Strengthening Postpartum Family Planning Services with IUCD Provision in Urban Facilities of Dhanbad, Jharkhand

I appreciated the coaching that the UPHC and UCHC staff and the entire district health team were receiving from TCI as it was making a lot of difference. Infrastructure, equipment, trained providers, uninterrupted FP supplies, and commodities must be ensured and then only the community will accept and acknowledge the services.

Sindri urban primary health center (UPHC) and the Gaushala Sindri urban community health center (UCHC) offered delivery services and temporary family planning methods but not PPIUCDs despite being delivery points.

In a subsequent coaching session, the DUHM with support from the TCI team conducted a deep dive to identify the potential reasons and next steps for getting PPIUCD services into both facilities.

With support from TCI, providers were already receiving training, and the medical officer in charge was considering ways to improve the existing UPHC infrastructure. Because the time was ripe for the facilities to also start offering postpartum family planning services, a plan was presented to the Civil Surgeon (CS) and Dr. Sanjeev Kumar Prasad, DRCHO, in a family planning review meeting in November 2022.

The CS and Prasad both had questions about the readiness of these facilities and the staff, but after a few additional meetings, the DRCHO approved the plan. He then directed the medical officer-in-charge (MOIC) to initiate PPIUCD services immediately and report back to the CS office.

Prasad also wanted to ensure PPIUCD clients received follow-up care and instructed the MOIC and DUHM to seek the support of the district quality assurance team to improve the quality of family planning services.

After PPIUCD services began at the Sindri UPHC and Gausala Sindri UCHC in November and December 2022, HMIS data has since recorded 20 new PPIUCD clients.

An internal review of family planning HMIS data revealed that communities from two urban facilities couldn't avail PPIUCD services because of a lack of trained professionals and community health workers as well as poor UPHC infrastructure.