Through the Maternal, Neonatal, and Child Health/Family Planning/Malaria Project (2006 2011), funded by USAID, IntraHealth International trained providers in family planning counseling and provision of contraceptives, encouraged facilities to integrate mother-and-child health services with other reproductive health services, and engaged and educated communities through public campaigns.
This encourages facility attendance during the pregnancy.
They also promote use of clean delivery kits, encourage facility births and immediate newborn care.
Despite decades of efforts to encourage facility births, many women continue to deliver at home.
To encourage facility teams to continue pursuing problems, ZDF and Jhpiego arranged 3-day supportive supervision visits to each facility approximately twice a year.
Practitioners generally reflected positively on this, with CHWs playing an important role in contraceptives provision and community trust-building (e.g. encouraging facility deliveries).
Role modelling critical management practices and using language to signal new meanings First, nurturing the values and moral purpose of PHC staff – encouraging facility managers, for example, 'to dream' about working differently (ISDMT meeting notes, 20th October 2010).
Further, as the communities' fear of EVD deepens and their trust in health providers weakens, women are choosing to deliver away from the health system's reach, potentially reducing gains made in recent years to encourage facility delivery.
Facility administrators must appreciate the added and long-term value of having students in the clinical setting, as their presence encourages facility providers (both staff and preceptors) to keep up-to-date on the science that is the foundation for their clinical practice.
The sub-district managers, therefore, constantly and consistently affirm the importance of patients and the broader population in all their engagements with staff – for example, encouraging facility managers to align broader goals and targets with local priorities, or to respond speedily to patient complaints.
