Voices from the Field: Training Promises Family Planning Service Improvements At Senegal Work Sites

“I think I will be able to—in a short time—help clients to adhere to family planning and improve the quality of services I offered before,” says one participant in a quality improvement training for private sector family planning providers.

Forty-three private sector health care providers participated in the training in June 2008. Because of Senegal’s high maternal and child mortality rates, IntraHealth has been working in the country to improve the accessibility and raise the quality of health services and increase the use of family planning services. In 2007, the IntraHealth-led Maternal, Neonatal and Child Health/Family Planning/Malaria (MNCH/FP/Malaria) Project, funded by USAID, set out to improve the quality of the services of health care providers in both the public and private sector in Senegal.

First, the project turned to USAID’s Private Sector Partnerships One project (PSP-One), which provides technical leadership—including in the area of quality improvement—to increase the private sector’s involvement in the delivery of high-quality reproductive health services. PSP-One had successfully developed and disseminated a quality improvement tool in Uganda, India and Jordan.

During the initial phase of the plan PSP-One worked with the public sector providers. The MNCH/FP/Malaria project staff learned the concepts and methods of introducing a quality improvement program for use by different types of providers (medical doctors, nurses, midwives). Regional and district public sector program managers and tutors/supervisors received a malaria, neonatal and family planning training and quality improvement package of materials. The MNCH/FP/Malaria project is now preparing to integrate the package into existing programs in order to help public sector providers at the health huts and health posts assess and improve the quality of reproductive health services they provide.

Once the project had launched the tool in the public sector, IntraHealth staff began looking into the opportunity to introduce a family planning quality improvement package into the project’s private sector activities that take place at work sites.

The workplace component of the project works with health care providers employed by approximately 20 private enterprises (work sites) in two regions (Dakar and Saint Louis). The providers are trained in a variety of topics and provide most family planning methods (such as pills, condoms, IUDs and injectables). However, there has not been a program in place to determine or monitor the quality of the family planning services provided, and there is limited understanding by the providers of the importance of family planning in maintaining the health and well-being of their employees and their employees’ families.

In conjunction with PSP-One, the MNCH/FP/Malaria project is helping these providers at 18 work sites (14 in Dakar and 4 in Saint Louis) assess their skills and improve them based on identified performance gaps. The quality improvement package’s focus is on family planning counseling, method provision, and the marketing of family planning services to family members and to the community.

During the two orientation workshops in Dakar and Saint Louis, 43 supervisors and key service providers—physicians, nurses and midwives—discussed the package, interacting with providers from work sites. “I am very satisfied and welcome a post training follow-up, continuation of this kind of action and a synergy between the different private facilities,” notes one Dakar trainee.

Participants also practiced and discussed the various tools, including the self-assessment questionnaire and the action plan. “I really relate to the issues raised during these three days,” says one St. Louis participant. “The workshop was really instructive and will allow us to improve the services we provide.”

“Every provider/supervisor now has a tool which allows them—themselves—to identify the causes of quality discrepancies and to monitor and evaluate—themselves—how to improve service quality,” says one of IntraHealth’s workshop trainers, Dr. Manuel Pina. “The quality improvement process can be applied in all areas, not just in health or family planning.”

Participants agreed on a plan for the training and supervision of other service providers, reviewed a draft memorandum of understanding between each enterprise and the regional/district health management team and developed a monitoring and evaluation plan to measure the effectiveness of the package.

Says a Dakar trainee, “This is a great initiative that has been needed for a long time, so bravo!”

The Senegal MNCH/FP/Malaria project also aims to:

  • Increase use of family planning methods by ensuring that health districts are stocked with contraceptive products
  • Decentralize access to quality health care services
  • Encourage a spirit of leadership among health care management and providers to ensure high-quality services
  • Encourage male involvement in the use of family planning services
  • Empower women and girls to actively participate in decisions about their health
  • Increase providers’ and clients’ knowledge about prevention of malaria and the need for treatment services in order to save lives.