In addition, free service days  held to mark special days such as abortion day and National family planning day, often run in conjunction with awareness raising campaigns to increase the visibility of the clinics in their local communities. No refusal policy for the vulnerable groups is in place in overall FPAN clinics. The distribution of leaflets, booklets that give information on the safe abortion, family planning methods is important and effective ongoing strategy of demand generation.

Community clinic branding with Hiteshi: distinct identity for stigma-free services in Nepal

Hiteshi, meaning well-wisher. It has Improved community clinics’ branding to ensure women recognize these clinics as stigma-free safe places to receive quality services.

The logo and its mascot, the nurse, was a positive image with which people could easily identify and it gave FPAN a unique visual identity. Following positive feedback and additional input from the community, FPAN decided to build a brand around the logo and rolled it out in 10 of its community clinics and family Health centers

Training 

The staff at clinics continuing in the programme are provided with refresher training to maintain and further build their skills in abortion and contraceptive service provision. Trainings included providing updates on the latest contraceptive technologies focusing on the WHO guidelines for immediate provision of post abortion contraception, improving counselling skills and techniques, refreshing knowledge of infection prevention protocols and ensuring service providers have recent training on MVA and medical abortion provision. Ensuring training for staff continuing in the programme is an important strategy for increasing staff motivation, ensuring quality of care, and improving staff retention. Some of the trainings that were conducted during the project are Value clarification training, Complication management training, Pre/post counselling training, Routine data Quality management training, Infection prevention training, Comprehensive abortion care training, Family planning method training.

Data Capture and Usage

GCACI project initiate the clinical management Information system in all Family Health Center clinics and some in community clinics . These Family health facilities enroll a system known as CMIS to collect client data who visit the clinic for the services. CMIS is an electronic client based clinical management and Information system that allows service sites to collect, store, and analyze client -level data.

The system is based on client data where each has a unique identification number to enable service providers to easily access the client’s history and profile, and provide the best possible care over time. The system improves clinic efficiency by reducing waiting time and by minimizing the number of records and registers. CMIS also prevents stock-outs at clinics by generating alerts when medical products or drugs are below certain stock levels, or are near expiry. Having CMIS data supports performance monitoring, understanding of the gaps and strengths in service provision, and decision-making to ensure that resources are directed towards those who need them most. The system assists providers in making informed decisions about patient care, referral source. Use of the system has not only led to improved quality of care, but has also resulted in better understanding and practice of data utilization to make management decisions at clinics.

Monthly data analysis captured from the CMIS give the clear picture about the performance status of the clinic and find the weakness or the place to improve for the branch and with this help easy for branch manager for making discussion during the staff meeting and also make a strategy or plan to improve in that area

Client Statement

“There are so many positive impacts that have happened because I was able to have a safe medical abortion. I have now been able to give a lot of free time to my two daughters; if I had three children, I would not be able to give them the same level of care. Because I have some free time, I have also been able to start my own business allowing me to be independent and do what I like. Our finances are better, raising two children is better than raising three. Thus, I’ve been able to provide a good education for my two daughters. I am really happy about this.” - Abortion client GLOBAL COMPREHENSIVE ABORTION CARE INITIATIVE (GCACI)

GCACI Achievement 2013-2020

Looking at the data ,  abortions (including MVA,MA and TIA) of GCACI Project of FPAN in 2013 is 7095, in 2014 is 7444, in 2015 7254 , in 2016  is 7392, 2017 is  7135, 2018 is 7722, 2019 is 8237 and 2020 is 5207. The Post abortion uptake in 2013 was 77%, in 2014 was 88%, in 2015 89%, in 2016 89% in 2017 is 75 %, 2018 is 83 %, 2019 is 82 % and 2020 is 86 % . The GCACI project always focusing on providing and making easy access for the women seeking for the Safe abortion reducing the unsafe abortion and as well as the Post abortion contraception in order to reduce or avoid the repeated abortion. This data shows that GCACI has a great impact in over all FPAN abortion progarm. It contributes  more than 50% of abortion services by its 10 clinics in every year. Further analyzing the data, it shows that there is significantly increase in the TIA services in each year. From the year 2016 the government has a free policy of abortion from its health post. This add the big challenge for FPAN performance but still due to our quality services we are providing the remarkable services to the woman seeking abortion services. And in 2020 due Global Pandemic of COVID 19 the whole services were affected by it due to movement restrictions, lockdown and so on. During this time of Pandemic also FPAN services and clinics are open and providing services.