Project Background:

The project “Scaling up Family Planning and Reproductive Health Services in Selected Districts of Nepal (GGR Emergency Fund)” will be implemented from April 2018 to March 2020 for two years. The Global Gag rule grant has a compelling responsibility of fulfillment of the gaps in SRH services brought about by the enforcement of the GAG Rule. Apart, the service gaps, capacity enhancement of health work force and institutional strengthening of community organizations are the pivotal responsibilities, inevitably come along with the fulfillment of SRH services to this grant. In this context, this project envisages to deliver SRH services in 11 districts of Nepal targeting marginalized and disadvantage group including young people, migrants and vulnerable groups for the improvement of their sexual and reproductive health and rights. These 11 districts will be selected for their high rankings on the three criteria, viz, total fertility rate, contraceptive prevalence rate and unmet need for family planning.

Project Location:

11 Districts Province District Province-1 Jhapa, Sunsari Province-2 Dhanusha, Saptari Province-5 Palpa, Kapilvastu, Dang, Banke, Bardia Province-7 Doti, Baitadi

Overall goal

Improved Sexual Reproductive Health and Right of marginalized and disadvantage group including young, migrants and vulnerable groups.

Objectives of the project

• Improved access to quality integrated SRH services and information to marginalized and disadvantage group including young, migrants and vulnerable groups.
• Enhanced clinical skills of service providers including CBD workers making them skillful to provide quality family planning and reproductive health services.
• Improved enabling environment for the integrated SRH services for the marginalized and disadvantage group including young, migrants and vulnerable groups.

Activities:

To meet the goal and objective of the project following activities will be implemented through district branches.

Program Model-1: Community Based Distributions

Community based distribution model of service delivery in one of the low costs programme model. The service statistics of FPAN shows that this model contributes about 30% in the total SRH services. Under this model, the project will mobilize a total of 249 trained community volunteers (RHFVs) and peer educators (PEs) in the community door steps to promote FPRH.

• Reproductive Health Female Volunteers (RHFV) will be mobilize to conduct community sessions for demand generation, and service delivery including referral.
• A total of 99 Peer Educators (9 in each district) will be mobilize to conduct community sessions for demand generation and distribution of condoms and follow-up doses of oral pills.
• Community sessions will be organized by RHFV and trained peer educators in the selected community to impart specific information (through group counseling approach) on sexual and reproductive health and rights focusing to family planning among the PMSEU community.
• The project will provide diary and promotional materials will be provided to RHFV and Peer educators to keep records of the activities of the grassroots level volunteers. Three days training on Integrated Package of Essential Services (IPES) will be organized for 150 RHFVs and 99 PEs of 11 operational districts to enhance their skills and knowledge.
• Youth Friendly Service center will strengthen to increase uptake of family planning and sexual and reproductive health among the young people.
• Focus group discussions (FGD) in each project district will be conducted to generate qualitative information on knowledge, attitude and practices (KAP) of the target participants (young people, migrant and vulnerable groups) through the interactive meeting with the target groups.
• Supportive supervision will be made by district staff to supervise the field level activities of the project.
• Qualitative assessment will be conducted to identify the opinion of the beneficiaries' group towards the gaps in service delivery, service provision, accessibility of services, friendly services based on Participatory Ethnography Evaluation and Research (PEER) technique.
• Planning & review meeting will be organized to brief the project implementers at the district level about the GGR Emergency Fund in general.

Program Model-2: Mobile Clinic

FPAN organizes mobile clinics in those areas where the people are far from reach of SRH services. Mobile clinics help to increase access of marginalized and disadvantage people in remote rural areas to FPRH services. FPAN aims to provide VSC and LARC services through the mobile camps.

• The project will organize a total of 264 camps to deliver LARC and temporary family planning and reproductive services in strategic locations of the districts with integrated approach (STIs and cervical screening test by VIA method).
• A total of 785 Comprehensive VSC camps with special focus on male and female VSC services will be conducted in 11 districts, however other methods of family planning and essential reproductive health services will also be offered through the comprehensive camps.
• A rapid mapping exercise will be carried out in the selected districts in order to generate information about the stakeholders who can contribute in scaling-up family planning and reproductive health services focusing to the young people, migrant, vulnerable groups.
• Coordination meetings will be organizing by district branch at provincial and local level for enhancing SRHR for the marginalized and disadvantage group including young, migrants and vulnerable groups to establish functional relationship and partnership.
• Four days training on STI syndromic case management will be organized for 22 staff nurses.
• Six days training on cervical cancer screening by VIA method will be organized for 18 staff nurses in the beginning of the project implementation period.
• Supportive supervision by central staff to supports staff for maintaining standards, which includes mentoring, coaching, training, team problem solving and two-way communication.
• Final evaluation of the project will be conducted in the last quarter of the project period.

Program Model-3: Communication

It has been made appropriate provision for collecting analyzing, documenting and disseminating the appropriate information of the project at all level under the communication model. One of the main aims of the project is to cover the losses arise due to the effects of the Global Gag Rule, therefore, it is imperative to showcasing some concrete and measurable outcomes and best practices from the implementation of this project, which will definitely be meaningful to IPPF and FPAN to demonstrate to the donor organizations.

• Capturing stories including photo/video of interest to ensure stronger documentation and adherence to timelines committed.
• The project will generate information about the effect of seasonality in family planning such identify the reasons of peak demand of VSC services between September to March, high vasectomy services in Sept-Oct (migration and Dashain Festival); impact of withdrawal of family planning services and the reduction in number of vasectomies and other permanent family planning services. A qualitative report will be produced based on such information.
• Media people will be mobilized in the ground level to be informed about the situation of family planning and projects’ response in improvement of family planning.
• Report will be documented and disseminated based on the project’s contribution to scale-up the family planning and reproductive health services.
• The project will support to buy of emergency contraceptive pills to fulfill the requirement at the field. Apart, the project will contribute in procurement of software for Integrated Management Information System.