplan, most of the first QA and FP Compliance monitoring visits and follow-up visits should be done jointly with the Regional Supervisor, FPCST/QAT of the DGFP and DGHS counterparts, with an emphasis on problem solving. In this regard, a meeting was held with the Line Director (CCSDP), DGFP and his unit officials on 4 November 2015 and reached a consensus for these joint visits. During this quarter (Oct/15 to December/15), a total of 84 QA and FP Compliance monitoring visits were conducted by the Sr. QA and FP Compliance Officers at DGFP, DGHS and NGO service delivery facilities in 27 Districts Among these visits, 48 visits (8 MCWCs, 37 UHCs, 1 FWC and 2 NGO clinics) were first visits and 36 visits (5 MCWCs and 31 UHCs) were follow-up visits. The summary of the visited facilities is mentioned below in a matrix. (See Appendix-3 for detailed findings)
# of facilities conducted first visit # of facilities conducted follow-up visit Grand Quarter MCWC UHC H&FWC NGO Clinic Total MCWC UHC H&FWC NGO Clinic Total Total Q1 8 37 1 2 48 5 31 0 0 36 84
Task # 1.2.2d: MH–II’s Senior QA and FP Compliance Officers, who provided assistance in organizing 291 special LARC and PM service days by conducting
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facility walk through, reviewing the findings of the site visits, sending job-aid and IEC/BCC materials, supporting DGFP doctors by providing on-site coaching, and using hired surgeons to perform 6045 LARC, PM and injectable services during this quarter (including: 657 female sterilizations, 508 NSVs, 4,300 implants, 178 IUDs, and 402 injectables). Following are the service provisionsof special FP days mentioned above.
Performances Yearly Methods Achievements (Q1) Q1 Q2 Q3 Q4 Projection Female Sterilizations 657 3,395 657 Male Sterilization (NSV) 508 6,580 508 Implant 4,300 16,830 4,300 IUD 178 1,291 178 Injectables 402 2, 487 402 Total LARCs,PMs&Injectables 6,045 30, 583 6,045
Task # 1.2.2e: The Line Director (CCSDP) of the DGFP requested MH-II to provide LARC and PM comprehensive training to 44 DGHS doctors posted in different Upazila Health Complexes (UHC) under Chittagong, Sylhet and Barisal Division. In these UHCs, the posts of MOs (MCH-FP) are vacant. After being trained they will provide LARC and PM services in the UHCs where they are posted. A meeting was held with the LD (CCSDP), DGFP on 4 November 2015 and a subsequenttriparty meeting held with the Director (PHC), DGHS, LD (CCSDP), DGFP and Sr. Program Staff of MH-II on 12 November 2015 to set the modalities of the training program. The first batch of the training program involved 6 trainee doctors from different UHCs of Barisal Division from 26 December2015 in the Mohammadpur Fertility Services and Training Center (MFSTC) and till the 31 December 2015 for theoretical part only. For practical part to build capacity and skill development they will be located in different UHCs of Barisal Division for two weeks (first two weeks of January2016) where hands-on coaching will be provided by the Regional Supervisor, FPCST/QAT, Sr. QA and FP Compliance Officer and other trainer doctor in Barisal Division organizing special LARC and PM service delivery days. Task # 1.2.2h: All new staff joined EngenderHealth Bangladesh were provided orientation on USAID e-Learning course on “US Abortion and FP Requirements- 2013”, and afterwards they independentlyobtained the certificate.ADDITIONAL: During this quarter, a meeting was held with the Additional Secretary, Health Economics Unit (HEU), MOHFW and the Sr. Officials of the Quality Improvement Secretariat under HEU of MOHFW on 3 December 2015 to discuss about the integration of MH-II QA and FP Compliance activities with the quality improvement (QI) initiative of the QI Secretariat of the MOHFW. In the meeting, a consensus has been reached that MH-II Sr. QA and FP Compliance Officers will be part of the QI activities of the MOHFW. Each of the Sr. QA and FP Compliance Officers will be given a specific task to work for QI initiative of the MOHFW. These are organizing QI committee meetings at the district level, facilitating the meeting, developing minutes of the meeting and training of the members of the committee on QI process. Q2 Achievement ▪ In this quarter one Sr. QA & FP Compliance Officer joined on 3rd January 2016 to look after Dhaka division and she is located at EH B office and one Sr. QA & FP Compliance Officer assigned for Chittagong region resigned from the job in March 2016 due to ill health. Task # 1.2.2a & 1.2.2b: Sr. QA & FP Compliance officers prepared their monthly QA & FP Complinace visit plan and special day plan in consultation with local mangers. As a part of their planning and collaboration with RTMI, ‘Joint Action Plan Development Meeting’ between RTMI MSDCT and MH-II Sr. QA and FP
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Compliance Officers was held on 17 January 2016 followed by a Refresher Training on “Updates on Family Planning, Infection Prevention and Medical Monitoring” held on the 18 & 19 January 2016 involving all RTMI MSDCT members and Sr. QA and FP Compliance Officers. During the refresher training emphasis was given on Contraceptive updates, ICV and counseling, facilitative supervision, medical monitoring and coaching and Infection prevention. They were also oriented on “USAID statutory policies, regulations and FP compliance monitoring tools”. Task # 1.2.2c: The summary of the QA & FP Compliance visit is mentioned in the table below. The detailed findings are mentioned in Appendix-2. A circular from the CCSDP unit of the DGFP has been issued on the 23rd February 2016 regarding joing QA & FP compliance visits with the regional supervisors, FPCST /QA T of the DG FP. During this quarter 11 joint visits have been conducted.
# of facilities conducted first visit # of facilities conducted follow-up visit Grand Quarter MCWC UHC H&FWC NGO Clinic Total MCWC UHC H&FWC NGO Clinic Total Total Q2 10 45 0 3 58 0 14 0 0 14 72
Task # 1.2.2d: MH–II’s Senior QA and FP Compliance Officers, who provided assistance in organizing 326 special LARC and PM service days by conducting facility walk through, reviewing the findings of the site visits, sending job-aid and IEC/BCC materials, supporting DGFP doctors by providing on-site coaching, and using hired surgeons to perform the services. Below are the service statistics from the special FP days:
Performances Yearly Achievements Methods Q1 Q2 Q3 Q4 Projection (Q1 +Q2) Female Sterilizations 657 460 3,395 1,117 Male Sterilization (NSV) 508 488 6,580 996 Implant 4,300 4,792 16,830 9,092 IUD 178 161 1,291 339 Injectables 402 341 2, 487 743 Total LARCs,PMs&Injectables 6,045 6,242 30, 583 12,287
Task # 1.2.2e: Three batches of 18 days “Basic training on LARC and PM” for DGHS doctors were organized in this quarter. 15 doctors from Barisal, Chittagong and Sylhet divisions participated in the training. The trainings were organized by three regional training centers (Dhaka, Barisal and Chittagong) and conducted by the regional trainers. Sr. QA and FP Compliance Officer working in Khulna region was closely involved to providing hands on coaching to the doctors working for Barisal region. Task # 1.2.2g: As per discussion with DD(FP), a circular was circulated which allows the existing OT in the UHC to be used for providing LARC & PM services particularly IUD insertion and removal. In this qurter 31 OT in different districts have been handed over to the DGFP.
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Task # 1.2.2h, 2i & 2j: All new staff joining EngenderHealth Bangladesh and MH-II Sub-Awardees were oriented on the US Governments Laws and Policy Requirements on Family Planning and Abortion related issues. A total of 123 EngenderHealth Bangladesh core staff and all the program staff including MH-II Sub- Awardees, technical and program staff, completed the e-Learning course on ‘US Abortion and FP Requirement-2016’ and were given a certificate. The list of the participants has been sent to USAID, Dhaka. The electronic copies of all these certificates are kept on-line in the Compliance File at EngenderHealth Bangladesh. The hard copies of the certificates are kept in a file at the EHB office. ADDITIONAL: The Sr. QA and FP Compliance Officers conducted ICV sessions for the FP Managers and DGFP field workers and NGO workers from 12 Upazilas from 8 Districts and distributed stickers on ICV to the field workers. The total number FP Managers and field workers oriented on ICV was 838. Along with the ICV sessions they also received an updated on LARC and PM including PPFP. Q3 Achievement Q4 Achievement
Activity 1.2.3 PARTNER WITH BKMI TO USE ICT TO STRENGTHEN TECHNICAL UPDATE/DISSEMINATE FP INFORMATION AND HAVE OPPORTUNITY FOR SELF- ASSESSMENT. This activity in collaboration with BKMI is to disseminate information using ICT as a method of long-distance learning, as well as self-assessment of the participants participating in the course. Partners/Collaboration BKMI, DGFP, selected service sites, hired IT firm Person of contact Dr. Ahmed Ifthekhar Alam Implementation Time Quarterly Achievement of Inter-Team Task # Task Description Frame Benchmark/Deliverables Benchmark/Deliverables Collaboration
Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4
1.2.3 a Work with BKMI and IR 2 team to Team 2 will take X X Plan for ICT based have discussion with DGFP based on lead for this activity distance learning program ed their need develop and implement plan including e-learning for the ICT based distance learning courses developed
program and e-learning courses
Not yet start yet Not started yet Not
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1.2.3 b Develop the technical update course Team 2 X X Curriculum and MCQ tests
content, curriculum and multiple for distance learning
choice questions (MCQ) tests with course developed started
emphasis on ICV for distance learning started
Not yet yet Not yet Not and e-learning courses
1.2.3 c Take support of in-house IT staff and In house IT staff, X Website for the distance
BKMI to update the existing website BKMI learning course available
e-learning course
Not yet yet Not started yet Not started
1.2.3d Participate/facilitate sessions in the X Sessions facilitated during
long-distance technical update the long-distance training
session
Not yet yet Not started yet Not started
1.2.3e Work with ME&R Team and BKMI to ME&R team to X A plan developed
develop a plan of monitoring/follow- follow up distance up of use of the long distance/e- learning training
learning training courses
Not yet yet Not started yet Not started Quarter-wise Narrative Description of Activity Q1 Achievement: No tasks of this activity were carried out. Q2 Achievement: MH – II recently recruited a Senior Program Officer with ICT and communication background. After the recruitment two meetings held and an outline of working on the subject matter has been decided. Q3 Achievement Q4 Achievement
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PY3/Sub-IR2 Workplan (October 1, 2014 –September 30, 2015) Activity Gantt Chart Achievements through Quarter 2
IR 2: Demand for FP Services, especially LARC and PM Increased Sub-IR 2.1 Communication intervention promoting social norms for delaying, spacing, and limiting births implemented Activity 2.1.1 DISSEMINATION OF IEC/IPC MATERIALS AT DISTRICT HOSPITALS, MATERNITY AND CHILD WELFARE CENTERS (MCWCS), UHCS, H&FWCS, NGOS/PRIVATE SECTOR HEALTH FACILITIES Partners/Collaboration CCSDP, Logistics & Supply, and IEM units of DGFP, Hired agency for doing the initial distribution of IEC/BCC materials POC Bashir Ahmed/ Saleh Ahmed Shareef Tasks Task Description Inter-Team Implementation Time Benchmark/ Quarterly Achievement of # Collaboration Frame Deliverables Benchmark/ Deliverables Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 2.1.1.a MH – II, BKMI, and SIAPS SIAP, BKMI, and x x x x - DGFP’s distribution Conducted projects will work with the DGFP IEM and L&S unit of channel and system Two L&S, and IEM units on adjusting DGFP in place and meetings the DGFP’s logistic and supply operation to order with IEM unit systems to enable the ordering and and distribute distribution of SBCC materials to IEC/BCC public, and selected NGO/private materialsby the end facilities to be in place and of PY3 operating.
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Tasks Task Description Inter-Team Implementation Time Benchmark/ Quarterly Achievement of # Collaboration Frame Deliverables Benchmark/ Deliverables Q1 Q2 Q3 Q4 Q1 Q2 Q Q4 3 2.1.1.b Develop/adapt, print/reprint, At the time of x x At least 7 types of - Printed the IEC/BCC materials including PPFP developing new IEC/BCC materials following for public and selected NGO/private IEC/BCC materials are printed for materials health facilities of PY3 Districts seek feedback from distribution in Roman and FU Districts of PY1 and PY2. Team1 and 3 1183 sites of 18 Banner districts of PY3, - Leaflet and 2459 of PY1 - Tihart and PY2 districts - IUD Flow chart - Flip Chart - FP pocket book
2.1.1.c Distribute and orientation on Hired Agency x 592 615 614 Distributed and 633 Facilities IEC/BCC materials to public, oriented at least Distribut selected private and NGOs facilities one staff member Oriented ed from each facility 2,505 staffs, 643,165 on IEC/BCC 607,305 IEC/BCC materials in half of materials BCC the above sites to 2,459. materials (1821) from facilities. public, selected distributed TThe private and NGO facilities materials - Roman are: - Banner Roman - Leaflet Banner - Tihart - Leaflet - IUD Flow - Tihart chart - IUD Flip Flow chart
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Tasks Task Description Inter-Team Implementation Time Benchmark/ Quarterly Achievement of # Collaboration Frame Deliverables Benchmark/ Deliverables Q1 Q2 Q3 Q4 Q1 Q2 Q Q4 3 - Flip Chart - FP pocket book - FP FAQ booklet
2.1.1.d Distribute IEC/BCC materials to SIAP, BKMI, and x x x Distributed L&S public, selected private and NGOs IEM and L&S unit of IEC/BCC materials supply facilities using DGFP channels of DGFP in remaining half unit distribution (1821) of the above agreed to mentioned public, distribute selected private and BCC NGOs facilities. materials of MH-II MH – II, BKMI through and SIAPS are their working on supply developing the channel. methodology of the The orientation on distributi IEC/BCC materials on of to be done in the BCC future. materials in PY1 and PY2 will start in Q3 2.1.1.d Share IEC/BCC materials All the team members x IEC/BCC materials One meeting
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Tasks Task Description Inter-Team Implementation Time Benchmark/ Quarterly Achievement of # Collaboration Frame Deliverables Benchmark/ Deliverables Q1 Q2 Q3 Q4 Q1 Q2 Q Q4 3 distribution situation and develop will participate in the distribution and conducted follow-up plan. follow-up plan sharing follow-up plan is in One meeting. place meeting conducted with IEM unit to discuss on how to engage L&S and IEM units of DGFP for IEC/BCC materials distribution and orientation. 2.1.1.e Work with IEM and CCSDP units ME&R will provide x x x x Progress measuring Drafted One of DGFP on how to measure the TA to develop tools to methodology IEC/BCC measuring utilization of IEC/BCC materials measure the utilization developed and follow up tool distributed by MH-II. of IEC/BCC materials. implemented. checklist to developed see the use of IEC/BCC materials 2.1.1.f Conduct follow-up visits (use All team members of 915 915 910 902 All facilities of Follow up Follow structured checklists) to see the use MH-II will follow-up PY3, PY2, and by phone- up by of IEC/ BCC materials at facility distribution of BCC PY1 where 652 phone- level materials at time of IEC/BCC materials 1,414 their field visit and have been Physical over telephone distributed are follow followed-up ME&R will conduct up-215 through physical DQA visits as per visit and over
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Tasks Task Description Inter-Team Implementation Time Benchmark/ Quarterly Achievement of # Collaboration Frame Deliverables Benchmark/ Deliverables Q1 Q2 Q3 Q4 Q1 Q2 Q Q4 3 M&E Plan telephone. Quarter-wise Narrative Description of Activity Q1. Task # 2.1.1.c: MH-II distributes IEC/BCC materials to 1,183 public and selected private and public facilities in 18 districts. Task # 2.1.1.d: The IEM units of DGFP and L&S would distribute and orient facility staff on IEC/BCC materials in 9 districts. To engage L&S and IEM units of DGFP for IEC/BCC material distribution, MH-II along with BKMI and SIAPS has developed a draft concept note on how to engage L&S and IEM units of DGFP for IEC/BCC materials distribution and orientation. Task # 2.1.1.c: An agency has been hired by MH-II through a competitive bidding process to distribute IEC/BCC materials to public and selected NGO/private facilities. The agency will also orient facility staff on how to use SBCC materials to improve the quality of FP counselling and demand generation activity. This activity will commence in January 2016. Task # 2.1.1.b: MH-II has procured 7 types of IEC/BCC materials for distributions. These are Roman Banner (250), Leaflet (600,000), Tiahrt (700), IUD Flowchart (700), Flipchart (700), and FP pocket book (5000). Roman Banner Leaflet Tiahrt IUD Flowchart Flipchart FP Pocket book Total 250 600,000 700 700 700 5000 607,350
Task # 2.1.1.f: MH-II developed an IEC/BCC materials follow-up strategy to see the use and availability of the materials distributed by MH-II. The follow-up will be conducted through self-administered checklists, physical visits and phone calls. Three-part time staff has been hired telephone follow-up. So far these staff followed 652 facilities through phone calls. In addition, MH-II also engaged senior official of IEM unit of DGFP for IEC/BCC materials follow-up. In the reporting quarter To implement the follow-up activity smoothly through self-administered checklists and phone call, IEC unit of DGFP has issued a directive in this regards. Q2. Task # 2.1.1.a: In PY1 and PY2, MH-II distributed FP IEC/BCC materials to public and private facilities through a hired agency. MH-II planned to distribute the materials in 9 districts through the Logistic and supply unit of the DGFP to mainstream the IEC/BCC material distribution and in the rest of PY3 districts (9), material will be distrbuted through the hired agency. To distribution IEC/BCC meterails through L&S unit of DGFP and to include a line item in eLMIS, MH-II along with BKMI and SIAP developed a concept note and shared it with IEM unit with aim that IEM unit would facilitate the process to include a line item in eLMIS and distribution IEC/BCC material through L&S unit of DGFP. The plan is that distribution of IEC/BCC material by L&S unit will start from the first month of Q3. NationalTechnical Committee approved Implant as a PPFP method, and this information will be included in the existing PPFP IEC/BCC materails. Additionally, some new job aids and IEC/BCC are required for counsel and creating demand for FFP services. MH-II has revised the existing materials and have developed new PPFP materials and shared with USAID. Based on the feedback, MH-II will revise job-aid and BCC materails for IEM Technical Committee’s approval. MH-IIis expecting that Job-aid and BCC materials by approved by the first week of Q3.
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Tasks Task Description Inter-Team Implementation Time Benchmark/ Quarterly Achievement of # Collaboration Frame Deliverables Benchmark/ Deliverables Q1 Q2 Q3 Q4 Q1 Q2 Q Q4 3 Task # 2.1.1. c: Through a hired agency, MH-II distributed 7 types of IEC/BCC materials, Roman Banner (634), Tiahrt Chart (633), Flipchart (633) Leaflets (633,000), Family Planning (FP) Pocket Booklet (3,817), FP FAQ Booklet (3,815) IUD and Insertion Flowchart (633) to 634 publics, private and NGOs facilities in Barisal, Bhola, Brahmanbaria, Feni, Khagrachari, Rangamati, Bandarban, Rajbaria and Faridpur districts. In addition, the hired agency also provided orientation to 2,705 staff of these facilities on how to use IEC/BCC materials during FP counseling and IPC.
Roman Banner Tiahrt Chart Flipchart Leaflets FP Pocket book FP FAQ booklet IUD Flowchart Total 634 633 633 633,000 3,817 3,815 633 643,165
Task # 2.1.1.f: In PY1 and PY2, MH-II had distributed IEC/BCC materials to 2,459 public, selected private and NGO facilities. To see the use and availability of the IEC/BCC materials, MH-II developed IEC/BCC material follow-up checklists and followed up 1,629 facilities t by telephone (1,414) and physical visited 215 facilities). The phone follow-up findings showed that 99% facilities received the IEC/BCC materials distributed by MH-II and more than 90% informed that they are using the materials during FP counseling and IPC sessions. MH-II also engaged IEM unit to follow-up facilities to see the use of IEC/BCC materials. They sent the IEC/BCC materials follow-up checklist developed by MH-II to 309 UFFO in Jan 2016. To date only 10% (32) of the UFPO sent back the filled in checklist. Q3 Q4 Activities 2.1.2 DEMAND CREATION AND MARKETING ACTIVITIES IN SELECTED FOR PROFIT PRIVATE HEALTH FACILITIES Partners/ Collaboration Private health facilities, DGFP and DGHS, NGO and UPHCSDP, SMC, Meridian Group International POC Saleh Ahmed Shareef/Shahid Hossain 2.1.2.a Continue providing training and 400 400 400 400 At least 1,600 Total FP Total FP material support to Reproductive Team-1 will provide clients received FP, Clients-939 Clients- Health Service Promotion Officers clinical training to especially referred referred (RHSPO) from 11 private sector build the capacity of injectable, and (Inj, LARC 1,194 (Inj facilities in Dhaka. service providers of LARC services and PM 253 LARC clients) and PM- selected private health using SMC facilities. 210 supplies clients)
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Tasks Task Description Inter-Team Implementation Time Benchmark/ Quarterly Achievement of # Collaboration Frame Deliverables Benchmark/ Deliverables Q1 Q2 Q3 Q4 Q1 Q2 Q Q4 3 2.1.2.b Select, negotiate, and sign MoU Team-1 will provide 10 5 New 15 facilities in 10 10 - - with new private health facilities to clinical training to Dhaka agreed to scale-up RHSPO interventions. build the capacity of implement RHSPO newly selected private intervention health facilities’ service providers. ME&R will provide support to develop 15 15 30 persons, trained - 12 M&E plan for newly on LARC/PM (1-2 persons from each selected private health facilities. facility).
At least 2400 clients received FP services, especially Injectable, and LARC services using SMC supplies 2.1.2 c Increase awareness among people Team-1 will organize - 5 FP living around the clinics where FP special days as per 75 FP special days special services day will be their plan. 10 20 20 25 service days (clients- organized (through distributing organized and 68) leaflets, promotion banners/posters implemented and conducting IPC) 2.1.2 d Collect information, compile ME&R 1 Outline best N/A relevant data and develop outline of practices Meridian will support lessons learned for write-up on best methodologies and analysis and practices from for-profit health write up developed documentation. facilities through the activities of the RHSPOs. Dissemination on best
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Tasks Task Description Inter-Team Implementation Time Benchmark/ Quarterly Achievement of # Collaboration Frame Deliverables Benchmark/ Deliverables Q1 Q2 Q3 Q4 Q1 Q2 Q Q4 3 practices will be done in next year. Quarter-wise Narrative Description of Activity Q1. Task # 2.1.2.a & 2.1.2.b: MH-II will continue providing support to 10 private health facilities of PY2 and will work with another 20 new facilities in PY3. In the reporting quarter, private health facilities selected in PY 2 has disseminated information on FP issues to 1,233 (male-191 and female-1,042) clients and of them, 469 clients chose to adopt an FP method. (Pill-123, Condom-159, ECP-35 injectable-79, implant-18, IUD-16 and Tubectomy-39 (PPIUD-07 and PPBTL-37). Pill Condom ECP Injection Implant IUD Tubectomy
123 159 35 79 18 16 39 469 In Q1 of PY3, 28 private health facilities were approached to work with MH-II to create demand for FP information and services among their clients. Of them, 12 facilities have agreed and signed a MoU with MH-II. Eight private facilities principally agreed to work with us and MOUs will be signed in January 2016.
Q2: Task # 2.1.2.a: MH-II Continued following up the activities of the RHSPO interventions. PY 2 10 private facilities provided FP services to 1194 clients (Injectable-119, Implant-21, IUD-25, Tubectomy 45 (44 cases were post-partum Tubectomy) Condom 506, Pill 401, ECP 77. Pill Condom ECP Injection Implant IUD Tubectomy Total 401 506 77 119 21 25 45 1194 Task # 2.1.3.f:c In addition, Five FP special days were organized in the private health facilities and 68 clients received FP services (Injection-30, IUD-03, Implant- 07, NSV-28). Injection Implant IUD NSV Total 30 07 03 28 68 Task # 2.1.2.b: Till Q2, 15 facilities signed a Letter of Agreement to work with MH-II. MH-II, provided training to 12 RHSPOs from 6 new private facilities. Rest of the facilities recruited their RHSPO in March 2016 and their training will start from 2nd week of April 2016 Along with orientation on how to use these materails, MH-II distributed IEC/BCC materials to 6 new private facilities and IEC/BCC materials will be distributed to the rest of the facilities after the training of the RHSPO. MH-II conducted 16 monitoring visits for PY2 private facilities to provide support to enhance the skills of RHSPOs to increase demand for LARC and PM services. Q3
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Q4 Activity 2.1.3 WORKPLACE INTERVENTIONS ON FAMILY PLANNING IN THE SELECTED GARMENT FACTORIES. Partners/ Collaboration BGMEA, garments factories, private health facilities, UPHSDP, NHSDP, DGFP and DGHS, Meridian Group International POC Saleh Ahmed Shareef /Shahid Hossain Tasks Task Description Inter-Team Implementation Time Benchmark/ Quarterly Achievement of # Collaboration Frame Deliverables Benchmark/ Deliverables Q1 Q2 Q3 Q4 Q1 Q2 Q Q4 3
2.1.3.a Continue FP information ME&R will conduct 4,000 4,00 4,500 12,500 garments Out of Out of dissemination to garment workers DQA as per M&E 0 workers from 15 5,348 3,006 in group sessions by Workplace plan factories of PY1 and 2,035 Referred Coordinator (WPC) and Peer PY2 received workers clients 186 Educators. information on FP received received and sources of FP FP inj, LARC services. Ensured methods and PM supply of pills and including methods condoms at the LARC
facilities & factories. and PM (72 LARCs PM).
Tasks Task Description Inter-Team Implementation Time Benchmark/ Quarterly Achievement of # Collaboration Frame Deliverables Benchmark/ Deliverables Q1 Q2 Q3 Q4 Q1 Q2 Q Q4 3 2.1.3.b Collect information, compile Meridian will support x Outline of best This task Developed relevant data and develop outline of analysis and practices will start a draft lessons learned for write-up on best documentation. methodologies and in Q2 project practices from workplace write up developed brief on interventions. Dissemination best workplace
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practices will be done in next year. interventio n and shared with Meridian 2.1.3.c Work with BGMEA to select new Meridian will support 20 20 new garment 30 RMG - - - garment factories to implement scale-up strategy. factories agreed to selected workplace interventions and implement workplace increase private investment. interventions on FP issues
2.1.3.d Skill building of newly selected 20 x Tanrained 20 mid–level 42 mid- - - - factories to create awareness on FP and management staff and level issues among their workers. 100 100 senior garments Manage workers of newly ment selected factories staff and and 116 sennior workers were trained
2.1.3.e Provide on the job training to 60 30 10 x The first two group 60 30 Workplace Coordinators (WPC) sessions in each and Peer Educatosto conduct group selected factories are sessions on FP issues. organized jointly by MH-II staff and WPC.
Tasks Task Description Inter-Team Implementation Time Benchmark/ Quarterly Achievement of # Collaboration Frame Deliverables Benchmark/ Deliverables Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4
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Tasks Task Description Inter-Team Implementation Time Benchmark/ Quarterly Achievement of # Collaboration Frame Deliverables Benchmark/ Deliverables Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 2.1.3.f Facilitate the process of organizing Team-1 will help 15 10 25 25 1,125 FP client 10 26 FP additional special FP services day. organize FP special received services service services days from 75 FP service days were days organized in organized. garment premises for A total of garments workers. 2,764 clients received FP services and of which 186 were Inj, LARC and PM clients
2.1.3.g Provide support to garment Team-1 will build 31 List of referral - 31 factories to conduct facility capacity of referral facilities are prepared mapping exercise to establish facilities if required. by each factory referral linkages for FP services. 2.1.3.h Provide orientation to selected ME&R will act as 5 10 Selected BGMEA 5 10 BGMEA officials on the follow up resource person in officials are checklists to the monitor progress orientation session. conducting follow-up of workplace interventions visits and submitting report to MH-II and BGMEA 2.1.3.i Provide need based support to 50 Selected 25 factorie’ selected factories to provide LARC clinics who want to information and services from their provide injectable and own clinics (not from BGMEA LARC services. Clinic).
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Tasks Task Description Inter-Team Implementation Time Benchmark/ Quarterly Achievement of # Collaboration Frame Deliverables Benchmark/ Deliverables Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 2.1.3.j Develop a system to make FP Team-3 and 1 will x A system of A tri- commodities available in the help establish linkage indentifying and pary selected health centers of garments between BGMEA collecting FP MoU has factories. health facilities and commodities by the been clinics in selected factory clinics from signed garments factories the BGMEA Health among who are willing to Centers was DGFP, provide FP services. established. FP BGMEA commodities (pill, and condom and EHB. injectable) are Under available in 25 the garment clinics. MOU, factories can get injectbale , pill and condom from DGFP outlets
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Tasks Task Description Inter-Team Implementation Time Benchmark/ Quarterly Achievement of # Collaboration Frame Deliverables Benchmark/ Deliverables Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 2.1.3.k Develop and implement Meridian will support 10 Innovative Develope communication plan for factory- development of counselling d plan to based campaign (SMS, leaflets, and communication approaches/strategies create job aids to counsel injectable and strategy. and tools developed demand other short acting contraceptive and implemented to among Team-1 will guide on clients to LARC methods). increase the use of the clinical issues LARC methods in the garment developing the plan. workplace. workers through SMS. This
intervesti Action plan developed plan Action ons will start from Q3
Quarter-wise Narrative Description of Activity Q1. Task # 2.1.3.a: In partnership with BGMEA, MH-II has been rolling out workplace interventions on FP issues in 14 garments factories from PY2. In the reporting quarter, 5,308 garments workers have been educated on FP issues and 2,035 workers received FP (need service breakdown from Bashir) methods including LARC and PM (72 LARCs PM). Task # 2.1.3.f: In order to increase the access of garments workers to LARC services, 10 special FP service days were conducted in the garment factory premises. To sustain FP program, MH-II will build the capacity of the clinical services providers from these factories and build the capacity of the Workplace Coordinator (who will educate their workers on FP issues) and how to organize special days in their garments factory using their own resources. Task # 2.1.3.c/ 2.1.3.d: To scale-up workplace interventions, MH-II along with BGMEA has selected 30 garments factories in PY3 and trained their mid-level management staff (32) and senior garment workers (116) who will work as Workplace Coordinator and Peer Educators respectively to implement workplace interventions in their garment factory. Workplace Coordinator and Peer Educators will begin educating their staff on FP issues from Q2. Q2. MH-II Provided support to BGMEA to get affiliation of their 05 Clinic in Gazipur#2, Narayangonj#1, Hemayetpur#1 and Ashulia#1, Narayangonj has already got Govt. affiliation and the other 4 is currently in the process. Task # 2.1.3.a: The workplace intervention has been ongoing in 45 readymade garments factories. To create awareness on FP methods, IEC and BCC materials have been disseminated to 30,000 garments workers which will increase their knowledge and eliminate the myths and misconceptions
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regarding FP. Moreover, a number of sessions have been conducted to ensure effective communication on Family planning in the workplaces. MH-II continued to provide support to factories as and when required. To increase demand for LARC and PM services, Peer Educators and Workplace Coordinators conducted 554 batches of FP session at workplace for 13,937 (Female: 9,478 and Male: 4459). In addition to group session, Workplace Coordinators conducted 85 video shows at workplace on FP issues. A total of 4,397 attended the video show. MH-II, BGMEA and DGFP signed a tri- party agreement through which the garment factories will be able to procure free FP commodities from DGFP. MH-II has also taken an initiative to build the capacity of the selected factories so that garments workers can get LARC services from their factory’s clinic. Task # 2.1.3.f: MH-II provided support to organize 26 Special FP Service Day at garments factory premises and referred 3006 workers. From the special day services, 2,764 workers chose to adopt an FP method (Injection-167, Implant-11, IUD-04 and Tubectomy-04, condom-1,042 and Pill- 1,536) Condom Pill Injection Implant IUD Tubectomy Total 1042 1536 167 11 04 04 2,764
Task # 2.1.3.g: Provided support to 31 garment factories to conduct facility mapping exercise to establish referral linkages for FP services. The garment workers are referred to Smiling Sun clinic, Marie Stopes, UPHCSDP-II, Govt. Hospital, BRAC and other local FP service providing centers.
Q3 Q4 Sub-IR: 2.2 Accurate knowledge of FP, especially LARCs and PMs, increased among community leaders, families, and clients SUPPORT TO THE DGFP, DGHS, BCC WORKING GROUP, CCSDP AND UNFPA UNIT OF THE DGFP TO Activity 2.2.1 INCREASE USE OF LARC AND PM SERVICES Partners/Collaboration CCSD, DGFP, DGHS, UNFPA, BCC Working Group POC Bashir Ahmed/ Waliul Islam/Shahid Hossain Tasks Task Description Inter-Team Implementation Time Benchmark/ Quarterly Achievement of # Collaboration Frame Deliverables Benchmark/ Deliverables Q1 Q2 Q3 Q4 Q1 Q2 Q Q4 3
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2.2.1.a Provide support to CCSDP and 6 6 x x Provided TA on 35 IEM unit of DGFP to build the technical in-depth Orientation Orienta skills of satisfied IUD and NSV discussion related to Session tion users to generate new IUD and LARC and PM to conducted Session NSV clients. DGFP in 12 with conduc workshops. TA also satisfied ted provided to develop a users with tracking system to satisfie monitor the d users performance of the oriented satisfied NSV and IUD clients. Tasks Task Description Inter-Team Implementation Time Benchmark/ Quarterly Achievement of # Collaboration Frame Deliverables Benchmark/ Deliverables Q1 Q2 Q3 Q4 Q1 Q2 Q Q4 3 2.2.1.b Provide training and supply BCC Team-3 will provide x x x x 28 DGFP staff and Training Traini materials to CCSDP unit of DGFP capacity building 750 Volunteers delayed ng to scale up YMC intervention in 14 schedules for the received training due late to delaye Upazillas (2 Upazillas of one volunteers. Required IEC/BCC recruitme d due District from each of the 7 materials provided to nt of late to Divisions) CCSDP in 14 volunteers recruit Upazillas where ment YMC interventions of will be implemented. volunt 28 DGFP staff and eers 750 Volunteers received training 750 volunteer will reach at least 750,000 YMCs. 2.2.1.c Coordinate with UNFPA at the x 1 x 1 One coordination 3meet 2 district-level to have synergy meeting every 6 ings meetin between UNFPA’s district level months attended for gs
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(five districts) FP campaign and UNFPA FP campaign MH-II activities. in each of the five districts (10 meetings). 2.2.1.d Participate in BCC Working Group x x x x Participated in BCC 1 meeting and sub group meetings. Working Group and sub group meetings (estimated 6 meetings).
Tasks Task Description Inter-Team Implementation Time Benchmark/ Quarterly Achievement of # Collaboration Frame Deliverables Benchmark/ Deliverables Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 2.2.1.e Disseminate MH-II achievements, All teams will write- x x x x Quick updates Published Publis lessons learned through quick up achievements and published in every Quick hed updates, social media, and provide key lessons learned. quarterand one article Updates Quick write-ups in the DGFP’s newsletter. on MH-II (news Update achievement letter) s (news published in DGFP letter)
newsletter.
2.2.1.f Participate in national and Members from the At least two events x ICAA nt
international days such as Safe each team will observed P- 1 eve 1 Motherhood Day; World Population participate. event 1 2015 Day; National FP/MCH service in delivery days. Dhak a Quarter-wise Narrative Description of Activity
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Q1. Task # 2.2.1.a: DGFP is providing orientations to the satisfied IUD acceptors and NSV clients to further generate new FP clients especially new IUD and NSV clients. MH-II is providing technical support to the CCSDP unit of DGFP to conduct these orientations. In the reporting period, a total of 35 sessions have been conducted and 675 IUD acceptors and 175 NSV clients have been orientated in Magura, Feni, Shariatpur, Bandarban, Khagrachari, Kishoreganj, Rajshahi, Nilphamari and Jhalakathi districts. In most of the places where NSV satisfied acceptors workshop has been conducted we have started seeing a positive increase in the number of NSV acceptors. The data comes from the 3 months pre & post NSV performanace analysis where satisfied NSV intervention was conducted betwee, January and November 2015 Task # 2.2.1.b: In order to scale up the YMC intervention the CCSDP unit of DGFP had planned to recruit 750 volunteers but they were not able to recruit these volunteers yet. Once they recruit, MH-II will provide necessary support to implement this initiative. Task # 2.2.1.c: In the reporting period, MH-II has attended three meetings on the National FP campaign progress review meeting. This year UNFPA is implementing a National FP campaign in five (Narsingdi, Barisal, Jhenaidah, Sirajganj and Rangpur) districts where MH-II will be working in two districts (Barisal and Narsingdi) in PY3. Task # 2.2.1.d: During this period MH-II has attended a workshop on ICT intervention in SBCC organized BCC working groups held on 28 October 2015. The objectives of this workshop were to use ICT in designing SBCC materials and attended 18th BCC working group meeting held on 15 December 2015. In this working group meeting the special focus was given on PPFP and greater collaboration with other stakeholders to avoid duplication. Task #2.2.1e: In order to disseminate MH-II achievements and lesson learned through quick updates and social media, 6 events information have been posted into Facebook and two success stories have been posted into the e-bulletins published by IEM unit of DGFP. Q2. Task # 2.2.1.a: To create demand for FP services, especially IUD and NSV methods, CCSDP with the support from MH-II built the capcity of 79 IUD clients and 172 NSV clients through 7 batches of orientation seesion in Ragamati and Moulvibazar districts. The satistied IUD and NSV users worked with the FWAs to increase demand and dismiss myths and misconceptions about IUD and NSV methods. Analysis of 69 Upazillas’ performance data shows that the uptake of NSV servcies increased by 16% due to this intervensions Task # 2.2.1.b: For scaling up of YMC intervention, CCSDP unit of the DGFP has issued a circular on 28 February 2016 to recruit 1195 volunteers for 14 upazillas in 7 districts (1. Jamalpur: Islampur and Dewanganj; 2. Rangamati: Rajasthali and Baghaichari; 3. Cox’s Bazar: Ukhia, Ramu; 4. Noakhali: Begumganj and Hatia; 5. Sunamganj: Dharmapasha and Jagganthpur; 6. Sirajganj: Shahajadpur and Kazipur; 7. Barguna: Amtoli and Bamna). CCSDP has planned to complete the recruitment process of YMC volunteers by March 2016 and then MH-II will provide TA to build the capacity of the YMC volunteers and will ditrbute IEC/BCC materials for demand creation. Task #2.2.1.c: In order to ensure ffective coordination, UNFPA and MH-II meet periodically and share information. In the reporting quarter, MH-II attended two meetings organized by UNFPA. To strengthen demand generation efforts, MH-II distributed FP IEC/BCC materials in UNFPA national FP campaign areas. In this reporting period MH-II has attended an International Congress on AIDS in Asia and the Pasific (ICAAP-2015) in Dhaka from 12 to 14 March 2016. In this conference MH-II set up a stall and distributed different IEC/BCC materials among the conference participants. Q3. Q4. Sub-IR 2.3 Client Identification and referral increase through community facility links
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Activity 2.3.1 STRENGTHEN COMMUNITY-FACILITY LINKAGES THROUGH ON BCC AND ADVOCACY WORK TO INCREASE REFERRALS for LARC AND PM ServicesTHROUGH SHUSHILAN IN KHULNA – A DISTRICT BASED NGO. THIS SUB-GRANT will END IN PY3 Partners/Collaboration GO and NGO FP service delivery facilities, Meridian Group International POC Waliul Islam/Bashir Ahmed Tasks Task Description Inter-Team Implementation Time Benchmark/ Quarterly Achievement of # Collaboration Frame Deliverables Benchmark/ Deliverables Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 2.3.1.a Review performance and provide ME&R will conduct 1,850 1,850 1,850 1,850 At least 90 % of 7400 referred clients received supportive supervision to Shushilan DQA as per M&E Out of Out of injectable or LARC and project staffs to achieve objectives plan 2.057 2.474 PM services from of the project. reoffered reoffer nearby 13 public clients, ed facilities 1,817 clinets, received 1,898 injection, receive LARC d and PM injecti on, LARC and PM metho d
Tasks Task Description Inter-Team Implementation Time Benchmark/ Quarterly Achievement of # Collaboration Frame Deliverables Benchmark/ Deliverables Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 2.3.1.b Collect information, compile All senior team Outline of best We relevant data and develop outline of members will review practices have lessons learned for write-up on best best practices and methodologies and started practices. Dissemination best provide comments write up developed devlopin practices will be done in next year. g a project
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brief on comunit y enagage ment interven stion of MH-I project 2.3.1.c Provide guidance for organizing FP Team-1 will help 400 clients received special days through building the organize FP special LARC and PM capacity of the NGOs so that they service days (Implant, IUD can do the activity in future by 10 5 5 5 Tubectomy, and 12 13 Special themselves. NSV) services during Special Days 25 special FP services Days days organized in 130 169 areas where LARC LARC Shushilan is working. and and PM PM methods method received s receive d
2.3.1.d Negotiate and provide support to Integrated LARC and Shushilan to integrate LARC and 1 1 1 x PM in their 3 other Integrat Integrate PM related information in their programs. The ed FP d FP other 3 programs where applicable outcome of issues issues in and develop a sustainability plan integration would be in NIRAPA measured by the SHADI D prog number of referrals KHAR made. A prog sustainability plan developed.
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Quarter-wise Narrative Description of Activity Q1. Task # 2.3.1.a: A total of 2057 prospective FP clients were referred and 1,817 of them chose to take method. (Injectables-885, Implants-646, IUD-165, Tubectomy-91, NSV-30).
Injection Implant IUD Tubectomy NSV Total 885 646 165 91 30 1817
Out of 1,817, clients 130 clients received FP services from 12 special days organized by Sushilan with support from EHB (Implant-79, IUD-28, Tubectomy-20 of whhc17 were PPFP and NSV-03). Task # 2.3.1.b: 130 clients received FP services from 12 special days organized by Shushilan with support from EHB (Implant-79, IUD-28, Tubectomy-20 [PPFP- 17] and NSV-03). To build the capacity of Shushilan to organize FP special day with minimal support from MH-II, FP special day organization guidelines are being developed. The guidelines will be finalized and orientation on the guidelines will be completed by January 2016.
Injection Implant IUD Tubectomy NSV Total 885 79 28 20 03 1015
As part of integration, Shushilan have been using their community based volunteers working in one Upazila of Satkhira district. In the reporting quarter, 20 volunteer generated 385 FP clients (Tubectomy-13, NSV-07, IUD-35, Implant-70 and Injectable-260).
Injection Implant IUD Tubectomy NSV Total 260 70 35 13 07 385
Q2. Task # 2.3.1.a: A total 1,898 clients received services against 2474 referred cases (Injectables-875, Implants-701, IUD-218, Tubectomy-73 and NSV-31); of the total clients 169 received FP services from 13 special FP days which as orgnaised due to the advocacy effort of MH-II and Shushilan (Implants-135, IUD-02, Tub-28
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and NSV-04). Review of reports shows that the uptake of IUD has increased from Q1 (165) to Q1 (218). Injection Implant IUD Tubectomy NSV Total 875 701 218 73 31 1898
Task # 2.3.1.c: 13 special FP days which as orgnaised due to the advocacy effort of MH-II and Shushilan (Implants-135, IUD-02, Tub-28 and NSV-04) Implant IUD Tubectomy NSV Total 135 02 28 04 169 Task # 2.3.1.d: As per plan, Shushilan has organized 21 Pot Songs and Drama shows in diferrence places in their workg areas to increase demand for LARC and PM services, in each show approximately 300 people from the community attended. Shushila has now integrated FP issues in their Shadhikar Program. Q3
Q4 Activity 2.3.2 STRENGTHEN CLIENT MOBILIZATION AND REFERRALS FOR LARC AND PM Services USING BRAC FIELD FUNCTIONARIES. THIS SUB-GRANT WOULD END IN PY3 Partners/Collaboration DGFP, DGHS, NGOs POC Sushanto Shekhar Roy/ Shahid Hossain Tasks Task Description Inter-Team Implementation Time Benchmark/ Quarterly Achievement of # Collaboration Frame Deliverables Benchmark/ Deliverables Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 2.3.2.a Review performance and provide ME&R will conduct 27,500 27,50 27,50 27,50 At least 50% referred 10,358 16,531 0 0 0 Referal supportive supervision to BRAC DQA as per M&E clients (110,000 Referals field staffs to achieve objectives of plan clients) received s
the project. injectables, and 9,990 LARC Accept 15,759 ors Acceptor s 2.3.2.b Collect information, compile All senior team x x Outline of best - - relevant data and develop outline of members will review practices
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lessons learned for write-up on best the write up on the methodologies and practices. Dissemination best Best Practices and will write up developed practices will be done in next year. provide their comments
Tasks Task Description Inter-Team Implementation Time Benchmark/ Quarterly Achievement of # Collaboration Frame Deliverables Benchmark/ Deliverables Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 2.3.2.c Provide guidance for organizing FP Team-1 will help 12 15 15 8 50 additional special 11 FP 18 FP special days by building the organizing FP special FP services days days days capacity of the NGOs so that they services days organized and 500 can organize activity in future by clients received themselves services Clients- Clients- 299 491
Guideline on how to organize FP special days and used by 5 NGOs Quarter-wise Narrative Description of Activity Q1 Q1. Task # 2.3.1.a: A total of 2057 prospective FP clinets were referred and 1,817 of them chose to take method. (Injectables-885, Implants-646, IUD-165, Tubectomy-91, NSV-30).
Injection Implant IUD Tubectomy NSV Total 885 646 165 90 30 1817
Task # 2.3.2.c: Out of 1,817, clients 130 clients received FP services from 12 special days organized by Shushilan with support from EHB (Implant-79, IUD-28, Tubectomy-20 [PPFP-17] and NSV-03). To build the capacity of Shushilan to organize FP special day with minimal support from MH-II, FP special day organization guidelines are being developed. The guidelines will be finalized and orientation on the guidelines will be completed by January 2016.
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Implant Injection IUD NSV Tubectomy Total 79293 885 28 03 20 1,015
As part of integration, Shushilan have been using their community based volunteers working in one Upazila of Satkhira district. In the reporting quarter, 20 volunteer generated 385 FP clients (Tubectomy-13, NSV-07, IUD-35, Implant-70 and Injectable-260). In this reporting quarter, Shuhsilan integrated FP issues in their Shadhikar program which is a self help group of Shushilan and this mostly work with rights related issues.
Injection Implant IUD tubectomy NSV Total 260 70 35 13 07 402
Q2. Task # 2.3.1.a: A total 1,898 clients received services against 2,474 referred cases (Injectables-875, Implants-701, IUD-218, Tubectomy-73 and NSV-31); of the total clients 169 received FP services from 13 special FP days which as orgnaised due to the advocacy effort of MH-II and Shushilan (Implants-135, IUD-02, Tub-28 and NSV-04). Review of reports shows that the uptake of IUD has increased from Q1 (165) to Q1 (218). Injection Implant IUD Tubectomy NSV Total
875 701 218 73 31 1.898
Task # 2.3.1.c: 13 special FP days which as orgnaised due to the advocacy effort of MH-II and Shushilan (Implants-135, IUD-02, Tub-28 and NSV-04) Implant IUD Tubectomy NSV Total 135 02 28 04 169
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Task # 2.3.1.d: As per plan, Shushilan has organized 21 Pot Songs and Drama shows in diferrence places in their workg areas to increase demand for LARC and PM services, in each show approximately 300 people from the community attended. Shushilan proposed to integrate FP issues in one of their program called NIRAPOD. The aim of this program is to reduce the unwanted pregnancy Q3 Q4 Activity 2.3.3 ENGAGE PRIVATE HEALTH FACILITIES AND GARMENT FACTORIES IN CHITTAGONG TO INCREASE The USE OF INJECTABLE, LARC AND PM SERVICES THROUGH YPSA Partners/Collaboration NGOs (especially USAID implementing partners), private and GOB FP services delivery facilities, BGMEA and Bangladesh Export Processing Zone Authority (BEPZA) POC SushantoShekhar Roy/Shahid Hossain Tasks Task Description Inter-Team Implementation Time Benchmark/ Quarterly Achievement of # Collaboration Frame Deliverables Benchmark/ Deliverables Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 2.3.3.a Review performance and provide ME&R will conduct 300 300 300 300 At 85% referred 1,994 1,913 supportive supervision to YPSA DQA as per M&E client (1200) clients Referals Referral field staffs to achieve objectives of plan referred for LARC s the project. and PM services. 1,635
Acceptor s 1,419 Accepto rs 2.3.3.b Collect information, compile Meridian will support x x Outline of best - - relevant data and develop outline of analysis and practices lessons learned for write-up on best documentation. methodologies and practices. Dissemination best write up developed. practices will be done in next year.
Tasks Task Description Inter-Team Implementation Time Benchmark/ Quarterly Achievement of # Collaboration Frame Deliverables Benchmark/ Deliverables
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Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 2.3.3.c Provide support to YPSA to expand Meridian will support x x x x Within BEPZA Prelimi Workin their program to other BGMEA and scale-up strategy. (Chittagong)/ nary g with Bangladesg Exporting Process Zone Chittagong Export steps CEPZA (BEPZA) factories. Processing Zone initiated where Authority (CEPZA to work there is )188 factories will with a have access to FP CEPZA hospital information and located services. 2.3.3.d Provide support to YPSA to make Team-3 will provide x x Commodities (oral Work in Work in FP commodities available from support to get clinics pill, condom, progress progress DGFP in Chittagong BGMEA and affiliated with DGFP injectable and IUD of CEPZA health facilities on a DGFP source) routine basis. available in the CEPZA health facilities. The commodity availability system from DGFP established as soon as the CEPZA and BGMEA Chittagong facilities are affiliated with DGFP
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Tasks Task Description Inter-Team Implementation Time Benchmark/ Quarterly Achievement of # Collaboration Frame Deliverables Benchmark/ Deliverables Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 2.3.3.e Provide guidance for organizing FP Team-1 will help 5 15 15 10 675 clients received 39 26 FP special days through building the organizing FP special LARCs from 45 Special special capacity of the NGOs so that they services days special FP service Day Days can do the activity in future by days organized in the themselves workplace. 630 566 clients Clients receive received d Inj, inj, LARC LARC & & PM PM services services (Injecta (Injectabl bles 86, es 57, Implant Implant 44) 47, IUD 1)
Quarter-wise Narrative Description of Activity Q1. Task # 2.3.3a: In the reporting quarter, 1,994 clients were referred, of which 1,635 chose to adopt an FP servics (Injection-940, Implant-576, IUD-63, Tubectomy-56). Injection Implant IUD Tubectomy 940 576 63 56
2.3.3.c Approximately 88 factories are in Chittagong Export Promotion Zone and workers these factories receive Health services from CEPZ hospital. Through YPSA, MH-II introduced FP services in this hospital. With MH-II advocacy effort, DDFP deployed a Family Welfare Visitor who provides LARC services twice a week from this hospital. In addition, YPSA also deployed staff who create demand among in patients and their companions. MH-II decorated this hospital with FP information and provided IEC/BCC materials for counselling clients on FP methods and demand generation Task # 2.3.3e: YPSA organized and conducted 39 FP special days with the technical support from the DGFP/MSC/MAMATA at Community and workplace under Chittagong city. Out of 1,635 FP clients, 630 clients received FP services from 39 FP special services day. Of the total FP special services day, 11 were organized in
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garments factories and the other 28 were in or near slums areas where YPSA educates slum dweller on FP issues. To build the capacity of YPSA to organize FP special day with minimal external support from MH-II, guidelines on FP special day organization is being developed and will finalized in January 2016. Then YPSA will be given orientation on the guidelines In this quarter YPSA has been providing support BEPZA to expand the workplace intervention at CEPZ Chittagong areas. To enhance the capacity of referral facilities to provide quality LARC and PM services, MH-II trained 8 female doctors from (7 from MOMOTA and 1 from South Point Hospital). Q2. Task # 2.3.3a: In this reporting quarter Jan, 16-Feb-16, 1913 clients were referred, of which 1419 received FP services (Injection-984, Implant-347, IUD-54, and Tubectomy-32 NSV-2). Injection Implant IUD Tubectomy NSV 984 347 54 32 02 Task # 2.3.3e: YPSA organized and conducted 28 FP special days up to March’16 with the technical support from DGFP/MSC/MAMATA at Community and workplace under Chittagong city. Out of 1419 FP clients, 566 clients received FP services from 36 FP special services day. Number of the total FP special services day, 10 were organized in garments factories and the other 26 were in or near slums areas where YPSA educates slum dweller on FP issues. MH-II provides orientation to the YPSA program staff about FP special day guideline and distributes the materials and handout to the participants. In this quarter YPSA conducted 130 group education sessions for the Garments workers. Total participants 3,058 (Male-505 female-2,553) and refered 159 FP clients.134 clients received FP services (Injectable -87, Implant-47). In this quarter YPSA extended their number of volunteers and orient the new 20 volunteers who are working in the different slums in Chittagong city. All 40 volunteers are involved in slums intervention in Chittagong city area. Q3 Q4 ENGAGE DIFFERENT COMMUNITY GROUP/VOLUNTEERs ON DEVELOPING LARC & PM REFERRAL Activity: 2.3.4 NETWORK (CLIENT MOBILIZATION TO ACTUAL SERVICES RECEIVED) Respective CCSDP/DDFP offices, RTMI, selected district based NGOs, hired IT firm, Union Information and Services Partners/Collaboration Center POC Rabiul Hossain/ Bashir Ahmed Tasks Task Description Inter-Team Implementation Time Benchmark/ Quarterly Achievement of # Collaboration Frame Deliverables Benchmark/ Deliverables Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4
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2.3.4.a Train YPSA’s 100 microcredit Team-1 build the 2 training sessions 2 1 group leaders to disseminate FP capacity of referral organized for 100 Sessions x x x x Nil information to their beneficiaries centers to provide microcredit group 100 and community people (12, 000) in LARC and PM leaders with 50 Leaders Comilla (PY 2) and Feni district of services if required. participants in each PY1. session.
Tasks Task Description Inter-Team Implementation Time Benchmark/ Quarterly Achievement of # Collaboration Frame Deliverables Benchmark/ Deliverables Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 2.3.4.a Engage YPSA’s microcredit group Team-1 will build the 100 300 400 400 Use microcredit Referre Referred 2 leaders to disseminate FP capacity of service LARC LAR LAR LAR group leaders (100) to d 267 1.305 information to their beneficiaries providers of 14 public & PM C & C & C & reach 12,000 clients clinets and communities in Comilla and referral centers to Client PM PM PM gatekeepers and for FP for FP Feni districts. provide LARC and s Clien Clie Clien eligible couples (1200 services services and of and of PM services if ts nts ts LARC & PM which which required. Received clients) with FP especially 202 Inj, 1007 Inj, ME&R will provide LARC and PM LARC LARC & support to develop information and & PM PM M&E plan and will Clients Clients referral. conduct DQA visits as per plan
2.3.4.b Engage women empowerment Team-1 will build the 550 1,000 1,05 1,250 Use women Referre Referred group of Mukti (Kushtia based capacity of service LARC LAR 0 LAR empowerment group d 2,744 4,495 NGO) to disseminate FP providers of 29 public & PM C & LAR C & leaders (160) to reach clients clients information to their group members referral centers to Client PM C & PM 18,660 gatekeepers for FP for FP and community people. provide LARC and s Clien PM Clien and eligible couples services services and of of which PM services ts Clie ts with FP messages which nts especially for LARC 2,273 ME&R will provide and PM services and 493 support to develop Inj, refer clients from 28 M&E plan and will Inj, LARC & unions of Kushtia conduct DQA visits as LARC PM District. & PM Clients per plan Clients
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2.3.4.c Train district (Barguna, Barisal, Team-1 will build the 2,466 2,466 2,466 MoU signed with 5 - 3,439 1 Rangamati, Faridpur, and Rajbari) capacity of referral LARC LAR LARC NGOs to use their LARC based NGO volunteers to centers to provide & PM C & & PM 400 volunteers to & PM disseminate FP information among LARC and PM Client PM Client disseminate FP clients their community. services if required. s Client s information and refer s clients from their communities Tasks Task Description Inter-Team Implementation Time Benchmark/ Quarterly Achievement of # Collaboration Frame Deliverables Benchmark/ Deliverables Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 2.3.4.c Engage district based NGOs to use ME&R will provide x x x x 400 volunteers of 5 Screeni Enagage 2 their volunteers to disseminate FP support to develop NGOs reached 24,000 ng d PSTC information among their M&E plan and will gatekeepers and NGOs community. conduct DQA visits as eligible couples with per plan FP especially LARC and PM information 2.3.4.d Work with BKMI and IR 1 team to Team-1 will provide x x x Implemented in one Develop Work in have a discussion with the DGFP ICT based training to district headquarter ed progress concept/ based on their need, develop an selected services on pilot basis. startegic implement plan for the ICT based providers. note distance learning program and e- learning courses. Quarter-wise Narrative Description of Activity Q1. Task # 2.3.4a2: MH-II has engaged 50 microcredit group leaders of YPSA in Comilla. These group leaders were trained by MH-II and now they are disseminating information on FP issues in the community. These volunteers have referred 267FP clients. MH-II will also engage 50 microcredit group leaders of YPSA in Feni. Training program for micro-credit group leader will start January 2016 Task # 2.3.4.b: With technical assistance from MH-II, Mukti, a district based women empowerment organization, has engaged 160 volunteers in 5 Upazilas in the Kushtia district to create demand for LARC and PM services. These volunteer were trained by MH-II on FP issues. In the reporting quarter, these volunteers referred 350 LARC & PM clients to the public facilities and all of them received FP services. Task # 2.3.4.c1: Through VPKA Foundation community based volunteers, MH-II will create demand for LARC and PM services in Rajbari and Faridpur districts. With the suggestion from DDFP, this NGO has been selected. Approximately, 240 volunteers will work in the vacant position of FWA and in hard to reach areas. DDFP will participate in the volunteer selection process to reduce duplication.
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Q2. Q3 Q4 Activity- 2.3.5 DEMAND GENERATION IN THE URBAN AREAS TO INCREASE USE OF LARC AND PM SERVICES Create demand in the slums of 4 municipality area for LARC and PMs Partners/Collaboration UPHCSDP NGO, City Corporation, BRAC, Community Radio
POC TBD/Rabiul Hossain /Shahid Hossain Tasks Task Description Inter-Team Implementation Time Benchmark/ Quarterly Achievement of # Collaboration Frame Deliverables Benchmark/ Deliverables Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 2.3.5.a Create demand in selected urban Meridian to support x x x x UPHCSDP partner NA NA areas through Urban Promary strategy development. NGOs working in 6 Health Care Service delivery divisional Project UPHCSDP partner NGOs headquarters have integrated FP in outreach activities, including PPFP. 2.3.5.b Provide support/TA to UPHCSDP Team-1 will provide x x x x Field workers and to create demand for LARC and PM training to clinical clinical staff from in their working areas. services providers. UPHCSDP are trained to disseminate and provide LARC and PM information and services.
Tasks Task Description Inter-Team Implementation Time Benchmark/ Quarterly Achievement of
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# Collaboration Frame Deliverables Benchmark/ Deliverables Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 2.3.5.c Use community radio to x x x x Adolescent listeners’ Using Negotiatin disseminate DGFP approved groups reached one Com g with 10 readio com information on LARC and PM. through 3 community radion to radio stations enage them for promoting FP service weeks 2.3.5.d Establish referral networks with 7,980 7,980 7,980 MoU signed with 5 - Referale d NGOs working in the slums. NGOs (Other than UPHCSDP NGOs) 5,214 working in the divisional clients and of headquarters (Khulna, which Barisal, Chittagong, 2,085 Rangpur and clients Rajshahi) providing received LARC and other short Inj, acting methods. LARC and PM methods
Quarter-wise Narrative Description of Activity Q1. Task #2.3.5.a: and Task #2.3.5.b:
Task # 2.3.5.c: MH-II conducted a day long discussion with the representatives from Community Radio Stations namely Radio SagorGiri, Radio Lokobetar, Radio Chilmari, Radio Bikrompur and Radio Mukti, and drafted a plan of action to disseminate FP information through community radio. The plan along with deliverables will be finalized by the first week of January 2016. Task # 2.3.5.d: It has been revealed from secondary information that Population Services and Training Center (PSTC), a leading national NGO, has a good urban based SRH program in the major cities of Bangladesh. Considering their experience and coverage of SRH program, MH-II signed a MoU with PSTC to engage their
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665 volunteers to generate demand for FP services in 11 major cities namely Rangpur, Rajshahi, Dhaka, Jamalpur, Gazipur, Narayanganj, Sylhet, Mymensing, Barisal, Jessore, Bagerhat. To engage the volunteers effectively, MH-II will provide TOT to the mid-level program staff of PSTC. They will then be able to train volunteers to disseminate FP information correctly and appropriately and refer prospective FP clients to the nearest FP service facility. MH-II expects to generate over 15,000 new FP clients from the urban slum areas. TOT for Mid-level staff of PSTC will be conducted in the first week of January 2016 Q2. Task #2.3.5c: MH-II selected two community Radio stations SagorGiri and Radio Padma community to create demand in selected areas Chittagong (mostly costal belt) and Barisal districts and Rajshahi district. These community radios will begin airing DGFP approved Radio Commercial for demand creation for FP services. Their listener groups will be oriented on FP issues and will start disseminating and referring the clients to the nearby facilities.
Task # 2.3.5.d: MH-II provided a 3-day TOT on FP methods to 16 mid-level program staffs from PSTC and these staff provided a one-day orientation to 345 volunteers (till the end of March, 2016) who are working in the selected slums of 11 major cities (Rangpur, Rajshahi, Dhaka, Jamalpur, Gazipur, Narayanganj, Sylhet, Mymensing, Barisal, Jessore, Bagerhat) in Bangladesh. The volunteers have started disseminating information on FP methods through interpersonal communication, home visits, group sessions. In the reporting quarter, the volunteers have referred 5,214 FP clients to the nearest FP facilities. Of the total referred clients 2,085 chose to take one of FP methods. Details of FP dervice updake by referred clinets Number of Referred clinets Number of referred clinets received injectable, LARC and PM services Injection Implant IUD Tubectomy NSV Total 5,214 1,357 605 76 39 08 2,085
Q3 Q4
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PY3/Sub-IR3 Workplan (October 1, 2015 –September 30, 2016) Activity Gantt Chart Achievements through Quarter 2
IR 3: Supportive Enabling Environment to Advance Access to LARC and PM and Other FP/RH Services Sub-IR3.1 Key policy issues related to LARC and PM including PPFP identified , revised or developed Activity # 3.1.1 IDENTIFICATION OF NEW BARRIERS AT DIFFERENT LEVELS AND INITIATION OF CORRECTIVE MEASURES Partners/Collaboration MOHFW, MOLGRD&C, DGFP, DGHS, Private Sector, NGOs, MIH, FC+, Stakeholders working on SRHR issues in Bangladesh, Avenir Health POC Md. Abul Quiyume/Azmal Hossain/ Nahid Anjum Siddiqui
Tasks Inter-Team Implementation Time Benchmark/Deliverables Quarterly Achievement of Collaboration Frame Benchmark/Deliverables Task # Task Description Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 3.1.1.a Periodic review to identify SRH policy and All MH-II senior 1 1 1 3 brainstorming sessions— 1 advocacy related issues with MH –II staff staff would be one with 20 MH-II senior Sessi and other relevant stakeholders of engaged for the staff and 2 with 40 relevant on MOHFW, MOLGRD&C, NGOs, Private brainstorming stakeholders of DGFP, sectors, etc. sessions DGHS, NGOs and Women’s groups working on SRHR issues in Bangladesh held Report on barriers and recommendations identified 3.1.1.b Review and revise the policy barrier matrix All IR teams X X X X Policy barrier matrix Done Done in line with the above review and Medical especially, revised Eligibility Criteria (MEC) of WHO, Capacity Building CDC/US and service access barriers Advisor, and identified by MH-II project Avenir Health
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Tasks Inter-Team Implementation Time Benchmark/Deliverables Quarterly Achievement of Collaboration Frame Benchmark/Deliverables Task # Task Description Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 3.1.1.c Mapping of LARC and PM service All MH-II staff, X X X - A district-wise list of X
providers, champions and leaders by Avenir Health, LARC and PM service
public, private and NGO facilities to ME&R to support providers and champions ble categorize their roles in advocacy for mapping developed through the offices of CS and DDFP. This is available and shared with the DGFP, DGHS,
NGOs and Private sector availa list is A stakeholders 3.1.1.d Organize local level advocacy workshops Support from all 3 4 4 3 14 local level advocacy 0 10 for showcasing service providers’ critical IR teams meetings (non-technical in roles in the LARC & PM services and nature) held with the planning for ensuring service provisions. participation of 30 service These would be held in Districts of PY1, PY2, and PY3 where provider biases are providers in each event more prevalent in connection with PPFP. held 3.1.1.e Organize an advocacy training for the MH- All IR teams, 1 1 training on advocacy 0 1 II Sr. QA and Compliance Officers, RTM especially support techniques, and content mobile service delivery care team members of PM (QA/FP held with participation of and selected staff of MIH and FC+ and compliance) to 20 participants which MH-II facilitate the includes all of the Sr. QA & training FP Compliance Officers; all of the mobile service ME&R team delivery team members of would analyze RTM; some selected staff data for advocacy members of MIH and FC+. 3.1.1.f Continue advocacy with MOHFW and Support from PM X X - - Cost centers established at On- On- CAG to set-up ‘Cost Center’ at DGHS (QA & FP all Medical College going going service centers for FP services Compliance), LD Hospitals and District (CCSDP), JS (FW Hospitals under DGHS of MOHFW) is substantially
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Tasks Inter-Team Implementation Time Benchmark/Deliverables Quarterly Achievement of Collaboration Frame Benchmark/Deliverables Task # Task Description Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 important 3.1.1.g Support DGFP to organize and conduct All team’s efforts 2 5 - - Meetings with 50 FP 0 Integ advocacy meetings for the implementation are required service providers each at 7 rated of changed policies specially during divisional level held with field trip of MH-II 3.1.1. staff d 3.1.1.h Advocacy to the MOHFW, DGHS and This is a joint X X X X DGHS/MOHFW allows a On- On- DGFP for a better place for IUD service effort with Team-1 separate IUD insertion going going delivery at the Upazilla Health Complex and therefore, a room/or the procedure to be (UHC) substantial carried out in the OT of the involvement of the UHC team is required 3.1.1.i Advocacy with the MOHFW for the Support from PM X X - - Planning unit of DGFP sent 2012 Final finalization of the action plan developed in (QA/FP the draft plan to MOHFW; Pop ized connection with the National Population Compliance) is 2 inter-ministerial Polic Policy 2012 using BDHS 2014 & Urban considerably consultation meetings on y Health Survey 2013 Health and important the draft action plan is held Final Population indicators as baseline and with the participation of 30 ized dissemination of the same officials of different ministries and Ministerial action plan of the Population Policy 2012 is finalized 3.1.1.j Advocacy with the MOHFW for the Support from all PPFP Action Plan finalized, Done finalization and implementation of the IR teams and advocacy done to include Done PPFP Action Plan particularly from these in relevant OPs of PD DGHS and DGFP
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Quarter-wise Narrative Description of Activity Q1: Task # 3.1.1.a: As a part of a periodic review and SRH policy and advocacy related issues were identified during a brainstorming session conducted on 17December 2015. The staff from MH –II, MIH, Fistula Care Plus, MH-II sub-awardees (RTMI, OGSB, YPSA, Brac, and Shushilan), and MH-II collaborative partners like PSTC and Mukti participated in this session. The specific objectives were: to review the policy issueswith the policy barrier matrix that the Policy Advocacy team updates periodically; and, to brainstorm among the participants on new policy barrier, prioritize the issues and solicit participant insights on addressingpriority issues. The key policy barrier issues identified in the brainstorming session are: no mechanism for private facilities to report their FP performance to the DGFP, no specific guidance/strategy from DGFP to organize FP special day/ services in the workplaces; no designated counselor for FP counseling; FWA’s involvement in the Community Clinics in 3 days in a week; affiliated NGO clinics don’t get imprest fund as advance; etc. Task # 3.1.1.b: Policy Matrix updated, finalized and circulated. Task # 3.1.1.c: A simple checklist was developed for the mapping of LARC and PM service providers, champions and leaders by public, private and NGO facilities to categorize their roles in advocacy. The checklist was also shared with the LD, CCSDP/DGFP so that the mapping can be completed by them. The LD advised to start this mapping after the field placement of 235 Medical Officers (MCH-FP) who have been recently been recruited by the Ministry of Health and Family Welfare. Task # 3.1.1.d: To conduct local level advocacy workshops for showcasing service providers’ critical roles in the LARC & PM services and planning for ensuring service provisions, a letter along with the agenda of the workshop was sent to the LD, CCSDP/DGFP for organizing such events in two PY3 districts—Manikganj and Munhsiganj. Due to heavy workload of CCSDP, they advised to hold those kinds of workshops in the next quarter. Task # 3.1.1.f: Advocacy for setting up cost center in the DGHS system has continued since PY2. This quarter, MH-II organized a meeting between LD, CSSDP/DGFP and the Chief Accounts Officer of the Ministry of Health and Family Welfare. According to the meeting decision, all district FP offices have been requested by CCSDP to send last years (September 2014-August 2015) PPFP performances of the District General Hospitals, Medical Colleges and Specialized hospitals. Out of 64 districts only 29 districts have sent the report although repeated follow-ups with the district FP offices were performed by MH-II. This PPFP performance in the different DGHS facilities will help determine the amount of money to be allocated against each of the facilities as the imprest fund. Task # 3.1.1.h: Three meetings (1 with LD, CCSDP/DGFP; 1 with Director, PHC/DGHS and 1 jointly with LD, CCSDP/DGFP and Director, PHC/DGHS) have been held as a part of advocacy for a better place for IUD service delivery at the Upazilla Health Complex (UHC). The last meeting decided to issue a joint circular allocating an Operation Theatre in favor of the FP unit of the UHC with the signature of both DGs of DGFP and DGHS. This circular is expected to be issued in early next quarter. Task # 3.1.1.i: The action plan for the Population Policy-2012 has been finalized and now ready for printing by the Planning Unit of DGFP. To finalize the action plan in the reporting quarter 2 meetings were held—1 with the Population Policy Action Plan Development Committee (held on 14th December 2015) and 1 with the Population Policy Action Plan Development Committee Sub-Committee (held on 22nd December 2015). Q2: Task # 3.1.1.d: As a part of local level advocacy workshops for showcasing service providers’ critical roles in the LARC & PM services including PPFP, 10 events were organized and conducted jointly by the MH-II and DGFP. The meetings were held in Munshogonj district on 19 January 2016, Tangail on 15 Februry 2016,
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Manikgonj on 17 February 2016, Barguna on 22 February 2016, Barisal on 23 February 2016, Bhola on 24 February 2016, Netrokona on 15 March 2016, Shariatpur on 27 March 2016, Faridpur on 28 March 2016 and Rajbari on 29 March 2016. Multisector stakeholders including DC, CS, DD-FP, Upazila Chairmen, UNO, UHFPO, UFPO, Obs/Gynea Consultant, MO (MCH-FP), DD-IFB, President/Secretary of Imam Samiti, Journalists, attended the workshops. The key outcomes of the events are: commitments by the different stakeholders to help FP program like commitment by the CS to allocate an OT to the DGFP that will increase quality FP services; commitment by the DGHS providers for more PPFP services; commitment by both DGHS and DGFP providers for ensuring implementation of all changed policies including 100% counseling on FP focusing PPFP during each ANC, PNC and immunization services; and so on. DGFP has also issued call-up letters for the remaining 8 PY3 districts—6 April in Narshingdi, 16 April in Jhalokathi, 17 April in Pirojpur, 23 April in Khagrachari, 25 April in Rangamati, 27 April in Bandarban, 7 May in B. Baria and 8 May in Feni. Notably, instead of supporting DGFP to organize and conduct advocacy meetings for the implementation of changed policies separately, the issue has been incorporated as one of the local level advocacy issues and being discussed in those advocacy workshops accordingly. Additionally, MH-II has supported DGFP in organizing and conducting CCSDP OP budgeted upazila level LAPM advocacy meetings. In the reporting quarter total of 15 Upazila level advocacy meetings were held in Naogaon, Bhola, Jhenidah and Satkhira districts where 979 DGHS and DGFP officials and field staff attended. Task # 3.1.1.e: On 17 Februay 2016, an advocacy training was provided to the MH-II Sr. QA and Compliance Officers, RTMI mobile service delivery care team members so that they can negotiate with the local program managers on certain local level advocacy issues like implementation of changed policies, ensuring privacy for IUD insertion at UHC and thereby advocacy for OT allocation for FP services in the upgraded 50-bed UHCs, resolving imprest fund and logistical issues at the DGHS facilities through a local arrangement between DGFP and DGHS managers and/or providers, etc. Task # 3.1.1.f: In the reporting quarter there is substantial progress on the issue of setting-up cost center in the DGHS facilities. After intensive follow-up by the MH-II staff, LD, CCSDP succeeded to receive district-wise PPFP performances of DGHS facilities in the first week of February 2016. On 16 February 2016 LD, CCSDP sent that report of the district-wise PPFP performances and an estimated cost against those performances to the CAO, MOHFW. On 24 February 2016, the CAO of MOHFW provided positive opinion in a letter to the LD, CCSDP with copy to the Secretary, MOHFW recommending of opening up of cost center in the DGHS facilities. The recommended ceiling of the imprest fund against Dhaka Medical College Hospital, Sir Salimullah Medical College Hospital, Bangabandhu Sheikh Mujib Medical University and all Medical College Hospitals located in divisional towns is BDT 150,000 and BDT 100,000 against other Medical College Hospitals, Specialized Hospitals and Sadar Hospitals located in district towns. On 3 March 2016 LD, CCSDP forwarded the above mentioned letter of the CAO, MOHFW to the Secretary, MOHFW with copy to the Additional Secretary, MOHFW who is also the Chairperson of the PPFP Committee of the MOHFW to take action in favor of opening up cost center in the DGHS facilities. The next steps, are expected to take place in the following quarter, if the Secretary, MOHFW agrees to the opinion of CAO he would send the CAO’s letter to the Secretary of Ministry of Finance for endorsement and then the Secretary, Ministry of Finance after giving his endorsement would send the letter back to the Secretary of MOHFW for issuance of a circular in favor of opening up of cost center in the DGHS facilities. Q3
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Q4 Activity # 3.1.2 PROVIDE SUPPORT TO THE NATIONAL TECHNICAL COMMITTEE (NTC) TO REVISE AND DEVELOP NEW POLICIES. Partners/Collaboration MOHFW, DGFP, DGHS, NTC members, Avenir Health, EngenderHealth Global Clinical Support Team POC Md. Abul Quiyume/Azmal Hossain Tasks Inter-Team Implementation Time Benchmark/Deliverables Quarterly Achievement of Collaboration Frame Benchmark/Deliverables Task # Task Description Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 3.1.2.a Continue support to DGFP to organize For technical 1 1 1 1 4 NTC meetings held with 0 1 NTC meetings as and when required information 40 participants in each for Meet support from approval of policy ing Team-1 is required decisions 3.1.2.b Present findings of pilot experiences Team-1 needs to - 1 - - Experiences shared at the - - (started in PY2 and led by IR1 Team) to lead this task as NTC meeting with 40 NTC members to approve nation-wide the intervention participants provision of 1st dose of injectable would be led by contraceptive by trained FWAs/CSBAs the team (assuming successful piloting) 3.1.2.c Advocacy with DGFP and DGHS so that For technical X X - - NTC approved implant as On- Appr NTC approves implant as an immediate information an immediate PPFP method going oved PPFP method support of Team- A circular issued to the 1, particularly DGFP, DGHS and NGO Capacity Building sites at the field level Advisor, EngenderHealth Global Clinical Support Team, WHO is required 3.1.2.d Approval of PPFP counseling in all ANC This is a joint X X X X Received NTC approval, On- Appr and PNC visits by NTC effort with Team-1 and a joint circular is issued going oved with instructions referring to SOPs and guidelines to the DGFP, DGHS and
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NGO sites field for providing PPFP counseling during all ANC and PNC visits
Tasks Inter-Team Implementation Time Benchmark/Deliverables Quarterly Achievement of Collaboration Frame Benchmark/Deliverables Task # Task Description Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 3.1.2.e Approval of PPFP counseling during This is a joint X X X X NTC approval received, On- Appr Immunization services and availability of effort with Team-1 and a joint circular is issued going oved short acting methods (pills, condoms and and substantial to the DGFP, DGHS and injectable) at the Immunization centers involvement of the NGO sites at the field level team is required for providing PPFP counseling and FP services during Immunization services Quarter-wise Narrative Description of Activity Q1: Task # 3.1.2.a/b/c/d: On 2 December 2015, NTC issued the Minutes of the 65th NTC meeting held on 6 August 2015. The decisions on 3 MH-II raised issues are: (1) Implant can be provided to clients immediately after delivery of a baby irrespective of parity of that particular woman. However, NTC wants to have more clarifications on the pros and cons of introducing Implant as the immediate PPFP method. Final decision would be taken after discussion with the MEC expert from WHO headquarter who is supposed to visit Bangladesh and clarify the issue in a special NTC meeting soon. (2) A circular will be issued to provide PPFP information during each ANC, PNC and immunization visits jointly signed by the DG of DGFP and DG of DGHS. Short acting FPmethodservices such as pills, condoms and injectables should be available at the Immunization sites. (3) Due to recent few policy changes, and the WHO recommendation on MEC, the relevant section of the Family Planning Manual will be reviewed. The revised parts of the FP Manual will be printed separately and that will be added as addendum with the existing Manual. Q2: Task # 3.1.2.c: On 15 March 2016, NTC issued the Minutes of the 66thNTC meeting held on 10 February 2016. The decisions on 1 MH-II raised issue is “NTC approved Implant and Progestin-only-Pills (POP) as immediate PPFP method and as such Implants and POPs can be provided to clients immediately after delivery irrespective of the womans parity. Note that the 65thNational Technical Committee (NCT) meeting sought additional clarification on the pros and cons of allowing contraceptive implants as immediate postpartum family planning (PPFP) method. Then MH-II invited an Medical Eligibility Criteria for Contraceptive Use (MEC) expert from the World Health Organization (WHO) in Geneva who made several presentations to the representatives of the Bangladesh Medical Association (BMA), Obstetric and Gynecological Society of Bangladesh (OGSB), Directorate General of Family Planning (DGFP), and Directorate General of Health Services (DGHS) service providers, research and training institutes, and finally to the NTC (08 Februay at OGSB Dhaka; 09 February at BMA, Chittagong; 10 February at
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Tasks Inter-Team Implementation Time Benchmark/Deliverables Quarterly Achievement of Collaboration Frame Benchmark/Deliverables Task # Task Description Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 DGFP, Dhaka and 11 February at MFSTC, Dhaka). The policy was approved during the 66thNTC meeting, thereby expanding the FP choices available to the 3.1 million postpartum women in Bangladesh.
On 16 March 2016, a circular jointly signed by the DG of DGFP and DG of DGHS regarding the decision of the 65th NTC meeting, that is, providing PPFP information during each ANC, PNC and immunization visits and making short acting FP method services such as pills, condoms and injectables available at the Immunization sites is sent out to all relevant program managers and service providers working with DGFP, DGHS, NGOs and private sectors. Q3 Q4 Activity # 3.1.3 ADVOCACY FOR LARC/PM SERVICE PROVISION AT URBAN AREAS Partners/Collaboration MOLGRD&C, MAB, Pourashavas, City Corporations, UPHCSDP POC Bikash Barman/Sadikur Rahman 3.1.3.a Continue advocacy at various levels of It is expected that X X X X Key liaison persons X Postp urban areas (UPHCSDP, City Corporations both IRs—1 and 2 identified in the oned and Pourashavas) to create an enabling will let IR-3 know MOLGRDC, City environment for the provision of LARC the specific policy Corporations, Pourashavas, and PM services issues that need to UPHCSDP and relevant be addressed for NGOs and service centers creating enabling responsible for provision of environment health and FP services Regular communications maintained and need based meetings with liaison persons held to ensure uninterrupted LARC and PM services 3.1.3.b Conduct advocacy meeting with the Teams-1 and 2 to 1 - - - One advocacy meeting with 0 1 executive committee of Municipal provide key the executive committee of Meet Association of Bangladesh (MAB) for the activities to be Municipality Association of ing provision of LARC and PM services in undertaken for Bangladesh (MAB) held selected 4 municipality areas/Pourashavas service delivery
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Tasks Inter-Team Implementation Time Benchmark/Deliverables Quarterly Achievement of Collaboration Frame Benchmark/Deliverables Task # Task Description Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 of PY3 Districts which are yet to be and training and with 30 participants finalized in consultation with MAB> also for SBCC 3.1.3.c Develop and sign an MOU with the MAB Teams-1, 2 and - X - - A MOU with MAB Done for introducing LARC and PM services in ME&R team will developed and signed 4 Pourashavas review the draft MOU and provide their inputs 3.1.3.d Support DGFP to organize and conduct Teams-1 and 2 to X X X X 4 advocacy meetings held 0 0 local level advocacy meetings with the provide key with 40 selected Mayors of 4 Pourashavas activities to be participants at district level undertaken for with MOLGRDC (UP service delivery members & Chairman), and training and DGFP, DGHS, UPHCSDP also for SBCC & other key stakeholders for LARC and PM services provision in Urban areas 3.1.3.e Conduct advocacy meetings at 4 Teams-1 and 2 to - 2 2 - 4 advocacy meetings held 0 0 Pourashavas to strengthen the provision of provide key at selected Pourashavas LARC and PM services activities to be with 40 participants each undertaken for and need based tripartite service delivery meetings of Pouroshava, and training and local DGFP office and MH- also for SBCC, II held at district/Upazilla and MAB level secretariat 3.1.3.f Link Pourashavas with the local All teams’ support - X X X TA to selected Pourashavas No No contraceptive planning of DGFP for for follow-up and provided for affiliation with clinic clinic regular supply of logistics, commodities monitoring during the DGFP (if necessary) of requi requi and services field trip is service centers, renewal (if re re essential necessary) of the same and affili affili ensure uninterrupted supply ation ation
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Tasks Inter-Team Implementation Time Benchmark/Deliverables Quarterly Achievement of Collaboration Frame Benchmark/Deliverables Task # Task Description Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 of logistics and supp supp commodities from DGFP ort ort Quarter-wise Narrative Description of Activity Q1: Task # 3.1.3.c: An MOU has been signed between MAB and MH-II/EHB on 26th October 2015. The specific objective of the MoU is to ensure FP service delivery particularly injectable, implant, IUD, and sterilization services in addition to the existing provision of health services in the Pourashava facilities, partner NGOs and City Corporation health centers and create demand for different FP especially LARCs and PM services among urban population. Task # 3.1.3.d: A need and capacity assessment of 5 Pouroshavas namely PabnaSadar, Bera and IswardiUpazila of Pabna district, SingraUpazila of Natore district and KaliakairUpazila of Gazipur district has been done by MH-II staff. A combined report has been prepared with required activities to be undertaken. Task # 3.1.3.e: At this moment the nation-wide election for Pourashavas are going on and therefore, all relevant activities are withheld until the election completes in 30 December 2015. Q2: Task # 3.1.3.b: In this quarter, a meeting with MAB and selected Paurashavas was held on 31 January 2016 at EHB office at Dhaka. The purposes of this meeting was to bring all existing and newly elected Paurashava Mayors from selected 4 Paurashavas together and share the findings of the Need and Capacity Assessment conducted in November 2015, incorporated the ideas of newly elected Mayors and to agree upon activities for the Paurashavas to increase LARC & PM services in the Paurashava area. Task # 3.1.3.e: MH-II will organize Paurashava level advocacy meeting in the next quarter involving Paurashava, DGFP, DGHS, private clinics, NGOs and local community leaders to implement the agreed activities. Q3 Q4 Activity # 3.1.4 ADVOCACY FOR LARC/PM SERVICE PROVISION AT PRIVATE SECTOR FACILITIES Partners/Collaboration MOHFW, DGFP, BGMEA, Meridian Group International, Avenir Health POC Bikash Barman/Sadikur Rahman 3.1.4.a Develop and finalize LARC and PM PM of MIH X X - - LARC and PM Private X Draft Private Sector Working Approach of EHB project is leading Sector Working Approach ed in consultation with MIH, NGOs like this initiative. finalized
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Tasks Inter-Team Implementation Time Benchmark/Deliverables Quarterly Achievement of Collaboration Frame Benchmark/Deliverables Task # Task Description Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 NHSDP and other stakeholders. More support required from Meridian Group, Avenir Health, Teams-1, 2 and ME&R for review and inputs of the strategy 3.1.4.b Continue advocacy with DGFP for timely All teams’ support X X X X Supply of FP commodities On- On- and adequate supply of LARC, PM and for follow-up and to 10 DGFP affiliated going going Injectable commodities at DGFP affiliated monitoring during private clinics and hospitals private clinics and hospitals field trip is serving the very poor essential population
Quarter-wise Narrative Description of Activity Q1: Task # 3.1.4.a: The draft LARC and PM Private Sector Working Approach of EHB is now under review. Task # 3.1.4.b: An advocacy meeting was held on 17 September 2015 with private hospitals and NGO clinics, organized by Thana Family Planning Office in Mirpur, Dhaka. Service providers and managers from 19 private hospitals and clinics participated. Most of the private hospitals and clinics agreed to be linked up with DGFP for FP activities particularly for PPFP services. As a continuation of that effort, on 28 November MH-II provided orientation on PPFP to all FPIs and FWVs of Mirpur, Dhaka. The oriented DGFP staff refer clients to the private clinics now. In addition, an advocacy meeting was organized by MH-II with Divisional Director-FP, Dhaka Division and Deputy Director of Dhaka so that PPFP services could be expanded in another Thana, Tejgaon, of Dhaka city while government logistics, commodities and imprest funds would be made available in those facilities. Q2: Task # 3.1.4.a: The LARC and PM Private Sector Working Approach is being reorganized/rewritten with support from Ms. Cindi Cizek of Meridian Group International and this working approach would only contain the steps/ideas being pursued or to be pursued by MH-II. The working approach is structured following an agreed upon outline and is expected to be finalized in the next quarter.
Task # 3.1.4.b: In collaboraton with Thana Family Planning Office, Mirpur, Dhaka, 3 LARC & PM special days were organized in 3 private facilities in Dhaka city where 27 NSVs were performed. The clients were generated using DGFP’s own field staff located in different parts of the city. Alongside, due to our advocacy efforts in the last quarter, Thana Family Planning Office, Mirpur started to provide imprest fund, logistics and commodities to 6 private hospitals and 24 PPBTL services have been performed in this reporting quarter.
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Tasks Inter-Team Implementation Time Benchmark/Deliverables Quarterly Achievement of Collaboration Frame Benchmark/Deliverables Task # Task Description Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 Q3 Q4
Activity # 3.1.5 BUILDING PARTNERSHIP WITH NGOS TO PROVIDE LARC/PM AT WORKPLACES Partners/Collaboration MOHFW, DGFP, BSR, YPSA, BGMEA, Meridian Group International POC Bikash Barman/Sadikur Rahman Tasks Inter-Team Implementation Time Benchmark/Deliverables Quarterly Achievement of Collaboration Frame Benchmark/Deliverables Task # Task Description Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 3.1.5.a Continue advocacy with the DGFP for All teams’ support X X X X Supply of FP commodities On- On- timely and adequate supply of LARC and for follow-up and to BGMEA health centers going going injectable commodities at DGFP affiliated monitoring during systems developed and 7 of clinics of BGMEA field trip is made functional essential 10 clini cs recei ved FP com modi ties 3.1.5.b Advocacy with DGFP to permit supply of All teams’ support X X X X FP commodities available On- On- FP commodities from BGMEA affiliated for follow-up and at garment factories from going going clinics to garment factories, in order to monitoring during BGMEA affiliated clinics 8 increase uptake of LARC and injectable by field trip is and health centers with clinic systems established and
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garment factory workers essential made functional s recei ved FP com modi ties
3.1.5.c Environmental scanning for inclusion of Support from X X X A report containing the The The SRHR/FP as one of Health Compliance Meridian Group recommended actions steps work asses point for Garment Factories International developed and on sme disseminated including doin nt is inclusion of the availability g the com of SRHR/FP information asses plete and services as a compliance point sme d. nt is Awa ongo iting ing the repo rt
Tasks Inter-Team Implementation Time Benchmark/Deliverables Quarterly Achievement of Collaboration Frame Benchmark/Deliverables Task # Task Description Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 3.1.5.d Build partnership with BSR working at the Meridian will X X X X FP, particularly LARC/PM Done Link garment factories (where YPSA is not support information and referral ages
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working) to introduce/incorporate LARC development of services incorporated in the estab and PM referral and services this partnership BSR supported factories lishe based on their following development and d existing 5-year signing of an MOU with global relationship BSR Through this initiative with BSR. we will reach out to at least Teams- 1 and 2 25 new garment factories would provide Training and SBCC related supports to BSR once the MOU is signed. A separate M&E plan to be developed by ME&R team. Quarter-wise Narrative Description of Activity Q1: Task # 3.1.5.a: MH-II provided technical support to BGMEA to apply for affiliation of BGMEA clinics with DGFP to get commodities and impress fund support. During this quarter BGMEA submitted 4 applications to DGFP to obtain affiliation for 4 BGMEA clinics located in Narayanganj, Gazipur and Dhaka districts. Task #3.1.5.b: To ensure supply of DGFP commodities in all mini clinics of the garment factories, MH-II has also started advocacy for signing a tripartite MoU among DGFP, BGMEA and EHB. A draft MoU has also been developed and shared with DGFP and BGMEA for their review and input. Task # 3.1.5.d: MH-II has signed an MOU with Business for Social Responsibilities on 27 October 2015. Under this MOU, MH-II developed an Action Plan through a workshop with the participation of MH-II staff and representatives of BSR HERhealth project partners—Change Associates, Awaj Foundation and Momota held on 8 December 2015. The action plan covers issues and activities associated with service delivery and training, demand generation, monitoring, follow-up and documentation of impact and sustainability plan. MH-II is now revising FP training module of BSR’s HERhealth project. MH-II would provide TOT to BSR’s master trainers once the module is revised and endorsed by both MH-II and BSR. Task # 3.1.5.b: Q2: Task # 3.1.5.a: MH-II continues providing technical support to BGMEA in getting affiliation of BGMEA clinics from DGFP so that they obtain family planning commodities and impress fund support from DGFP. BGMEA has total 10 clinics in Dhaka. The mini clinics currently only receive OCP, injectable and condoms.Of those 7 are already affiliated and are receiving DGFP commodities and imprest fund for providing both short acting and LARC&PM services. During this quarter 1 BGMEA clinic located at Narayanganj city obtained affiliation and started receiving FP commodities from DGFP. 2 others got clearance from Upazila and District
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FP offices and were forwarded to DGFP HQ. Task #3.1.5e: MH-II also continues advocacy with the DGFP to supply DGFP family planning commodities and other applicable support directly to the readymade garment factories. A tripartite MOU was signed on the 16th February 2016 by the Directorate General of Family Planning (DGFP), Bangladesh Garment Manufacturers and Exporters Association (BGMEA) and EngenderHealth Bangladesh. Under this tripartite MOU, only the short acting methods (oral pills, condom and injectable) to be made available in the mini clinics within the RMG factories, not to the BGMEA clinics. This menas that for clinical services to be provided by the BGMEA clinics DGFP affiliation is still a prerequisite, as for clinical services there are certain infrastructural and medical preconditions/indicators those must be met by the individual clinic. The specific objective of this collaboration is to make family planning services available within the garment factories. BGMEA is a platform for 4,200 garment factories where 5.2 million people work, 80% of their workers are women and most of them are young. Because of this MOU, all BGMEA garment factories are now allowed to receive DGFP family planning commodiites without affiliation which has resulted in easy access to family planning services in the garment factories. Task # 3.1.5.c: David Wooford, Vice President (Public Private Partnership), Meridian Group Internatinal, Inc. visited Bangladesh on 22-30 January 2016 for the purpose of environmental scanning for inclusion of SRHR/FP as one of Health Compliance point for Garment Factories. During this visit, he visited ready made garment factories, corporate brand offices, and also met with ILO Better Work, UNFPA, UN Global Compact, BSR, Solidarity Center/Bangladesh and USAID. Mr. David will prepare the policy environment and strategy report and share it with Engenderhealth Bangladesh in early February 2016. Task # 3.1.5.d: Following the signing of an MoU with BSR in the last quarter, an action plan was developed in this reporting quarter involving BSR’s 3 partner organizations namely Change Associates, Mamata, and Awaj Foundation. MH-II has reviewed BSR’s Family Planning and MCH Training Modules based on that a TOT for BSR trainers is scheduled to be held on April 6-7, 2016. Q3 Q4
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Activity # 3.1.6 ADVOCACY WITH THE DGFP TO STRENGTHEN COMPLIANCE CULTURE IN MONITORING OF PERFORMANCE OF FIELD WORKERS/COMPREHENSIVE ACTIVITY BASED MONITORING Partners/Collaboration DGFP POC Sadikur Rahman/Azmal Hossain/Ninad Afrin Zohora Tasks Inter-Team Implementation Time Benchmark/Deliverables Quarterly Achievement of Collaboration Frame Benchmark/Deliverables Task # Task Description Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 3.1.6.a Organize meeting and brainstorming Require 2 - - - 2 brainstorming sessions 0 4 sessions with the DGFP to discuss substantial held at the DGFP with 30 alternative ways of supervising and involvement of participants and a report Sessi monitoring field workers. ME&R team, and generated ons MH-II senior Rep staffs ort deve lope d
3.1.6.b Organize a brainstorming session with Require - 3 - - 3 brainstorming sessions - Not Upazilla level managers to discuss substantial held at the divisional level held alternative methods DGFP supervisors involvement of with 40 district and could monitor field workers. ME&R team, and Upazilla level participants MH-II senior selected randomly from staffs PY1, PY2 and PY3 Districts and a report generated 3.1.6.c Collaborate with the MH-II ME & R team Require - X X X An innovative program - Meet to initiate and pilot the recommended substantial approach is designed and ing alternative scheme in 1 district of PY3 for involvement of implemented in 1 district of held six months and recommend for possible ME&R team PY3; quick assessment of with scale-up the intervention is ME conducted and a report &R containing next steps for
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advocacy and scale-up is Tea generated m and actio n steps disc usse d
Tasks Inter-Team Implementation Time Benchmark/Deliverables Quarterly Achievement of Collaboration Frame Benchmark/Deliverables Task # Task Description Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 3.1.6.d Organize national level meetings with the Require - - - 1 1 meeting held at the DGFP Not Wou DGFP to discuss the results of the pilot and substantial with 40 participants held ld be discuss about the possible nation-wide involvement of held scale-up ME&R team, and in MH-II senior the staffs next quart er Quarter-wise Narrative Description of Activity Q1: Task # 3.1.6.a: In order to design the compliance culture to capture the performance of the DGFP field workers in one of the MH-II PY3 districts, a letter has been sent to LD, CCSDP/DGFP requesting him to issue a call-up letter for holding a barnstorming session with the Deputy Program Managers, Program Managers and the Directors and Line Directors of all units of the DGFP. A concept note covering the rationale for introducing a compliance culture, the intervention modalities, monitoring and assessment of the pilot intervention and potential scale-up was also developed and sent to the LD, CCSDP with the request letter. Q2: Task # 3.1.6.a: During the reporting quarter MH-II in collaboration with the CCSDPof DGFP organized and conducted4 regional level workshops in Dhaka, Rangamati, Chittagong and Comilla with the participation of all district and upazila level program managers and service providers. A detailed report on the workshop has been developed and shared with the DG of DGFP.
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Tasks Inter-Team Implementation Time Benchmark/Deliverables Quarterly Achievement of Collaboration Frame Benchmark/Deliverables Task # Task Description Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4
The mentioned initiative that is introducing comprehensive activity based monitoring (compliance culture) got laudable attention of the participants of the brainstorming sessions. The recommendations of the sessions for the next steps are: (1) For introducing comprehensive activity based monitoring of the DGFP field workers, a pilot will take place in one district covering all of the Upazilas of that District. The district would preferably be from Chittagong division; (2) The step-wise pilot will include: (a) sharing of the findings of the national and regional level brainstorming sessions with the upazila level managers through a workshop at the district level. The participants are Deputy Director, Assistant Director (FP/CC), Upazila Family Planning Officers, Medical Officers (MCH-FP), Medical Officer (Clinic), Assistant Family Planning Officers, Assistant Family Welfare Officers, selected 5 Family Planning Inspectors, selected 5 Family Welfare Visitors, selected 5 Sub-Assistant Community Medical Officers and selected 5 Family Welfare Assistants; (b) redefining the roles and responsibilities of the staff: (all staffs shall have to be made understand that contraceptive performance is a composite outcome of all of the activities carried out by FWAs, FPIs, FWVs, SACMOs, UFPOs, MOs (MCH-FP) and others; FWAs: FWA’s home visitation would be based on client segmentation; not all of the registered couples be visited; mobile follow-up of clients and a provision of transfer of FWAs from one unit to another; FPIs: assigning client referral and specific contraceptives projection to be given; make them responsible for health education activities particularly for the male; transfer of FPI from one union to another; peer reviewed system to be introduced, i.e., an FPI would be assigned to review the performance of another FPI and report accordingly; FWVs: more community level BCC work during the satellite clinic days; SACMOs: assigning for client counseling, client referral and giving responsibility of contacting males; (3) in the monthly meeting reporting should include number of home visits, number of court yard meetings, number of client referrals, number of interpersonal communications, number of couple counselling, number of client follow-ups, number of monthly meetings along with the achievements of the contraceptive projections and (4) Meeting minutes of all of the monthly meetings be written, documented and reviewed in the next monthly meeting. Q3 Q4 Activity # 3.1.7 SUPPORT DGFP TO USE THE ICV ENTRENCHED BOTTOM-UP CONTRACEPTIVE PLANNING APPROACH Partners/Collaboration MOHFW, DGFP, DGHS, UPHCSDP, City Corporations, Pourashavas, NGOs POC Farhana Yeasmin/Nusrat Zaman Sohani 3.1.7.a Continue support to DGFP to train/orient 15 25 30 30 TA provided to CCSDP to 33 18 field workers to do contraceptive planning organize 100 Upazilla Sessi exercise through client segmentation mostly from PY3 Districts Sessi ons process considering ICV norms level orientations for 6500 ons
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Tasks Inter-Team Implementation Time Benchmark/Deliverables Quarterly Achievement of Collaboration Frame Benchmark/Deliverables Task # Task Description Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 field workers 4,012 1,00 FWA 7 s FW orien As ted orien ted 3.1.7.b Advocacy to strengthen/revise client Support from X X X X The existing Software On- On- segmentation and bottom-up contraceptive ME&R team become more user friendly going going planning software developed by required for DGFP users MIS/DGFP for CCSDP/DGFP so that it reflects the local needs with possible use of EH Reality Check tool. Quarter-wise Narrative Description of Activity Q1: Task # 3.1.7.a: During 1st quarter, MH-II supported DGFP to organize and conduct 33 bottom-up contraception planning workshops in 33 Upazilas of 8 districts namely Chittagong, Pabna, Satkhira, Panchgar, Bogra, Jessore and Bramhanbaria. A total of 4,012 field workers of DGFP have been oriented on bottom-up contraceptive projection and planning. Additionally, to see the efficacy of the bottom-up contraceptive projection and planning, 2 iDQAs have been conducted in Laxmipur and Rangpur districts during this quarter. The finding of iDQA are yet to be analyzed. However, primary data shows that in the last FY bottom-up projection and planning exercises were done in each and every level—from the field workers to the district FP offices although they could not understand the long term qualitative outcome of such exercises. Q2: Task # 3.1.7.a: During 2nd quarter MH-II supported DGFP to organize and conduct 18 bottom-up contraception planning workshops in 18 Upazilas in 5 districts, Joypurhat, Munshiganj, NarayanganjNaogaonand Sylhet. A total of 1007 field workers from the DGFP have been oriented on bottom-up contraceptive projection and planning. Q3 Q4 Sub-IR3.2 National standards, guideline, curricula and policies are implemented by personnel at teaching institutions and service delivery
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Tasks Inter-Team Implementation Time Benchmark/Deliverables Quarterly Achievement of Collaboration Frame Benchmark/Deliverables Task # Task Description Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 points. Activity # 3.2.1 SUPPORT THE DGFP/MOHFW TO REVISE THE RELEVANT SECTION OF THE NATIONAL FAMILY PLANNING MANUAL PRINTED IN 2010 Partners/Collaboration MOHFW, DGFP, DGHS, NTC POC Nahid Anjum Siddiqui/Md. Abul Quiyume/Azmal Hossain 3.2.1.a Review the Medical Eligibility Criteria All IR teams, X - - - Changes in the 5th edition On- On- (MEC) of WHO (5th edition), CDC/US and especially support of WHO MEC identified going going Neighboring Countries and adapt from Capacity and to be used to revise the necessary changes according to Building Advisor relevant sections of the Bangladesh needs is considerably National FP Manual important 3.2.1.b Review recent policy changes not reflected The list to be X X - - A list of changes are On- Done in the National FP Manual 2010 and reviewed by MH- developed and incorporated going develop a list of changes to be incorporated II senior staffs in the FP Manual in the revised FP Manual 3.2.1.c Disseminate the list of needed changes in All staff X 1 dissemination meeting - Done the FP Manual with 20 participants from CCSDP, FSDP and MCH of DGFP 3.2.1.d Advocacy with DGFP to form a National MH-II senior staff - X X X A National FP Manual - The Review Committee and to include DGHS and PM of MIH review committee formed revie representative to revise FP Manual project to be inclusive of DGHS w included in the membership and supported com review committee to organize need based mitte Review Committee e yet meetings not form edd 3.2.1.e Support revision of the draft manual and MH-II senior staff - - X X The revised - Worf finalization of the FP Manual and obtain and PM of MIH sections/portions of the FP k has
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Tasks Inter-Team Implementation Time Benchmark/Deliverables Quarterly Achievement of Collaboration Frame Benchmark/Deliverables Task # Task Description Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 approval from the review committee would review the Manual finalized and ready not draft at hand for printing yet starts . 3.2.1.f Print the revised portion of the FP Manual - - - X 5000 copies of the revised - Proce portion of the FP manual ss to printed and attached as an print addendum/ inserter of the will existing manual start after The National FP Manual is the available in DGFP and revie other relevant websites w is comp leted 3.2.1.g Revise and print the PPFP Handbook IR-1 team will X - - - PPFP handbook is revised - Revi provide technical upon the approval of ewin support for the Implant as the immediate g is revision of the PPFP method and 2000 yet to handbook copies of the same is start printed PPFP handbook is available in DGFP and other relevant websites 3.2.1.h Print the Laminated Job-aid for PPFP IR-1 team will X - - - Laminated Job-aid for - Deve provide technical PPFP is revised upon the loped support for the approval of Implant as the and revision of the immediate PPFP method print job-aid and 5000 copies of the ed. same is printed Distri butio
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Tasks Inter-Team Implementation Time Benchmark/Deliverables Quarterly Achievement of Collaboration Frame Benchmark/Deliverables Task # Task Description Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 n starte d Quarter-wise Narrative Description of Activity Q1: Task # 3.2.1.a: During the reporting period, IR3 team has reviewed WHO MEC and the recent policy changes those are not reflected in the National FP Manual 2010 and developed a matrix of suggested changes needed to be incorporated in the revised FP Manual. The matrix has also been shared with the senior technical persons of MH-II for their review and input. Q2: Task # 3.2.1.d: As mentioned in the previous quarter, MH-II has sent out a letter to the DG of DGFP requesting him to form a ‘FP Manual Review Committee’. CCSDP has proposed names of the experts from different units of the DGFP HQ, training centers, field level program managers and service providers, NGOs (EHB, MSCS) and development partners (WHO, UNFPA, etc.) who could be included as the members of the committee. It is expected that after DG of DGFP’s approval in early April 2016, the committee would formally start reviewing the EHB developed matrix of suggested changes and do the revision of the manual accordingly. Q3 Q4 Activity # 3.2.2 MONITORING AND FOLLOW-UP OF THE IMPLEMENTATION OF CHANGED POLICIES IN COLLABORATION WITH DIFFERENT IR TEAMS OF MH-II AND USE OF ICT Partners/Collaboration MOHFW, DGFP, DGHS, MOLGRD&C, UPHCSDP, Private Sector, NGOs, City Corporations, Pourashavas, BGMEA, BSR, BERDO POC Nusrat Zaman Sohani/Md. Abul Quiyume/Ninad Afrin Zohora 3.2.2.a Include monitoring and follow-up of All teams X X X X ME&R Team of MH-II Done implementation of changed policies in the involvement included a section in the regular program/activity/trip report particularly of regular trip report on ME&R team is monitoring and follow-up considerably of implementation of important changed policies in the PY1 and PY2 Districts
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Tasks Inter-Team Implementation Time Benchmark/Deliverables Quarterly Achievement of Collaboration Frame Benchmark/Deliverables Task # Task Description Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 3.2.2.b Review trip reports and share with the Support from X X X X An analytical report - On- local managers to ensure implementation ME&R team is indicating the places where going of changed policies required the changed policies have been implemented and the places where problems were faced 3.2.2.c Share the policy changes through social Team-2’s X X X X Changed policy - On- media, quick updates and other ICT based involvement is information disseminated going efforts of MH-II substantially through MH-II Facebook required page, MH-II quick updates, DGFP and DGHS Website and BHE and IEM newsletters 3.2.2.d Collect office memo, office orders and All teams efforts X X X X Office memo, office order - On- circulars periodically from different units are required and circular from different going of DGFP and share those with MH-II staff units of DGFP are collected and relevant stakeholders including DGHS, and shared with MH-II staff NGOs like NHSDP and private sector and relevant stakeholders facilities including DGHS, NGOs like NHSDP and private sector facilities Quarter-wise Narrative Description of Activity Q1: Task # 3.2.2.a: In the first quarter of PY3, IR3 team has developed a checklist which has been introduced to monitor and follow-up the implementation of changed policies. The follow-up is inbuilt with regular field trips of MH-II team members. During this quarter, a total of 145 DGFP service providers and program managers at district and Upazila levels have been followed-up with by MH-II team members. The filled-in checklists have yet to be analyzed. However, primary findings reveal that all of the program managers and services providers are aware of the recent policy changes and that they disseminated changes with their colleagues during the monthly meetings. The district and upazila level program managersare very poor in documenting the relevant circular and many of them are not convinced to allow nulliparous women to accept implants. Q2:
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Tasks Inter-Team Implementation Time Benchmark/Deliverables Quarterly Achievement of Collaboration Frame Benchmark/Deliverables Task # Task Description Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 Task # 3.2.2.a: During the reporting quarter a total of 79 DGFP service providers and program managers at district and Upazila level have been followed-up by MH- II and MIH team members (20 by IR1, 5 by IR2, 39 by IR3, 12 by ME&R and 3 by MIH). Monitoring findings reveal that knowledge about all the 12 modified/new policies are not universal—highest (95%) know that Implant can be provided to nulliparous while only 42% know that for the management of excessive bleeding following implant use, two tablets of low dose oral contraceptive pills (Shukhi) can be used for 21 days; if bleeding does not improve within 1 cycle, then 2 cycles can be given, keeping a 7-day interval between cycles. Many of the program managers are not getting circulars and/or notifications from the DGFP HQ whereas the documentation of the circulars by them is also very poor. The policy change issues are shared with the field staff (91% regarding Tubectomy during C-section), still some of those are not disclosed among the staff (62% regarding Injectable by CHCPs). Many of those changed policies are not being implemented by them due to various reasons. For example, CHCPs are allowed to provide Injectable but being non-DGFP providers, they are not getting Injectable supply directly from DGFP.
For implementation of changed policies, MH-II has already taken several steps. The key steps are: - Resending of DGFP and DGHS issued circulars to over 4,200 program managers and service providers of DGFP, DGHS, NGOs and private sectors across the country via regular surface mail - Sending to over 700 program managers and service providers of DGFP, DGHS via email - In the district advocacy meetings and any other field level events of MH-II, staff are disseminating the information and discussing the issue so that the changed policies are implemented - The Sr. QA&FP compliance officers are discussing the issue in the districts and upazila level monthly meetings of the DGFP - To double the effect, the district immunization medical officers (DIMOs), the WHO supported local level staff of DGHS, are also being oriented so that they disseminate the information and ensure that in each ANC, PNC and immunization services, PPFP counseling is done - A free of cost android based application is also under development to monitor the implementation of changed policies. Q3 Q4 Activity # 3.2.3 SUPPORT CCSDP OF DGFP FOR THE SCALE-UP OF YMC INTERVENTION AT SELECTED DISTRICTS Partners/Collaboration DGFP, UNFPA POC Nahid Anjum Siddiqui/Azmal Hossain 3.2.3.a Provide TA (on a needs basis) to CCSDP IRs 1 & 2 would X X - - Need based TA provided to Done of DGFP for the revision of the training review the CCSDP for revising and curriculum for training of the peers who curriculum and finalization of training will be recruited by CCSDP under the ME&R team will curriculum for training of YMC scale-up program develop a M&E the peers and as such training curriculum is ready
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Tasks Inter-Team Implementation Time Benchmark/Deliverables Quarterly Achievement of Collaboration Frame Benchmark/Deliverables Task # Task Description Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 plan at hand for training of the peers 3.2.3.b Provide TA to CCSDP for the recruitment IRs 1 & 2 would X X - - A selection and recruitment Done of peers for the YMC scale-up program. review the criteria is developed in recruitment consultation with FSDP and criteria and CCSDP provide inputs 3.2.3.c Provide need based TA to CCSDP for the Team 2’s - 2 - - 2 TOT sessions organized - Postp TOT for DGFP trainers (who will train involvement is and conducted at regional oned YMC peers). substantial and level near the Upazillas need to lead this where YMC would be training as BCC is scaled up with the the main participation of 20 trainers component in each session 3.2.3.d Provide need based TA to CCSDP for the Team 2’s X X X X Need based TA to CCSDP - - conduction of training of the peers involvement is for the conduction of substantial and training for the peers (25 need to lead this batches, 750 participants) training as BCC is are provided the main
component At least 75,000 YMCs are reached by the peers 3.2.3.e Provide need based IEC/BCC materials All the required - X X X Required IEC/BCC - Done and demand generation support to CCSDP materials to be materials are distributed to for the promotion of LARC and PM in the provided by CCSDP and a monitoring PY3 Districts including a monitoring plan Team-2 plan developed Quarter-wise Narrative Description of Activity Q1: Task # 3.2.3.a/b: Although YMC scale-up intervention has been incorporated in the Operational Plan of the CCSDP, the implementation of this program has not yet
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Tasks Inter-Team Implementation Time Benchmark/Deliverables Quarterly Achievement of Collaboration Frame Benchmark/Deliverables Task # Task Description Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 started because of the long bureaucratic approval procedure for the recruitment of YMC peers from the Ministry of Health and Family Welfare and the Ministry of Finance. The Ministry of Health and Family Welfare approved the recruitment issue which was then sent to the Ministry of Finance. This second approval is expected to be obtained by the early next quarter. Notably, MH-II has provided technical support to CCSDP for the development of the selection and recruitment criteria of the YMC peers. In the meantime, IR3 team in consultation with the CCSDP has developed a training curriculum for training of the peers which is also ready at hand for training of the peers. Q2: Task # 3.2.3.a/b: The Ministry of Finance has approved the recruitment of 1195 volunteers in 14 hard-to-reach Upazilas in 7 low-performing districts. CCSDP/DGFP has sent out a circular to these districts to complete the recruitment of the volunteers by the end of March. The circular contains the selection and recruitment criteria for the YMC peers. The implementation of the intervention is expected to start in the next quarter with a 2-day TOT for all Program Managers and Service Providers of the districts. Then cascaded training would be started for the YMC peers. For this, MH-II has sent different kinds of IEC/BCC materials and job aids (1195 copies each of LARC/PM Flipchart, Volunteer Guidebook, Court Yard Meeting Roman Banner, Bag, Umbrella, Diary and 239000 LARC/PM leaflets) to CCSDP. Q3 Q4 Activity # 3.2.4 DEVELOPMENT AND DISSEMINATION OF AN ADVOCACY BOOKLET ON ‘WHY LARC AND PM’ Partners/Collaboration MOHFW, DGFP, DGHS, NIPORT, UNFPA POC Azmal Hossain/Farhana Yeasmin 3.2.4.a Desk review of the available literature on Avenir Health’s X X - - Available literature On- On- the LARC and PM involvement is including Costed going going substantial; ME& Implementation Plan of R team would also UNFPA and those of support during NIPORT are reviewed, review process summarized and used in the booklet 3.2.4.b Case studies and relevant points collected Avenir Health and X X - - A booklet developed On- Done from MH-II experience and other sources ME&R team containing the 5 collected going such as NHSDP that supports the would provide case studies and other importance of LARC and PM guidance on case points study
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Tasks Inter-Team Implementation Time Benchmark/Deliverables Quarterly Achievement of Collaboration Frame Benchmark/Deliverables Task # Task Description Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 methodology 3.2.4.c Finalize and print the advocacy booklet MH-II senior - - X - Advocacy booklet drafted - On- staffs review and and finalized going input is required 5000 copies of the for the finalization advocacy booklet printed of the booklet and shared with the DGFP, DGHS, NGOs and Private sector stakeholders
Quarter-wise Narrative Description of Activity Q1: Task # 3.2.4.a/b: As a part of the development of this booklet called ‘Why LARC and PM’, a guide for case study collection was developed by Avenir Health. To the extent possible, the case studies will point to some results arising from innovative, successful and/or promising interventions undertaken or supported by MH-II. Broadly speaking, there will be 2 types of case studies—the case studies (2-3) that illustrate the health, economic, and social-psychological rationale for improving access to LARC/PM and case studies (2-3) on potential or recent LARC/PM acceptors who were counseled and/or were provided with LARC/PM services by the clinicor community workers trained by MH II or other USG projects. The first draft of the booklet is expected to be shared in mid-February 2016 as the draft is linked with the publication of the final report of the Bangladesh Demographic and Health Survey 2014 which will be published in early January 2016. Q2: Task # 3.2.4.a/b: Following the case study collection guide developed by Avenir Health in the last quarter, MH-II had recruited a consultant who collected 17 cases from Cox’s Bazar, Sylhet, Khulna, Mymensingh and Gazipur. The cases were shared with MH-II senior staff as well as with Avenir Health. They later then 3 case studies in the draft version of the booklet ‘Why LARC and PM in Bangladesh’ which is targeted only for the Policy Makers. A complied feedback from MH-II has been sent to Avenir Health for further revision of the booklet. Another version of the booklet targeting the field workers and service providers is being drafted by Avenir Health and will be shared with MH-II soon. Now, it is forseen that in the next months both the booklets would be ready to share with EH, HQ and USAID Bangladesh for comments and feedback for finalization. Q3 Q4
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PY3/ME&R Workplan (October 1, 2015 –September 30, 2016) Activity Gantt Chart of ME&R Achievements through Quarter 2
Monitoring Evaluation and Research (ME&R) Activity # 1 Program Progress Monitoring Activity 1.1 REVIEW AND UPDATE THE ME&R PLAN ME&R team review and updates the annual ME & R plan based on annual Workplan. Partners/Collaboration Population Council POC Shahana Rahman
Implementation Time Quarterly Achievement of Inter-Team Task Description Frame Benchmark/Deliverables Benchmark/Deliverables Task # Collaboration Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 1.1 a Review and update the ME&R plan based All team X
on annual Workplan of IR teams Done Done 1.1b Share draft plan and seek approval of AOR X Updated ME&R Plan
USAID shared and approved
updated Send to USAID Quarter-wise Narrative Description of Activity Q1. Task # 1.1a & 1.1b: Reviewed and updated ME&R plan based on PY3 Workplan and will be sent to HQ NY for their review. Q2. Task # 1.1a & 1.1b: Reviewed and revised ME&R plan based on PY3 Workplan and have sent to HQ NY on 22nd February 2016 for their review; as well as shared with USAID for review. After receiving the comments from HQ and USAID we will finalize the ME&R plan and will be submitted to USAID. Q3
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Implementation Time Quarterly Achievement of Inter-Team Task Description Frame Benchmark/Deliverables Benchmark/Deliverables Task # Collaboration Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 Q4 Activity 1.2 ESTIMATE PROJECTION FOR USAID STANDARD AND CUSTOM INDICATORS
This is a yearly based USAID requirement, where the benchmarks for standard and custom indicators of MH-II project will be establish. Partners/Collaboration NA POC Liaquat Ali 1.2a Conduct benchmark estimation exercise X Performance data table
with program staff based on baseline and
yearly target and achievements
Done 1.2b Estimate benchmarks for standard and X Estimated benchmark table shared with AOR
custom indicators and send to IR teams for
review and revise
Done 1.2c Finalize benchmarks for standard and X Finalized benchmark available
custom indicators and submit to USAID/D
Done Quarter-wise Narrative Description of Activity Q1. Task # 1.2b & 1.2c: Estimate benchmarks for standard and custom indicators finalized and submitted to USAID/Dhaka. Q2. Not applicable for this quarter. Q3. Q4 Activity 1.3 CONDUCT INTERNAL DATA QUALITY ASSESSMENT (iDQA) Internal Data Quality Assessment is a process to assess and monitor the implementation of selected planned activities, quality, and timeliness of MH-II activities to provide feedback to the IR teams about their work and decision making.
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Implementation Time Quarterly Achievement of Inter-Team Task Description Frame Benchmark/Deliverables Benchmark/Deliverables Task # Collaboration Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 Partners/Collaboration N/A POC Shahana Rahman
1.3a Identify at least one activity from each IR IR team 1,2, and 3 X X X X iDQA tools adapted
team and adapt tools for conducting iDQA
DQA DQA
i
2 tools done Not 1.3a-i Conduct iDQA and debrief facility X X X X iDQA reports generated
and used by the respective
managers and concerned IR teams about up
-
the visit; and provide guide to data use for persons DQA
decision making. i
Preparing report 2 2 bottom 1.3a-ii Prepare report and share with IR teams X X X X Reports shared with IR
Teams
yet yet
Not 1.3a-iii Review of previous iDQA findings and X X Review the implemented N/A follow-up whether recommendation has recommendations been implemented
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Implementation Time Quarterly Achievement of Inter-Team Task Description Frame Benchmark/Deliverables Benchmark/Deliverables Task # Collaboration Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 1.3b Conduct iDQA of sub-awarded projects: IR Team 1 and 2 X X X X iDQA tools adapted identify at least onesub-warded projects for iDQA visit in consultation with IR teams and develop tools for iDQA. (Linked with IR team 1 activity# #1.1.4a,
and IR team 2 activity IEC/BCC # 2.1.1e,
Workplace # 2.1.3a, Shushilan # 2.3.1.a,
BRAC # 2.3.2.a, YPSA (BGMEA,
llage RTMI
Community) # 2.3.3.a, Mukti # 2.3.4.b,
District based NGOs# 2.3.4.c and ICT # DQA
2.3.4e) i
4 iDQA in BRAC, YPSA, Eastwest Madical collage and Ali Monsur medical co 2 1.3bi Conduct iDQA and debrief facility X X X X iDQA conduction schedule 4 managers about iDQA visit developed 1.3. bii Prepare iDQA report and share with X X X X iDQA reports 2
concerned authority of sub-awardee and IR
teams to make informed decisions
4 reports shared Quarter-wise Narrative Description of Activity Q1. Task # 1.3a: iDQA of IR team activity: bottom-up contraception: To assess and monitor the implementation of client segmentation and bottom-up contraception projection activity, the ME&R team has conducted two internal data quality assessment (iDQA) in Rangpur and Luxmipur districts. In the Luxmipur district, the iDQA team comprises the Program officer ME&R, Program Manager and Program officer from IR team 3, and the ADP of CCSDP, DGFP. In the Rangpur district, the team comprises DD and PM (QA) CCSDP, DGFP and Program Manager, ME&R, EHB. The data collected through interview with DDFPs, UFPOs, MOs (MCH-FP), FPIs and FWAs. The team also verified the contraception projection number by examining different level of forms prepared by the UFPOs, MOs(MCH- FP), FPIs and FWAs. Task # 1.3b: Two iDQA were also conducted to assess the data quality of RTMI mobile service delivery team. One iDQA was conducted at Hakimpur UHC, Dinajpur on 16-19 November, 2015. ME&R team conducted another iDQA in Rupganj & Sonargaon upazilas of Narayanganj District on 18 November 2015. The overall finding revealed that there are some data inconsistencies between field level data and their reports submitted to EHB. To improve the data quality and receiving correct data a meeting was held with the senior management of RTMI at EHB. Afterwards, RTMI has taken some measurement to improve the data
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Implementation Time Quarterly Achievement of Inter-Team Task Description Frame Benchmark/Deliverables Benchmark/Deliverables Task # Collaboration Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 quality. Q2. Task # 1.3a: Prepared iDQA report of Q1 iDQA Task # 1.3b: Four iDQAwere conducted in this quarter. ME&R team has conducted internal DQA (iDQA) at BRAC in Chittagong on 27-28 January 2016. The ME&R team of EHB Program Manager and Program Officer along with BRAC representatives, Dhaka Divisional Manager & District Coordinator, visited BRAC Rangunia and Patiya office and their catchment areas. The team verified the data of training, referral and referral clients who received services. There was some data inconsistency identified and the ME&R team suggested to revised their complied reporting form. BRAC revised their form and shared with the ME&R team.
One i-DQA was conducted in YPSA in Chittagong District on 19 January, 2016. The team comprising Ms. Caitlin Shannon, Director, KM, ME&R, EngenderHealth NY; Program Manager E&R and Program Officer, IR team2, EngenderHealth Bangladesh. The team verified the client referral data and did not identify any inconsistency. An iDQA was conducted at East West Medical College & Hospital on16 March, 2016 to review the reporting system on LARC&PM services data by the RHSPO. During this visit no data inconsistency was identified with the reports submitted to EHB in last 5 months, October 2015 to February 2016. Similarly, another iDQA was conducted at Monsur Ali Medical college and did not identify any data inconsistency with the data submitted to EHB.
Q3 Q4 Activity 1.4 CONDUCT DATA QUALITY ASSESSMENT (DQA)
This activity will assess the data quality of the public MIS reported from the field. Partners/Collaboration N/A POC Shahana Rahman Implementation Time Quarterly Achievement of Inter-Team Task Description Frame Benchmark/Deliverables Benchmark/Deliverables Task # Collaboration Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4
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1.4a In consultation with USAID and X X X X DQA visit schedule
DGFP/DGHS identify districts to conduct developed
joint 2 new DQA and 2 follow-up DQA
visits. The districts will be selected from Done Done PY1 and PY2 districts. done Not 1.4b Conduct DQA and debrief facility X X X X 4 Debriefing session held managers and concerned IR teams about after the DQA visit
the visit. completed 1 Debrief Debrief 1
1.4c Prepare DQA reports and share with MIS X X X X 4 DQA report generated unit to make informed decision; and and letters written to
strengthen the capacity of DGFP. concerned staffs of DGFP
1 report 1 generated Quarter-wise Narrative Description of Activity Q1. In this quarter joint DQA has not been conducted because the staffs of the DGFP were involved in trainings in ICV and FWA register. EHB ME&R team also provided support for these training and was present. Q2. Task # 1.4b: A DQA was conducted to review the quality of data (validity and reliability) of the permanent and long acting and injectable family planning service delivery system at district, upazila and union levels of the government and non-government organizations. A team consisting of Director (MIS), and DPM MIS Unit of DGFP and program officer ME&R of EHB visited in different locations of Kushtia Sadar upazila of Kushtia district and Chuadanga Sadar & Alamdanga upazila of Chuadanga district from 14-15 February 2016. During the debriefing with the staff of all upazilas of Kustia and Chuadanga districts the Director (MIS) requested all officers to fill-up the consent form properly. Currently all consent forms are available but they have been kept in different places with different service providers. He also emphasized that postpartum bilateral tubal ligation (PPBTL) should be properly reported on a monthly basis particularly in Chuadanga district the service providers reported all tubectomies as interval BTL including the PPBTL ones. He also requested the service providers to record the name of the referee of the clients of MUKTI (a MOU partner of MH-II). Q3.
Q4 Activity 1.5 ORGANIZE QUARTERLY PROGRESS REVIEW MEETINGS, PREPARE& SUBMIT QUARTERLY AND ANNUAL PROGRAM PERFORMANCE REPORTS TO USAID/DHAKA Progress review meetings are a quarterly activity intended to review and discuss the achievements of the previous quarter and plan for the following quarter. After the meeting, the quarterly program performance report is finalized. The project’s achievements are submitted to the AOR within 30 days of end of each quarter. Similarly, an annual activity based on each year achievements
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(cumulative data of all four quarters) is submitted to the AOR within 30 days at end of each year. Both the quarterly and annual reports will contain the description of mutually agreed contents with AOR. Partners/Collaboration EngenderHealth HQ POC Shahana Rahman Implementation Time Quarterly Achievement of Inter-Team Task Description Frame Benchmark/Deliverables Benchmark/Deliverables Task # Collaboration Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4
1.5a Circulate updated activity Gantt Chart All teams X X X X
matrix to all IR teams for quarterly activity
information
Done Done Done
1.5b Collect the Gantt Chart matrix and compile X X X X
the report and update the indicator tracking
table
Done Done Done Implementation Time Quarterly Achievement of Inter-Team Task Description Frame Benchmark/Deliverables Benchmark/Deliverables Task # Collaboration
Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4
1.5c Review draft report, share with IR teams X X X X
for clarification and revise the draft report
Done Done Done
1.5d Share updated indicator tracking table with X X X X Updated indicator tracking IR teams inviting comments and table
suggestions
Updated Updated &Shared Updated &Shared
1.5e Incorporate suggestions and share the draft All teams X X X X
report with EH/HQ for feedback
Done Done
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1.5f Conduct quarterly review meetings and All teams X X X X
meeting with the AOR
1 2016June
Done On
1.5g Finalize the report and submit to USAID X X X X Four Quarterly Reports for their review and approval (two sets of hard copies along with soft copy to
AOR)
Q1 report Q1 submitted report Q2 submitted 1.5h Compile four quarters data and update X Updated annual N/A annual performance indicators tracking performance indicator
table and analyze annual performance data tracking table
based on the indicators Done 1.5i Compile and prepare draft annual progress X N/A report based on IR Teams’ four quarterly
activity matrix Done Implementation Time Quarterly Achievement of Inter-Team Task Description Frame Benchmark/Deliverables Benchmark/Deliverables Task # Collaboration Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 1.5j Share draft annual program performance X N/A
report with EH/ HQ for feedback Done
1.5k Finalize the annual program performance X A annual report, two sets of N/A report and submit it to USAID for review hard copies along with soft
and approval copy to AOR Submitted Submitted Quarter-wise Narrative Description of Activity
Q1. Task# 1.5d to 1.5g: Developed indicators progress tracking table for Q4 and annual progress tracking table for PY2. Prepared Q4 report and annual report of PY2.Shared draft Q4 performance reports with EH/ HQ for their feedback. Finalized the Q4 report and annual program performance report and submitted it to
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USAID/D for review and approval. Also developed the quarterly report for Q1 of PY3 will be sent to EH HQ for feedback and the final report will be submitted to USAID by 31 January, 2016.
Q2. Task# 1.5d to 1.5g: Developed indicators progress tracking table for Q1of PY3. Prepared Q1 report of PY3 and shared draft Q1progress reports with EH/ HQ for their feedback. Finalized the Q1 report and submitted it to USAID/D for review and approval. Also developed the quarterly report for Q2 of PY3 and shared draft Q2 progress reports with EH/ HQ and incorporated their feedback. The final report submitted to USAID. Q3 Q4 Activity 1.6 REGULAR PROGRESS MONITORING OF MOU PARTNERS, SUB-AWARDED PROJECTS AND SOME SPECIFIC ACTIVITIES To monitor progress, assess performance and track against deliverables of the sub-awarded NGOs; and provide evidences for strategic changes, and actions accordingly. In PY3 several sub-awardees and partners NGOs and few specific activities such asBRAC, YPSA, RHSPO, Shushilan, RTM international OGSB, IEC/IPC Material Distribution, MUKTI, MAB, Client segmentation activities, Satisfied NSV and IUD client, Religious leaders training and collaboration with MSD. Partners/Collaboration Population Council
BRAC, YPSA, RHSPO, Shushilan, RTM international, OGSB, IEC/IPC Material Distribution, MUKTI and UPHSDP POC Liaquat Ali Implementation Time Quarterly Achievement of Inter-Team Task Description Frame Benchmark/Deliverables Benchmark/Deliverables Task # Collaboration Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4
1.6a Collaborative monitoring activities with IR All IR team X X Reports generated after
teams (e.g. OGSB, use of Android, scale each monitoring visits up IUD and injectable program, BCC
material distribution.)
In In Progress Data collection on going 1.6b Provide support for monitoring (e.g. IR Team-1 X X X X Orientation sessions 1 conducted on monitoring
Linked with IR Team1 activities up - Strengthening Injectable services #1.1.7d tools and methodology
and ICT #1.2.3d)
follow visits Quarter-wise Narrative Description of Activity
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Q1. ME&R team has conducted several collaborative monitoring activities with IR teams: Task # 1.6a: • In PY2 MH-II conducted training to the service providers on use of Android for 78 facilities. To assess the use of Android ME&R team has developed a brief checklist and oriented the QA and Compliance officers for collecting data from 47 facilities. Data collecting on use of Android assessment is underway. • The data collecting on scale up IUD and injectable program is on-going. The data collection on IUD service delivery of FWV’s and female SACMO is underway in Chittagong and Bogra. Monitoring the service provision of female physician and female SACMO for IUD service delivery and CHCP for injectables second and subsequent doses (linked to IR 1.1.6 g & h in PY2). Task # 1.6b: As a part of implementation of ‘1st dose injectable performed by CSBA/FWA and 2nd and subsequent dose performed by CHCP’ policy. MH-II engaged training teams in Brahmanbaria district to cover training requirement of CSBA, CHCP, FWA and FWV. The ME&R team also conducted visits to observe and review and streamline the collection process of first dose injectable performed by CSBA/FWA and second and subsequent doses injectable performed by CHCP (who received training on 23rd November 2015). Another orientation session was held in Chittagong from 19th December to 21 December 2015. Q2. Task # 1.6a: To monitor progress and assess performance of some of the activities ME&R team has arranged monitoring visits in 69 upazillas. For this monitoring the staff from all IR teams visited different upazillas and collected information by using structured checklists. The monitoring visit includes: • Follow-up for LARC and PM special day • Monitoring of changed/modified polices during 2009 to 2015 • Monitoring distribution and use of BCC materials The findings revealed that amang these 69 upazilas in 62 facilities have fixed day for LARC/PM special session. More than half (36) of the facilities conducted 6 to 10 LARC/PM sessions in a month. Average client flow in each session is 12. UFPO of 26 facilities mentioned that other organizations such as Marie Stopes, Family Planning Association of Bangladesh and other local NGOs provided support to conduct session for LARC/PM. For example, these NGOs hired surgeon of DGFP and referred clients to the government facilities. In all these facilities UFPO & MO (MCH-FP) mentioned that they know most of the changed/modified policy. From this monitoring visit findings IR teams will take measurement accordingly. In addition to that ME&R team has conducted several collaborative monitoring activities with IR teams: • Data collecting on use of Android assessment is underway. QA and Compliance officers are collecting data from 47 facilities while conducting their regular scheduled work till date data has been collected from 35 upazilas. • The data collecting on the scale up IUD and injectable program is on-going. The data collection on IUD service delivery by FWV’s and female SACMO is underway in Chittagong and Bogra. Task # 1.6b: MH-II project in collaboration with the Field Service Delivery Program of DGFP started piloting in three districts Dhaka, Brahmanbaria and Cox’s Bazar after approval of the policy which has been that ‘1st dose of injectable to be provided by CSBA trained FWAs and 2nd and subsequent dose can be given by CHCP of the CCs’. During the pilot period in collaboration of DDFP office the project has developed a reporting system in alignment with the regular DGFP MIS
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injectable report for capturing of 1st dose injectable performance of CSBA trained FWA and 2nd and subsequent doses of injectable performance of CHCP. In this quarter the DGFP and EHB staff also conducted follow-up visits in Brahmanbaria and Cox’s Bazar to monitor the data collection and streamline the process.
Q3. Q4. Activity 1.7 QA AND FP COMPLIANCE DATA ANALYSIS
Partners/Collaboration Population Council POC Liaquat Ali Implementation Time Quarterly Achievement of Inter-Team Task Description Frame Benchmark/Deliverables Benchmark/Deliverables Task # Collaboration Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4
1.7a Quarterly QA and FP compliance data X X X X Four QA and compliance
storing, processing, analyzing, and summary finding reports
preparing summary findings.
1 report 1 report 1 1.7b Share findings of QA and FP compliance X X X X 4 finding sharing meetings - with IR teams, donors and partners held
particularly with DGFP.
1 sharing sharing 1 meeting
Quarter-wise Narrative Description of Activity Q1. Task # 1.7a: QA and FP compliance data storing processing is on-going. Task # 1.7b: A comparative analysis between the first visit and follow-up visit of QA and compliance has been conducted. The findings suggested that the quality of the facilities has improved after the recommendations of first QA and compliance visits. ME&R team has shared findings with the IR teams. Q2. Task # 1.7a: QA and FP compliance data storing processing is on-going. Task # 1.7b: Findings of comparative analysis between the first visit and follow-up the visit of QA and compliance shared with USAID during the quarterly review meeting of Q1 of PY3 on 24th February, 2016. Q3. Q4.
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Activity 1.8 DATA USE FOR INTERNAL DECISION MAKING
Partners/Collaboration Population Council POC Liaquat Ali Implementation Time Quarterly Achievement of Inter-Team Task Description Frame Benchmark/Deliverables Benchmark/Deliverables Task # Collaboration Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4
1.8a Analyze data of those Upazillas where X X An analysis report available
Bottom-up contraceptive projection have
been held
Done Done Done 1.8a-i Analyze Upazilla level MIS data on CAR X An analysis report available
and method mix and compare that with the
yet yet
BDHS relevant data.
N/A Not done Implementation Time Quarterly Achievement of Inter-Team Task Description Frame Benchmark/Deliverables Benchmark/Deliverables Task # Collaboration Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 1.8a-ii Share finding with IR teams, ME&R/ HQ X A report
and donors and DGFP
N/A IR Shared teams 1.8b MIS data analysis, comparing pre and post X X
“satisfied NSV acceptors’ workshop”
findings and performance
Done Done Done
1.8b-i Share finding with IR teams, ME&R/ HQ X A report
and donors and DGFP
Shared IR IR Shared teams IR Shared teams
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1.8c MIS/MH-II data analysis share with IR IR Team 1 and 2 X X X X Finding tables based on teams for decision making different IR teams request (Linked with IR Team1 activities RTM #1.1.b, 1.1.d; PPFP #1.1.2a, 1.1.2i, PAC#1.1.3d, performances of urban facilities #1.1.4e, BGMEA#1.1.5c, IUD service of SACMO and FWV# 1.1.6d, NGO #1.1.8c, OGSB # 1.2.1d, QA and FP compliance#1.2.2f and #1.2.2o Linked with IR Team2 Shushilan #2.3.1.a,
IEC/BCC materials # 2.1.1.e, RHSPO
#2.1.2.b, Workplace #2.1.3a, BGMEA #
2.1.3.h, BRAC # 2.3.2.a, YPSA# 2.3.3.a
Done Done Done
1.8c-i Share findings with IR teams. X X X X
one one
D D Quarter-wise Narrative Description of Activity Q1. Task 1.8a: Analyzed Upazila level MIS data of those Upazilas where bottom-up contraceptive projection orientations had been held. The findings revealed that the bottom up contraception projection orientation have positive impact on increasing the uptake of LARC/PM. Task # 1.8b: MIS data analysis is going on to compare pre and post “satisfied NSV acceptors’ workshop” findings and performance. Findings will be shared soon. Task # 1.8c: Periodically data of sub-awardees shared with relevant teams for decision making. Q2. Task # 1.8c: • MIS data was analyzed for different types of internal decision making at the request of IR Team 1, 2, and 3 such as IR Team 1 used the data of performance trend of different activities, performance PPFP, performance of RTMI, IUD performance by SACMO, injectable performance of BRAC, training and event information of MFSTC, IR Team 3 used the data of LARC and PM performance of DGFP, CAR data of 17 districts, number of community clinics by upazilas, number of delivery disaggregated by NVD, C-section types. • Periodically data and some analysis of sub-awardees and partner NGOs shared with relevant teams for decision making. • Analyzed PPFF data and shared with IR team1, based on the findings the team has planned to provide training at all Sadar Upazilas and data will be collected from those upazilas form MIS data of DGFP.
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• Specific activity wise progress analysis done and shared with IR teams. Q3. Q4. Activity 1.9 ACTIVITIES FULFILLING ENGENDERHEALTH HQ REQUIREMENTS According to EH HQ requirements ME&R team prepare EngenderHealth Global organizational indicators update which they do annually. Prepare the semi- annual portfolio review report and quarterly Country projects updates Partners/Collaboration NA POC Shahana Rahman/ Liaquat Ali Implementation Time Quarterly Achievement of Inter-Team Task Description Frame Benchmark/Deliverables Benchmark/Deliverables Task # Collaboration Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 1.9a Compile, analyze and submit MH-II X Updated annual N/A N/A project annual data on selected indictors of standardized organizational annual standardized organizational indictors project data indictors Implementation Time Quarterly Achievement of Inter-Team Task Description Frame Benchmark/Deliverables Benchmark/Deliverables Task # Collaboration Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4
1.9b Compile information for Semi-annual X X Two Semi-annual portfolio
portfolio review report and submit to EH reports for
HQ
report
1 submitted N/A this quarter
1.9c Country projects updates (quarterly) X X X X Four Country projects
updates reports
report report
1 submitted 1 submitted Quarter-wise Narrative Description of Activity Q1. Task # 1.9b The semi-annual portfolio review report and the PowerPoint presentation for the time period of April to September, 2015 prepared and submit to EH HQ. Task # 1.9c: In addition to that quarterly country projects’ updates for the months of April to June submitted to EH HQ.
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Q2. Task # 1.9c: Prepared quarterly country projects’ updates for the months of July to December, 2016 and submitted to EH HQ. Q3 Q4 Activity Data Management
Activity 2.1 UPDATE MH-II MIS DATABASE
This is a regular monthly activity to incorporate the MH-II accomplishments reported from program staff, partners, NGOs and private sectors through an efficient web-based data input and output system. For sub-awarded projects data collect in the standard format prepared by ME&R team.
Partners/Collaboration NA POC Saiful Hasan 2.1a Collect data from/ data entry by program X X X X Updated MH-II database
staff, partners, NGOs and staff of private
sectors through web-based input output
system
Done Done Done Implementation Time Quarterly Achievement of Inter-Team Task # Task Description Frame Benchmark/Deliverables Benchmark/Deliverables Collaboration
Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4
2.1a-i Data cleaning, error checking X X X X
Done Done Done
2.1a-ii Update database routinely X X X X
Done Done Done
2.1a-iii Trouble shooting of new database X X X X
N/A N/A
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2.1a-iv Refresher training on new web-based X
system
For IR 1 ForIR Q1 in Done
2.1a-v Update and maintenance of web-based data
system (i.e software update, equipment) as
and required
N/A N/A 2.1b Data Management of sub-awarded X X X X
projects: Collect sub-awarded projects data
in the standard format prepared by ME&R
team and analyze these
Done Done
2.1b-i Update data base regularly X X X X Updated database
Done Done
2.1b-ii Update Performance data tracking table X X X X Updated tracking table
quarterly for internal monitoring
Updated Updated Updated Quarter-wise Narrative Description of Activity Q1. Task # 2.1a: Routinely data collected from program staff, partners, NGOs and staff of private sectors. Task # 2.1a-v: Pilot basis data entry in web-based data system has been started. Task # 2.1a-iv: Refresher training on new web-based system was conducted for IR team 1 Task # 2.1b-i: Collected quarterly data of sub-awarded projects in the standard format prepared by ME&R team, checked the data and recommended for corrections where necessary; and analyzed those data for decision making. Task # 2.1b-ii: Updated program performance data tracking table for Q4 and annual performance data tracking table for PY2. Program performance data tracking table for Q1 of PY2 is underway. Q2. Task # 2.1a: Routinely data collected from program staff, partners, NGOs and staff of private sectors.
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Task # 2.1a-v: Pilot basis data entry in web-based data system is continuing. Previous years back lock data will be uploaded in the web-system soon. Task # 2.1b-i: Collected quarterly data of sub-awarded projects in the standard format prepared by ME&R team, checked the data and recommended for corrections where necessary; and analyzed those data for decision making. Task # 2.1b-ii: Updated program performance data tracking table for Q1 performance data tracking table for PY3 and Program performance data tracking table for Q2 of PY3 is underway. Q3 Q4 Activity # 2.2 UPDATE USAID TRAINET ONLINE DATABASE ON TRAINING INFORMATION
This is a regular monthly activity intended to update MH-II training information every month to the USAID TraiNet. Partners/Collaboration NA POC Rajatangshu Saha Implementation Time Quarterly Achievement of Inter-Team Task # Task Description Frame Benchmark/Deliverables Benchmark/Deliverables Collaboration
Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4
2.2a Identify training events and relevant X X X X
information from MH-II database
Done Done Done
Implementation Time Quarterly Achievement of Inter-Team Task Description Frame Benchmark/Deliverables Benchmark/Deliverables Task # Collaboration
Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4
2.2b Compile training information according to X X X X
TraiNet need
Done Done Done
2.3c Upload training information on the TraiNet X X X X
online input system
Done Done Done
2.2d Prepare summary training report from the X X X X Four summary reports
TraiNet database and submit to USAID/D
report report report
submitted submitted 1 1 1
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Quarter-wise Narrative Description of Activity Q1. Task # 2.2a: Identified training events of IR teams 1, 2 & 3. Task # 2.2c: Uploaded Q4 of PY2 training information on the TraiNet online input system and Q1 of PY3 training information uploading is in process. Task # 2.2d: Prepared Q4 of PY2 summary training report from the TraiNet database and submitted to USAID/Dhaka. Q2. Task # 2.2a: Identified training events of IR teams 1, 2 & 3. Task # 2.2c: Uploaded Q1 of PY3 training information on the TraiNet online input system and Q2 of PY3 training information uploading is in process. Task # 2.2d: Prepared Q1 of PY3 summary training report from the TraiNet database and submitted to USAID/Dhaka. Q3. Q4.
Activity TA/Collaborative activities
Activity 3.1 MAINTAIN LIAISON WITH DGFP FOR GATHERING NATIONAL MIS SERVICE STATISTICS AND PROVIDING FEEDBACKS This activity describes the liaison with DGFP to through providing TA in checking the online MIS data and provides feedbacks to the DGFP. Partners/Collaboration NA POC Saiful Hasan Implementation Time Quarterly Achievement of Inter-Team Task Description Frame Benchmark/Deliverables Benchmark/Deliverables Task # Collaboration Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4
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3.1a Check DGFP online MIS data consistency X X X X
and provide feedback to DGFP
Done Done Done
3.1b Gather FP service statistics from the online X X X X FP service statistics
database of DGFP available
Done Done
3.1c Store gathered FP service data in the MH- X X X X
II data input system
Done Done Done Quarter-wise Narrative Description of Activity Q1. Task # 3.1a-3.1c: ME&R team checked and verified MIS data of DGFP for the months of August to October 2015 including calculation of service data and data consistency. The ME&R team stored/ gathered FP service data in the MH-II data input system for the month of August to October, 2015. Service statistics data of LARC, PM and injectable analyzed for various purposes, such as CYP calculation as well as to observe LARC and PM trends, and shared these with IR teams. Q2. Task # 3.1a-3.1c: ME&R team checked and verified MIS data from the DGFP for the months of November to December 2015 including calculation of service data and data consistency. The ME&R team stored/ gathered FP service data in the MH-II data input system for the months of November to December, 2015. Service statistics data of LARC, PM and injectable analyzed for various purposes, such as CYP calculation as well as to observe LARC and PM trends, and shared these with IR teams. Q3. Q4.
Activity 3.2 TA/COLLABORATIVE SUPPORT TO IR TEAMS Partners/Collaboration NA POC Shahana Rahman / Liaquat Ali Implementation Time Quarterly Achievement of Inter-Team Task Description Frame Benchmark/Deliverables Benchmark/Deliverables Task # Collaboration Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 3.2a Provide support to develop M&E plan IR Team 1, 2 and X X X X 10 M&E plans developed 1 1 3 for different important Mukti (Linked with IR Team 2 activities: activities of the Workplan RHSOP # 2.1.2.b, lessons learned from
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RHSOP # 2.1.2d, YPSA #2.3.4a, Mukti #2.3.4b, District based NGOs#2.3.4c, ICT NGOs#2.3.4e Linked with IR Team 3: MAB #3.1.3.c, BSR # 3.1.5d, BERDO# 3.1.5.e, NGOs working at workplaces #3.1.5.f, YMC scale up 3.2.3a) 3.2b Provide support to develop tools for IR Team 1, 2 and X X X X 10 monitoring tools 3 1 monitoring and other TA 3 developed/adapted Mukti (Linked with IR Team1 activity #PPFP #1.1.2a, IR Team 2 IEC/BCC# 2.1.1.f, Workplace, BGEAM #2.1.3h, IR Team 3 mapping # 3.1.1c, data analysis for advocacy # 3.1.1.e, Advocacy on LARC/PM monitoring --- pilot#3.1.4.a, Reality check # 3.1.7.b, changed policy # 3.2.2.a and 3.2.2b (include a session in trip report), case studies # 3.2.4.b and best practices # 3.2.5.a) Quarter-wise Narrative Description of Activity Q1. Task # 3.2a: M&E plan developed: • In Q1 of PY3ME&R team prepared the M&E plan for BSR. Task # 3.2b: Developed monitoring tools and TA to IR teams: • ME&R team has also conducted training on data recording and reporting system of the participants from the partner NGOs of BSR. • Prepared standard formats for community level data collection tools for PSTC and provided training on data recording and reporting. • Developed checklists for interview the Managers, FPI and FWA to assess the implementation of client segmentation and bottom-up contraception projection
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activities. • Visited Bogra districts to train and assist two QA and Compliance officers on data recording system of QA and Compliance visit checklist. • A comprehensive follow-up check list has been developed which includes all IR teams relevant follow-up check lists. • Provided technical assistance to IR team 3 to develop check list for changed/ modified policies. To monitor the implementation of changed/ modified policies approved through the initiative of EHB. These two tools have been attached as a part of comprehensive monitoring for any staff who will conduct field visit for any activities/purpose. • Three monitoring visit has been conducted by ME&R team on material distribution and implementation of changed/modified policies at Family Planning Office of Shibganj upazila of Bogra district, Mithapukur upazila, Pirganj upazila of Rangpur district on 29 to 30 December, 2015. Q2. Task #3.2a: M&E plan developed: • In Q1 of PY3ME&R team prepared the M&E plan for Mukti. Task # 3.2b: Developed monitoring tools and TA to IR teams: • A tool has been developed to assess the proper use of BCC materials which are distributed in GOB facilities for data collection. • Reviewed the reporting tools of BRAC, and suggested to revise the format of monthly compiled report of ShathoKormi (field level worker) as the reporting format is very complicated. BRAC has revised this and send to us for review. • Visited Shushilan a sub-awadee to observe the activities of ‘Pot song’ for preparing an assessment plan, the ME&R team will develop this soon. • Two monitoring visits have conducted by ME&R team on material distribution and use in Rangunia upazila FP office and Kachui FWC of Patiya upazila. In total with other activities ME&R team conducted materials distribution monitoring by using a checklist developed by MH-II in 12 facilities. • Compiled the data of materials distribution follow-up through phone call. • Complied and analysis the data of materials distribution and use. Q3 Q4 Activity 3.3 KNOWLEDGE MANAGEMENT (KM)
The purpose of creating KM to leverage knowledge, evidence, and experience to improve performance and program results and better fulfill our goal.
Partners/Collaboration EngenderHealth HQ POC Shahana Rahman
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Implementation Time Quarterly Achievement of Inter-Team Task Description Frame Benchmark/Deliverables Benchmark/Deliverables Task # Collaboration Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 3.3a Develop and finalize Knowledge X A KM plan developed which would be utilized Management (KM) plan way
internally and externally under
3.3b Share with EH HQ X Not yet Not
3.3c Assist IR teams in documentation and use X X X A KM system
of KM documents. Not yet Not Quarter-wise Narrative Description of Activity Q1. Task # 3.3.a: A meeting of KM team was held on the 15th November 2015 regarding the outline of EHB KM plan. The KM team discussed the internet and external KM plan with Program Associate, Knowledge Management of EH HQ in a skype meeting. The draft out line of KM with EH HQ. In consultation with HQ it was decided that a consultant will be involved for developing plan and implementing the Knowledge Management. The recruitment process is underway. Q2. Task # 3.3.a: KM consultant was recruited in mid-January 2016. A Skype meeting was conducted on 21 January with Christopher Lindahl, Senior Program Associate, Knowledge Management and Caitlin Shannon, Director, Knowledge Management, Monitoring, Evaluation and Research from HQ, KM team from EHB and KM consultant. The consultant shared a draft outline of the Knowledge Management plan and KM framework on pipeline products with the KM team in the meeting. The KM members have provided their comments. The KM plan is now being finalized. Q3. Q4. Activity 3.4 PROVIDE TECHNICAL ASSISTANCE FOR GENDER SENSITIVE APPROACHES IN MH-II PROGRAM
This activity is to strengthen the integration of gender in EHB programs and for promoting gender equitable staff dynamics and attitudes. A Gender Focal Team (GFT) has been formed to look after the gender issues in EHB. A session on gender will be included in all trainings or orientations of service providers, if the duration of the training more than two days.
Partners/Collaboration EngenderHealth Global Technical Support Team POC Shahana Rahman
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Implementation Time Quarterly Achievement of Inter-Team Task Description Frame Benchmark/Deliverables Benchmark/Deliverables Task # Collaboration Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 3.4a Organize quarterly Gender Focal Team GFT X X X X Meeting minutes 1
(GFT) meeting
meeting meeting
1 held 3.4b Monitor whether gender issues are X X X X Done included in all trainings /orientations (if the duration of the training more than two days) and Monitor gender indicator regularly and feedback to IR teams. 3.4c Gender training for the relevant staff of all IR Team 1, 2 and X Training report Done sub awardee projects and other gender 3 issues related activities Quarter-wise Narrative Description of Activity Q1. Task # 3.4a: Gender orientation training integrated into technical providers’ trainings, in all trainings if the duration of the training more than two days. Collecting pre-post test result of the participants of gender training for monitoring the gender indicator. Task # 3.4c: Gender training for sub awardees will be held soon. Q2. Task # 3.4a: A gender focal team members meeting has been conducted. It was decided that the gender training module developed by the Senior Program Associate Gender/Men As Partners, EH NY will be translated in Bangla as per the training module which was translated in Bangla. Task # 3.4c: According to the plan a gender orientation was held on 4th February, 2016 for the IR1 team members who are conducting training for service providers. After this orientation in all service providers’ trainings ‘Orientation on basic gender issues’ started by the IR1 (training) team members. In this quarter total 78 participants have received the training. In this orientation we have used the gender training module developed by Senior Program Associate Gender/Men As Partners, EH NY. The purpose of this orientation is to increase the awareness of the service providers to provide gender sensitive services. Pre and post test have administrated during the training and the result shows that 93% participants achieved more than 80% number in the post test. Q3 Q4
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Activity Research and Evaluation
Activity 4.1 EXPLORING MENSTRUAL BLEEDING AMONG INJECTABLE CONTRACEPTIVE USERS, AND DISCONTINUERS: AN ONGOING EXPLORATORY STUDY
Partners/Collaboration Population Council and EngenderHealth Global ME&R Team POC Shahana Rahman/ Mahabub Anwar Implementation Time Quarterly Achievement of Inter-Team Task Description Frame Benchmark/Deliverables Benchmark/Deliverables Task # Collaboration Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4
4.1a X
Data collection
Completed Completed
4.1b X
Data review, transcription, & translation
Done Done
4.1c X X Qualitative data available
Data analysis
Analysis Analysis ongoing 12 FGD Implementation Time Quarterly Achievement of Inter-Team Task Description Frame Benchmark/Deliverables Benchmark/Deliverables Task # Collaboration Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4
4.1d Report writing X A study report
Underway Underway
4.1e X PowerPoint presentation Dissemination of findings with key
stakeholders Not yet yet Not
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4.1f Incorporate counseling messages for IR team 1 training sessions and training materials for service providers
4.1g An updated counseling information guide IR team 1 and 3 circulated to all providers through DGFP Quarter-wise Narrative Description of Activity Q1. Task # 4.1a: 12 FGDs have been conducted; from two districts Lalmonirhat and Netrokona. In each district two FGDs with injectable users, two FGDs with discontinuers and two FGDs with service providers. Task # 4.1b, 4.1c and 4.1d: Transcription and translation in English of these FGDs have been completed. Report writing is underway. Q2. Task # 4.1d: The report writing is underway. The report will be completed in next quarter. Q3. Q4.
Activity 4.2 EXAMINING THE UNMET NEED BY AGE, PARITY AND DIVISION TO IDENTIFY LARC AND PM PROGRAMMING GAPS
Secondary data of BDHS 2014 will be used for this purpose. Partners/Collaboration Population Council and EH Global ME&R Team POC Shahana Rahman/ Mahabub Anwar Implementation Time Quarterly Achievement of Inter-Team Task Description Frame Benchmark/Deliverables Benchmark/Deliverables Task # Collaboration Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 4.2a Prepare concept note X Concept note developed N/A 4.2b Collect secondary data from NIPORT, X Secondary data available N/A MEASURE DHS and BDHS etc. 4.2c Data analysis and Report writing X A study report N/A
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4.2d Develop intervention based on the X Intervention developed N/A secondary analysis findings 4.2e Coordinate with other IR teams to X N/A implement the intervention 4.2f Share findings with relevant stakeholders X Policy brief N/A Quarter-wise Narrative Description of Activity Q1. Not applicable for this quarter. Q2. Not applicable for this quarter. Q3. Q4.
Activity 4.3: EXPLORING PROVIDERS’ PERCEPTIONS ON DISCONTINUATION OF LARC TO IDENTIFY PROGRAMMING GAPS Secondary data will be used; and FGD and in-depth interview with service providers will be conducted for this study. Another organization is conducting a study on exploring the clients perception
Partners/Collaboration Population Council and EH Global ME&R Team POC Shahana Rahman/ Mahabub Anwar
Implementation Time Quarterly Achievement of Inter-Team Task Description Frame Benchmark/Deliverables Benchmark/Deliverables Task # Collaboration Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4
4.3a X X
Prepare concept note
Draft Draft concep tnote
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Implementation Time Quarterly Achievement of Inter-Team Task Description Frame Benchmark/Deliverables Benchmark/Deliverables Task # Collaboration Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4
4.3b X Collect secondary data from NIPORT,
MEASURE DHS and BDHS etc.
On On going
4.3c X X
Literature review and data analysis Not yet yet Not
4.3d
Develop proposal following E&R SOP of
EH Not yet Not 4.3e Get EH HQ, USAID and Ethical approval N/A 4.3f Conduct FGD/in-depth interview with X N/A service providers. 4.3g Data analysis and report writing X A study report N/A 4.3h Develop intervention/s based on secondary X Intervention/s developed N/A analysis findings 4.3i Coordinate with other IR teams to X N/A implement intervention/s 4.3j Share findings with relevant stakeholders X Policy brief N/A Quarter-wise Narrative Description of Activity Q1. Task # 4.3a: A concept note developed. Q2. Task # 4.3a: The concept note will be reviewed internally and send HQ for their review. Q3. Q4.
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Appendix 2: Indicator Tracking Table MH-II Indicator Tracking Table USAID Standard Indicators and Project Required Indicator
PY1 (FY 2014) PY2 (FY 2015) PY3 (FY 2016) SL Program Elements/ Indicator # Achievement Achieveme Achievem Achievement Annual Achievem Achievement Annual Achieveme Achievement Annual Q1, nt Q2, Jan ent of Q2 (Oct15- Target ent in % Target nt in % Target Oct 01-Dec31, 1 -Mar 31, in % Mar16) 2015 2016 Project Objective: Increased use of effective family planning (FP) and reproductive health (RH) services F:3 Couple years protection (CYP) in sites 3,676,131 2,350,857 64% 3,734,491 3,560,984 95% 5,271,489 983,165 1,087,064 82% 2,055,846 .1.7 supported by MH-II project .1 Method Implant CYP 460,775 240,294 52% 516,490 620,663 120% 1,029,080 205,070 222,344 426,104 86% IUD 529,526 340,911 64% 427,776 825,751 193% 1,167,764 225,754 245,139 84% 465,065 Tuectomy 1,091,569 451,012 41% 1,174,642 1,023,945 87% 1,643,700 277,251 267,995 65% 534,027 NSV 1,321,220 502,462 38% 1,389,679 850,447 61% 1,128,513 205,391 220,428 78% 424,398 Injectable 273,040 816,178 299% 225,904 240,179 106% 302,432 69,699 131,159 173% 206,252 IR1: Effective and high quality FP services delivered nationwide F:3 % of USG-assisted service delivery .1.7 sites providing family planning (FP) 1,273 1,777 140% 2,473 3,314 134% 3,642 2,534 998 110% 3,532 .1-3 counseling and services Type of DGFP 1,114 1,680 2,252 2,961 131% 3,228 110% 889 110% 3,241 Public sites DGHS 31 33 56 78 139% 81 15% 3 15% 32 NGO 110 43 130 213 164% 242 157% 95 157% 226 NGO/ Private Privat 18 21 35 62 177% 91 11 e 48% 48% 33 Cu # of injectable, LARC and PMs sto provided by mobile team/TA in public, 29,250 18,247 62% 122,746 111,885 91% 127,977 31,303 25,588 80% 56,891 m # NGO and private sectors sites 2 supported by USG fund Method Impla 7,000 8,103 116% 15,900 59,343 373% 73,953 16,418 13,349 72% 29,767 nt IUD 2,650 1,207 46% 3,854 7,039 253% 8,646 3,015 2,433 113% 5,448 Tubectomy 7,100 1,394 20% 9,432 10,509 170% 12,954 3,747 1,827 56% 5,574
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PY1 (FY 2014) PY2 (FY 2015) PY3 (FY 2016) SL Program Elements/ Indicator # Achievement Achieveme Achievem Achievement Annual Achievem Achievement Annual Achieveme Achievement Annual Q1, nt Q2, Jan ent of Q2 (Oct15- Target ent in % Target nt in % Target Oct 01-Dec31, 1 -Mar 31, in % Mar16) 2015 2016 NSV 4,000 2,797 70% 15,000 15,884 106% 20,025 3,011 2,258 45% 5,269 Injectable 8,500 4,746 56% 78,560 10,911 14% 12,399 5,112 5,721 185% 10,833 RTMI Impla 1,181 2,217 188% 6,099 39,856 653% 4,8063 11,877 8,414 70% 20,291 Service by nt Method IUD 600 47 8% 3,100 2,865 92% 3,776 926 1,218 129% 2,144 Tubectomy 1,991 300 15% 5,306 7,207 136% 8,814 1,804 941 43% 2,745 NSV 1,989 394 20% 10,281 9,482 92% 11,031 2,494 1,751 63% 4,245 Injectable 1,000 122 12% 1,860 1,388 75% 2,060 765 1,034 201% 1,799 MH-II Impla 5,819 5,886 101% 9,801 19,487 199% 25,890 4,541 4,935 76% 9,476 assisted nt service by IUD 2,050 1,160 57% 754 4,174 914% 4,870 2,089 1,215 100% 3,304 Method Tubectomy 5,109 1,094 21% 4,126 3,302 213% 4,140 1,943 886 86% 2,829 NSV 2,011 2,403 119% 4,720 6,402 136% 8,994 517 507 23% 1,024 Injectable 7,500 4,624 62% 76,700 9,523 12% 10,339 4,347 4,687 181% 9,034 Cu # of clients who adopted postpartum sto family planning (PPFP) methods 6,465 3,208 50% 8,810 6,976 79% 15,010 2,772 3,625 97% 6,397 m # (within 48 hours) 3 PPFP-Tubecomy 5,726 2,076 36% 6,510 4,370 67% 11,844 2,310 2,968 79% 5,278 PPFP-IUD 739 1,132 153% 2,300 2,606 113% 3,166 462 657 83% 1,119 Sub-IR 1.1: Capacity of public and private sector service providers to provide LARCs and PMs increased Cu # of providers receive training/or on- sto the-job training, orientation or 7,784 9,039 116% 13,484 19,206 142% 15,009 5,843 8,068 215% 13,911 m # mentoring with USG fund 5 Sex Number of Women 6,148 6,820 111% 10,518 13,859 132% 10,656 4,171 5,813 218% 9,984 Number of Men 1,636 2,219 136% 2,966 5,347 180% 4,353 1,672 2,255 207% 3,927 Cadre of Medical & Paramedical 536 807 692 975 1,667 trainees Sex Number of Women 493 731 583 875 1,458 Number of Men 43 76 109 100 209 Others 8,503 18,399 5,151 7,093 12,244 Number of Women 6,327 13,128 3,588 4,938 8,526 Number of Men 2,176 5,271 1,563 2,155 3,718 Cu % of MH-II trained service providers 85% 85% 99.52% 85% 92% 92% 85% 73% 73% 86% 73%
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PY1 (FY 2014) PY2 (FY 2015) PY3 (FY 2016) SL Program Elements/ Indicator # Achievement Achieveme Achievem Achievement Annual Achievem Achievement Annual Achieveme Achievement Annual Q1, nt Q2, Jan ent of Q2 (Oct15- Target ent in % Target nt in % Target Oct 01-Dec31, 1 -Mar 31, in % Mar16) 2015 2016 sto who performed at the national standard m # in the past year 6 Cu # of service providers trained at sto regional training center established by 200 0 0% 180 88 49% 192 58 104 217% 162 m # 7 SUG fund Proportion of service providers who GN report increased clear understanding on DR 6,148 0 0% 10,518 0 0% 432 10 88 81% 98 -3 gender after the USG supported training Sex Number of Women 699 0 0% 1,196 0 0% 307 10 79 103% 89 Number of Men 5,449 0 0% 9,322 0 0% 125 0 9 29% 9 Clear understanding on gender after the USG supported training 90% 98% 93% 103% 96% Sub-IR 1.2: Training, support, and performance improvement mechanisms institutionalized Cu # of supported sites that received at sto least one supervisory visit within the 226 199 88% 300 210 70% 210 89 67 128% 156 m # past year 8 Public DGFP 158 195 87 64 151 DGHS 20 - - NGO & NGO 14 13 2 2 Private Private 7 2 3 3 IR2: Demand for FP services, especially LARCs and PMs increased Sub-IR 2.1: Communication strategies promoting social norms for delaying, spacing, and limiting implemented Cu sto # of communication materials 10 13 130% 7 9 129% 15 8 3 80% 11 m # developed/updated by MH-II project 11a Cu sto # of communication materials 1,881,800 1,919,569 102% 3,449,727 5,046,076 146% 11,314,604 527,786 1,785,082 63% 2,312,868 m # distributed by MH-II project 11b Sub-IR 2.2: Accurate knowledge of FP, especially LARCs and PMs, increased among community leaders, families, and clients Sub-IR 2.3: Client identification and referrals increased through community-facility links
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PY1 (FY 2014) PY2 (FY 2015) PY3 (FY 2016) SL Program Elements/ Indicator # Achievement Achieveme Achievem Achievement Annual Achievem Achievement Annual Achieveme Achievement Annual Q1, nt Q2, Jan ent of Q2 (Oct15- Target ent in % Target nt in % Target Oct 01-Dec31, 1 -Mar 31, in % Mar16) 2015 2016 IR3: Supportive enabling environment advances access to LARCs, PMs and other FP/RH services Cu # of organizations/agencies including sto other ministries that incorporate FP m # messages and activities into their 5 7 i 140% 1 - 0% 2 - 1 ii 200% 1 15 training programs, and the nature of the work Sub-IR 3.1: Key policy barriers to LARCs and PM removed Cu # of policies and guidelines related to sto injectable, LARC & PMs updated, 2 4 200% 2 2 100% 1 - 2 200% 2 m # adopted or revised through USG 16 support and nature of changes Sub-IR 3.2: National standards, guidelines, curricula, and policies and implemented by personnel at teaching institutions and service delivery points Cu # of training regulatory bodies/training sto institutions that introduce or update m # pre-service and continuing medical 1 1 iii 100% 1 1 iv 100% 1 0 0 0% 0 17 education curriculum to include training on injectable, LARC & PMs, and the nature of the changes
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Appendix 3: Findings from QA and FP Compliance Monitoring Visit
PY3-Q2 (January-March 2016) • Total number of facilities visited was 72 (10 MCWCs, 59 UHCs, and 3 NGO clinics) in 25 Districts. Among these, 58 were first time visits (10 MCWCs, 45 UHCs, and 3 NGO clinics) and 14 were follow-up visits (14 UHCs). Eleven (11) visits were joint visits with the Regional Supervisor, FPCST/QAT of the DGFP of different regions and DDFP of different Districts. • During the follow-up visits in the 14 facilities it was observed that some changes or improvements occurred according to the recommendations and suggestions provided by the Sr. QA and FP Compliance Officers during the first visit. These are a) Tiahrt chart hanged in the proper place and are being used during counseling, b) Counseling clients individually rather than in a group maintaining auditory privacy and confidentiality, c) Counseling job-aids are now being used during counseling, d) All of the sections of the consent forms for VSC, Implant and IUD are now being properly filled, e) IUD insertions are being done following standard technique in accordance with the flow-chart supplied by MH-II, and in most of the facilities IUD services are provided in the Operation Theatre (OT) room instead of a space behind the Almirah in FWV’s room, f) Materials for IP practice has been procured and now available in the facilities g) Emergency drugs has been procured and are kept in the Emergency tray. Some of the identified gaps could not resolved due to inability of the local UH&FPO such as a) inability to provide extra room for counseling purposes due to shortage of room and expansion of health services, and b) Post of MO (MCH-FP) is vacant in some UHCs, and c) lack of supervision and monitoring and in some facilities. • No evidence found regarding method specific numbers or targets imposed on individual providers or referral agents in any of the 72 facilities visited. These were ascertained through observing whether any chart hung up in the wall and through interviewing the FP managers. • No incentives were found to be provided to clients or providers at any of the visited health facilities. The standard GOB-approved reimbursements to LARC and PM clients for travel costs, food and wage loss were provided according to GOB rules and regulations. These were ascertained through discussion with the FP managers and interviewing those referring clients. • Comprehensive FP wall charts (Tiahrt charts) were displayed and visible to FWVs and clients in either the waiting or counseling room at 59 out of the 72 facilities visited. In the remaining 12 facilities, the Tiahrt chart was hung on a distant wall and was not easily visible by FWVs or the clients. To resolve this issue, the Sr. QA and FP Compliance Officers conducting the visit moved the Tiahrt chart to a more visible wall location. • Client IEC materials and counseling job aids were available at all 72 facilities visited.
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• All FP methods are available at 69 of the facilities visited. VSC, implant and IUD services are not being provided in 3 facilities (3 NGO clinics they only provide short acting FP methods). However, referrals are made to the Upazilla Health Complexes for the services they do not provide. • Consent forms for VSC, IUD, and implant services were found to be properly filled-up and the client’s signature/thumb impression and the surgeon’s/provider’s signature were found in proper places on the form at the 69 facilities visited that do provide these services. In 16 of these 69 facilities, pre-procedure vital signs, procedure notes and post procedure vital sign records were not completed. When sharing findings from compliance visits with the FWVs and FP Managers, MH-II staff addressed this issue and FWVs agreed to fill-in consent forms properly in the future. Compliance with this agreement will be assessed during the next site visit. • Separate space for FP counseling and screening to maintain client privacy and confidentiality was not available in 51 facilities visited. MH-II Sr. QA and FP Compliance Officers discussed this issue with the UFPO and MO (MCH-FP). It was agreed that these facilities would install a curtain around the FWVs siting area to ensure that at least visual privacy is maintained. This will be followed up. • A separate space/room for IUD insertion was not available in 23 facilities visited. MH-II Sr. QA and FP Compliance Officers discussed this issue with the UFPO and MO (MCH-FP) about the importance of identifying a separate space/room for IUD insertion to ensure client privacy and confidentiality and requested that they use the existing Operation Theater (OT) for this service in the future. After a successful advocacy by the Sr. QA and FP Compliance Officers, in three Districts (Rajshahi, Bogra and Sirajgonj) the respective DDFP issued a circular to the Upazila FP managers under their jurisdiction regarding utilization of OT for IUD insertion. So, 29 UHCs of these three districts are utilizing OT for IUD insertion. • Approximately 80% of the facilities visited had a functional spotlight for use during IUD insertion, a functional OT light, a functional suction machine (to suck secretions from the nostrils and throat in case the patient having breathing problem), and IP materials. In the remaining 20% of the facilities the above mentioned equipment’s are not functioning. This issue was also discussed with the UFPO and MO (MCH-FP) to ensure the availability of this required equipment by requesting for supplies to the Supply Officer, Regional Ware House (RWH). This will be followed up. • In approximately one-sixth of the facilities visited, drugs for managing emergencies were not available. Again, this issue was discussed with the UFPO and MO (MCH-FP) to ensure that required emergency medicine is procured locally according to the circular from the CCSDP Unit of the DGFP. This will be followed up. • Steps for IUD insertion and removal were not followed in 11 facilities visited. Sr. QA and FP Compliance Officers demonstrated the proper steps for IUD insertion using a pelvic model and requested that the MO (MCH-FP) monitor the steps of IUD insertion going forward. This will be followed up.
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• Some IP practices were not followed in 16 facilities visited. The Sr. QA and FP Compliance Officers provided hands-on coaching on all IP practices and requested that FP Managers monitor IP implementation going forward. This will be followed up.
Appendix 4: Table 1a: Name of Districts and Upazilla coverage with MH-II key Intervention in Q2 Training/ Orientation and Advocacy activities of LARC & PM Training/ Orientation and Advocacy activities of PPFP and Injectable MHII MHII Program District Upazilla Program District Upazilla Year Year PY1 Gazipur Gazipur Sadar PY1 Bogra Bogra Sadar PY1 Kaliakair PY1 Sherpur Moulavi PY1 Bazar Maulvibazar Sadar PY1 Shibganj PY1 Sylhet Balaganj PY1 Dhaka Dhamrai PY1 Jakiganj PY1 Dohar PY1 Sylhet Sadar PY1 Keraniganj PY2 Comilla Laksham PY1 Mirpur PY3 Faridpur Faridpur Sadar PY1 Nawabganj PY3 Feni Feni Sadar PY1 Savar PY3 Khagrachhari Khagrachhari Sadar PY1 Tejgaon PY3 Munshiganj Munshiganj Sadar PY1 Dinajpur Birampur PY3 Rajbari Rajbari Sadar PY1 Birol PY3 Tangail Ghatail PY1 Dinajpur Sadar PY3 Kalihati PY1 Ghoraghat PY3 Mirzapur PY1 Hakimpur
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Training/ Orientation and Advocacy activities of LARC & PM Training/ Orientation and Advocacy activities of PPFP and Injectable MHII MHII Program District Upazilla Program District Upazilla Year Year PY3 Shakhipur PY1 Nawabganj PY3 Tangail Sadar PY1 Gazipur Gazipur Sadar PY3 Narshingdi Narsingdi Sadar PY1 Kaliakair PY3 Feni Feni Sadar PY1 Tongi PY3 Khagrachhari Khagrachhari Sadar PY1 Jessore Bagharpara PY3 Faridpur Faridpur Sadar PY1 Chowgachha PY3 Rajbari Rajbari Sadar PY1 Sharsha PY3 Barguna Amtali PY1 Khulna Dacope PY3 Bamna PY1 Daulatpur/Digholia PY3 Barguna Sadar PY1 Khulna Sadar PY3 Betagi PY1 Koyra PY3 Barguna Patharghata PY1 Lakshmipur Kamalnagar PY3 Barisal Agailjhara PY1 Lakshmipur Sadar PY3 Babuganj PY1 Raipur PY3 Bakerganj PY1 Ramganj PY3 Banaripara PY1 Ramgati PY3 Barisal Sadar PY1 Moulavi Bazar Barlekha PY3 Gournadi PY1 Kulaura PY3 Hizla PY1 Kuluara PY3 Mehendiganj PY1 Maulvibazar Sadar PY3 Muladi PY1 Sreemongal PY3 Uzirpur PY1 Narayanganj Araihazar PY3 Bhola Bhola Sadar PY1 Bandar PY3 Borhanuddin PY1 Fatullah PY3 Charfashion PY1 Goadril PY3 Daulatkhan PY1 Narayanganj Sadar
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Training/ Orientation and Advocacy activities of LARC & PM Training/ Orientation and Advocacy activities of PPFP and Injectable MHII MHII Program District Upazilla Program District Upazilla Year Year PY3 Lalmohan PY1 Rupganj PY3 Monpura PY1 Sonargaon PY3 Tajumuddin PY1 Noakhali Begumganj PY3 Manikganj Daulatpur PY1 Chatkhil PY3 Ghior PY1 Kabirhat PY3 Harirampur PY1 Senbag PY3 Manikganj Sadar PY1 Sonaimuri PY3 Saturia PY1 Subarna Char PY3 Shibalaya PY1 Sudharam (Sadar) PY3 Singair PY1 Panchgarh Atowari PY3 Munshiganj Gazaria PY1 Boda PY3 Lauhajong PY1 Tetulia PY3 Munshiganj Munshiganj Sadar PY1 Rangpur Gangachara PY3 Sirajdikhan PY1 Pirganj PY3 Sreenagar PY1 Rangpur Sadar PY3 Tongibari PY1 Sunamganj Chhatak PY3 Tangail Basail PY1 Jagonathpur PY3 Bhuapur PY1 Jogonnathpur PY3 Delduar PY1 Sunamganj Sadar PY3 Dhanbari PY1 Tahirpur PY3 Ghatail PY1 Sylhet Balaganj PY3 Gopalpur PY1 Biani Bazar PY3 Kalihati PY1 Biswanath PY3 Madhupur PY1 Fenchuganj PY3 Mirzapur PY1 Golapganj PY3 Nagarpur PY1 Jaintapur
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Training/ Orientation and Advocacy activities of LARC & PM Training/ Orientation and Advocacy activities of PPFP and Injectable MHII MHII Program District Upazilla Program District Upazilla Year Year PY3 Shakhipur PY1 Jakiganj PY3 Tangail Sadar PY1 South Shurma PY1 Sylhet Sadar PY1 Thakurgaon Baliadangi PY1 Haripur PY2 Chittagong Anowara PY2 Anwara PY2 Chandanaish PY2 Doublemooring PY2 Fatikchhari PY2 Lohagora PY2 Panchlaish PY2 Patiya PY2 Satkania PY2 Comilla Comilla Sadar PY2 Laksham PY2 Cox's Bazar Chakaria PY2 Cox's Bazar Sadar PY2 Kutubdia PY2 Moheshkhali PY2 Pekua PY2 Ramu PY2 Teknaf PY2 Ukhiya PY2 Habiganj Baniachhong PY2 Chunarughat
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Training/ Orientation and Advocacy activities of LARC & PM Training/ Orientation and Advocacy activities of PPFP and Injectable MHII MHII Program District Upazilla Program District Upazilla Year Year PY2 Nabiganj PY2 Kishoreganj Austagram PY2 Karimganj PY2 Nikli PY2 Kurigram Kurigram Sadar PY2 Rowmari PY2 Rajshahi Bagmara PY2 Poba (Sadar) PY2 Satkhira Asasuni PY2 Debhata PY2 Kaliganj PY2 Kolaroa PY2 Satkhira Sadar PY2 Shyamnagar PY2 Tala PY3 Bandarban Alikadam PY3 Bandarban Sadar PY3 Lama PY3 Naikhongchhari PY3 Rowangchhari PY3 Ruma PY3 Thanchi PY3 Barguna Amtali PY3 Bamna PY3 Barguna Sadar PY3 Betagi
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Training/ Orientation and Advocacy activities of LARC & PM Training/ Orientation and Advocacy activities of PPFP and Injectable MHII MHII Program District Upazilla Program District Upazilla Year Year PY3 Patharghata PY3 Barisal Agailjhara PY3 Babuganj PY3 Bakerganj PY3 Banaripara PY3 Barisal Sadar PY3 Gournadi PY3 Hizla PY3 Mehendiganj PY3 Muladi PY3 Uzirpur PY3 Bhola Bhola Sadar PY3 Borhanuddin PY3 Charfashion PY3 Daulatkhan PY3 Lalmohan PY3 Monpura PY3 Tajumuddin PY3 Brahmanbaria Akhaura PY3 Ashuganj PY3 Bancharampur PY3 Bijoynagar PY3 Brahmanbaria Sadar PY3 Kashba PY3 Nabinagar PY3 Nasirnagar
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Training/ Orientation and Advocacy activities of LARC & PM Training/ Orientation and Advocacy activities of PPFP and Injectable MHII MHII Program District Upazilla Program District Upazilla Year Year PY3 Sarail PY3 Faridpur Alphadanga PY3 Bhanga PY3 Boalmari PY3 Char Bhadrashion PY3 Faridpur Sadar PY3 Modhukhali PY3 Nagarkanda PY3 Sadarpur PY3 Saltha PY3 Feni Chhagalnaiya PY3 Dagonbhuiyan PY3 Feni Sadar PY3 Fulgazi PY3 Parshuram PY3 Sonagazi PY3 Khagrachhari Dighinala PY3 Khagrachhari Sadar PY3 Lakshmichhari PY3 Mahalchhari PY3 Manikchhari PY3 Matiranga PY3 Panchhari PY3 Ramgarh PY3 Manikganj Daulatpur PY3 Ghior
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Training/ Orientation and Advocacy activities of LARC & PM Training/ Orientation and Advocacy activities of PPFP and Injectable MHII MHII Program District Upazilla Program District Upazilla Year Year PY3 Harirampur PY3 Manikganj Sadar PY3 Saturia PY3 Shibalaya PY3 Singair PY3 Munshiganj Gazaria PY3 Lauhajong PY3 Munshiganj Sadar PY3 Serajdikhan PY3 Sirajdikhan PY3 Sreenagar PY3 Tongibari PY3 Rajbari Baliakandi PY3 Goalunda Ghat PY3 Pangsha PY3 Rajbari Sadar PY3 Rangamati Baghaichhari PY3 Barkal PY3 Belaichhari PY3 Jurachhari PY3 Kaptai PY3 Kawkhali PY3 Langadu PY3 Naniarchar PY3 Rajasthali PY3 Rangamati Sadar
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Training/ Orientation and Advocacy activities of LARC & PM Training/ Orientation and Advocacy activities of PPFP and Injectable MHII MHII Program District Upazilla Program District Upazilla Year Year PY3 Tangail Basail PY3 Bhuapur PY3 Delduar PY3 Dhanbari PY3 Dhonbari PY3 Ghatail PY3 Gopalpur PY3 Kalihati PY3 Madhupur PY3 Mirzapur PY3 Modhupur PY3 Nagarpur PY3 Shakhipur PY3 Tangail Sadar PY4 Chuadanga Chuadanga Sadar PY4 Damurhuda PY4 Joypurhat Akkelpur PY4 Joypurhat Sadar PY4 Khetlal PY4 Panchbibi PY4 Magura Magura Sadar PY4 Naogaon Atari PY4 Atrai PY4 Badalgachi PY4 Manda PY4 Mohadevpur
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Training/ Orientation and Advocacy activities of LARC & PM Training/ Orientation and Advocacy activities of PPFP and Injectable MHII MHII Program District Upazilla Program District Upazilla Year Year PY4 Naogaon Sadar PY4 Niamatpur PY4 Patnitala PY4 Porsha PY4 Raninagar PY4 Sapahar PY4 Jhenaidaha Harinakunda PY4 Jhenaidah Sadar PY4 Kaliganj PY4 Kotchandpur PY4 Moheshpur PY4 Sailkupa
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Table 1b: Name of Districts and Upazilla coverage with MH-II key Intervention in Q2 Distribution of IEC/BCC Materials QA & FP Compliance Visit LARC & PM Special Day MHII MHII MHII Program District Upazilla Program District Upazilla Program District Upazilla Year Year Year PY1 Dhaka Mirpur PY1 Bogra Adamdighi PY1 Bogra Dhunot PY1 Tejgaon PY1 Kahaloo PY1 Dupchanchia PY1 Khulna Khulna Sadar PY1 Nandigram PY1 Sariakandi PY1 Rangpur Rangpur Sadar PY1 Shajahanpur PY1 Sonatola PY1 Sylhet Sylhet Sadar PY1 Sherpur PY1 Dhaka Mirpur PY2 Chittagong Doublemooring PY1 Dhaka Mirpur PY1 Tejgaon PY2 Panchlaish PY1 Tejgaon PY1 Tejgoan PY2 Cox's Bazar Cox's Bazar Sadar PY1 Dinajpur Birol PY1 Dinajpur Birganj PY2 Kushtia Kushtia Sadar PY1 Chirir Bandar PY1 Chirir Bandar PY2 Rajshahi Poba (Sadar) PY1 Khanshama PY1 Debiganj PY3 Bandarban Alikadam PY1 Parbatipur PY1 Ghoraghat PY3 Bandarban Sadar PY1 Gaibandha Fulchhari PY1 Hakimpur PY3 Lama PY1 Gaibandha Sadar PY1 Nawabganj PY3 Naikhongchhari PY1 Gobindaganj PY1 Parbatipur PY3 Rowangchhari PY1 Gazipur Kapasia PY1 Ranisankail PY3 Ruma PY1 Gopalganj Gopalganj Sadar PY1 Jessore Bagharpara PY3 Thanchi PY1 Kashiani PY1 Bagherpara PY3 Barisal Agailjhara PY1 Kotalipara PY1 Chowgacha PY3 Babuganj PY1 Muksudpur PY1 Chowgachha PY3 Bakerganj PY1 Tungipara PY1 Jessore Sadar PY3 Banaripara PY1 Jessore Jhikargachha PY1 Jhikargacha PY3 Barisal Sadar PY1 Khulna Fultala PY1 Jhikargachha PY3 Gournadi PY1 Moulavi Kamalganj PY1 Rupsha
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Distribution of IEC/BCC Materials QA & FP Compliance Visit LARC & PM Special Day MHII MHII MHII Program District Upazilla Program District Upazilla Program District Upazilla Year Year Year Bazar PY3 Hizla PY1 Rangpur Badarganj PY1 Sharsha PY3 Mehendiganj PY1 Kaunia PY1 Khulna Batiaghata PY3 Muladi PY1 Mithapukur PY1 Daulatpur/Digholia PY3 Uzirpur PY1 Pirgachha PY1 Digholia PY3 Bhola Bhola Sadar PY1 Sunamganj Bishwamvarpur PY1 Paikgacha PY3 Borhanuddin PY1 Chhatak PY1 Paikgachha PY3 Charfashion PY1 Dherai PY1 Rupsha Moulavi PY3 Daulatkhan PY1 Jamalganj PY1 Bazar Barlekha Sunamganj PY3 Lalmohan PY1 Sadar PY1 Kamalganj PY3 Monpura PY1 Sylhet Biani Bazar PY1 Sreemongal PY3 Tajumuddin PY1 Companiganj PY1 Rangpur Pirgachha PY3 Brahmanbaria Akhaura PY1 Jakiganj PY1 Sunamganj Bishwamvarpur PY3 Ashuganj PY1 Kanaighat PY1 Chhatak PY3 Bancharampur PY1 South Shurma PY1 Dherai Kishoreganj PY3 Bijoynagar PY2 Kishoreganj Sadar PY1 Jogonnathpur Brahmanbaria PY3 Sadar PY2 Kurigram Nageshwari PY1 Sadar (South) PY3 Kashba PY2 Kushtia Khoksa PY1 Sunamganj Sadar PY3 Nabinagar PY2 Mirpur PY1 Sylhet Balaganj PY3 Nasirnagar PY2 Mymensingh Dhubaura PY1 Companiganj PY3 Sarail PY2 Fulbaria PY1 Golapganj PY3 Faridpur Alphadanga PY2 Gouripur PY1 Gowainghat PY3 Bhanga PY2 Haluaghat PY1 Jaintapur
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Distribution of IEC/BCC Materials QA & FP Compliance Visit LARC & PM Special Day MHII MHII MHII Program District Upazilla Program District Upazilla Program District Upazilla Year Year Year PY3 Boalmari PY2 Ishwarganj PY1 Jakiganj PY3 Char Bhadrashion PY2 Muktagacha PY1 South Shurma PY3 Faridpur Sadar PY2 Nandail PY1 Sylhet Sadar PY3 Modhukhali PY2 Phulpur PY1 Thakurgaon Haripur PY3 Sadarpur PY2 Trishal PY1 Ranisankail PY3 Saltha PY2 Natore Natore Sadar PY1 Panchgarh Atowari PY3 Feni Chhagalnaiya PY2 Nilphamari Kishoreganj PY1 Debiganj PY3 Dagonbhuiyan PY2 Rajshahi Bagmara PY1 Tetulia PY3 Feni Sadar PY2 Boalia PY2 Bagerhat Rampal PY3 Fulgazi PY2 Charghat PY2 Habiganj Baniachhong PY3 Parshuram PY2 Poba (Sadar) PY2 Chunarughat PY3 Sonagazi PY3 Barisal Agailjhara PY2 Madhabpur PY3 Khagrachhari Dighinala PY3 Barisal Sadar PY2 Nabiganj PY3 Khagrachhari Sadar PY3 Uzirpur PY2 Kushtia Gangni PY3 Lakshmichhari PY3 Manikganj Manikganj Sadar PY2 Khoksa PY3 Mahalchhari PY4 Chuadanga Jiban Nagar PY2 Kushtia Sadar PY3 Manikchhari PY4 Jhenaidaha Kaliganj PY2 Mirpur PY3 Matiranga PY4 Joypurhat Akkelpur PY2 Mymensingh Dhubaura PY3 Panchhari PY4 Kalai PY2 Ful[ur PY3 Ramgarh PY4 Panchbibi PY2 Fulbaria PY3 Rajbari Baliakandi PY4 Pabna Faridpur PY2 Ishwarganj PY3 Goalunda Ghat PY2 Natore Lalpur PY3 Pangsha PY2 Nilphamari Kishoreganj PY3 Rajbari Sadar PY2 Rajshahi Bagha PY3 Rangamati Baghaichhari PY2 Mohanpur PY3 Barkal PY2 Sirajganj Kamarkhanda PY3 Belaichhari PY2 Kazipur
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Distribution of IEC/BCC Materials QA & FP Compliance Visit LARC & PM Special Day MHII MHII MHII Program District Upazilla Program District Upazilla Program District Upazilla Year Year Year PY3 Jurachhari PY2 Shahzadpur PY3 Kaptai PY3 Brahmanbaria Bijoynagar PY3 Kawkhali PY3 Kashba PY3 Langadu PY3 Rajbari Baliakandi PY3 Naniarchar PY3 Pangsha PY3 Rajasthali PY4 Jhenaidaha Harinakunda PY3 Rangamati Sadar PY4 Jhenaidah Sadar PY4 Kaliganj PY4 Kaligonj PY4 Kotchandpur PY4 Moheshpur PY4 Sailkupa PY4 Magura Sailkupa PY4 Shalikha PY4 Shalitha PY4 Meherpur Gangni PY4 Meherpur Sadar PY4 Pabna Bhangoora PY4 Ishwardi
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