Access to services means the degree to which services can be obtained within the cost and effort limits that are acceptable to the general population. Even motivated clients can have their access blocked by medical and other barriers, such as cost, distance and social/cultural barriers. Service programs must go beyond making services merely available - that is, merely ensuring there is a supply of contraceptives in clinics with counselors and other service providers present to help clients choose and receive their method of choice. Service programs must also make sure that services are accessible by identifying and reducing or eliminating barriers such as cost, distance and social/cultural concerns.
Behavior change communication (BCC)An interactive process aimed at changing social and individual behavior, using targeted, specific messages and different communication approaches, which is linked to services for effective outcomes.
Community-based family planning (CBFP)
A programmatic strategy that brings family planning (FP) information and services to women and men in the communities where they live, rather than requiring them to travel to health facilities.
Is a term used throughout this course to refer to any person who provides CBFP services including CHWs (paid or unpaid), providers offering mobile health services, and drug shop operators.
CommoditiesUsed interchangeably with stock, goods, products, and other terms in this course to refer to all the items that flow through a logistics system.
Community health worker
CHWs are trusted members of the community who are trained to support the general health of community members. CHWs are linked with community health facilities, district health offices, and in some countries national ministries of health and nongovernmental organizations (NGOs). Among the services CHWs offer are basic family planning methods and information about reproductive health in a private and confidential setting that may take the form of CHW visits to the client’s home, client visits to the CHW’s home, or CHWs seeing clients at a community health post or another location in the community.
Use of the term CHW varies considerably by country. CHWs may be known as community reproductive health workers (CRHWs), community health officers (CHOs), community-based distribution agents (CBD agents), village health workers (VHWs), or other terms. For consistency, only “CHW” will be used in this course.
Couple-Years of Protection (CYP)CYP is the estimated protection provided by contraceptive methods during a one-year period, based upon the volume of all contraceptives sold or distributed free of charge to clients during that period.
Conceptual FrameworkA diagram of a set of relationships between factors that are believed to impact or lead to a target condition. It is the foundation of project design, management, and monitoring. Synonym: Conceptual model
Contraceptive Prevalence Rate (CPR)
Percent of women of reproductive age (15-49) who are using (or whose partner is using) a contraceptive method at a particular point in time. Source: Measure Evaluation
Drug shop operator
Also known as chemists or patent medical vendors manage shops that sell non-prescription drugs and prepackaged medicines and commonly offer medical advice, private consultations, and treatment.
Health management information system(s) (HMIS)A planned system of collecting, processing, storing, disseminating, and using health-related information to carry out functions of management. It consists of people, tools (paper-based and electronic) and procedures to gather, sort, and distribute timely, accurate information to decision-makers. Source: Adapted from Kotler, Phillip and Keller, Kevin Lane; Marketing Management, Pearson Education, 12 Ed, 2006.
complete, correct and clear information about all options, plus details about the chosen method
Something that encourages a person to do something or to work harder.
Information Education Communication (IEC)
A communication strategy for influencing behavior which emphasizes information and education and combines strategies, approaches, and methods that enable individuals, families, groups, organisations, and communities to play active roles in achieving, protecting, and sustaining their own health. Embodied in IEC is the process of learning that empowers people to make decisions, modify behaviors, and change social conditions.
Long-Acting and Permanent Methods (LAPMs)
LAPMs are by far the most effective types of modern contraception (with success rates of 99% or higher) and are very safe, convenient, and cost-effective in the long-run. These methods include intrauterine devices (IUDs), implants, female sterilization (such as tubal ligation), and male sterilization (vasectomy). They are all clinical methods and must be provided in health facilities by trained doctors, nurses, and/or midwives. Source: https://www.engenderhealth.org/our-work/family-planning/long-acting-and-permanent-methods.php
Long-acting reversible methods (LARCs)
Contraceptive methods that prevent pregnancy for an extended period of time without requiring user action, but do not permanently affect ability to have children. These include hormonal implants and IUDs.
LogisticsThe process of planning, implementing, and controlling the efficient, effective flow and storage of goods, services, and related information from point of origin to point of consumption to meet customer requirements.
Logistics Management Information SystemA logistics management information system (LMIS) tracks data in three main areas: contraceptive stock on hand; rate of contraceptive consumption; losses and adjustments due to expiration, theft, damage, or transfer.
Mobile servicesA team of health care providers travels from a health facility to a community (or from a higher to a lower-level health facility) to offer FP services and methods in areas where services are limited or do not exist. The purpose of mobile services is to make as many contraceptive methods as possible available to under-served and hard-to-reach groups.
Nongovernmental organization (NGO)
An entity that is neither a conventional for-profit business or a part of a government but operates at the discretion of the government. The organization may be international, national or local and is frequently established by ordinary citizens, and funded by governments (e.g., USAID, DFID), foundations, businesses, or private persons.
Private health sector
The private health sector comprises of all providers who exist outside of the public sector, whether their aim is philanthropic or commercial, and whose aim is to treat illness or prevent disease (WHO 2005). It is a large and diverse group that includes private practitioners, clinics, hospitals, and laboratories and diagnostic facilities; non-profit non-governmental organizations (NGOs) and faith-based organizations (FBOs); shopkeepers and traditional healers; pharmacies and pharmaceutical wholesalers, distributors, and manufacturers; and private companies not engaged in health that provide health care services to their employees and communities.
Health services delivered and managed by the government or Ministry of Health.
Provider-dependent methodsProvider-dependent methods are those that must be administered by a professional health worker. Surgical sterilization and IUDs are always provider-dependent methods. In some countries, Depo-Provera is provider-dependent; other countries allow CBD agents to deliver injectables.
Permanent methods (PMs)
Male sterilization (vasectomy) and female sterilization (tubal ligation) are highly effective contraceptive methods that are considered permanent. They are suitable for couples who are certain they don’t want any more children.
Specifically educated and trained health professionals who are charged by their national or other appropriate (e.g. state or provincial) authorities with managing the distribution of medicines to consumers and engaging in appropriate efforts to assure their safe and efficacious use (Source: WHO).
Referral in CBFP context
A process in which a health worker at a one level of the health system, having insufficient resources (e.g., drugs, equipment, skills) to manage a clinical condition, seeks the assistance of a better or differently-resourced facility at the same or higher level to assist in or take over the management of a client’s case (Referral Systems Assessment and Monitoring (RSAM) Toolkit, 2013).
A person, group or institution with involvement in, interests in, or in-depth knowledge of, a topic and/or context, who can affect or be affected by the actions associated with an intervention, program, study or policy.
The formal and informal ways of staying connected to stakeholders (e.g., conversations, committee involvement, champions, interviews, focus group meetings, site visits, written communications) so that they are in a position use research findings to inform programs, policies, and practice (K4Health Research Utilization Toolkit).
a system of organizations, people, activities, information, and resources involved in moving a product or service from supplier to customer
Social Franchise of Health Providers
A social franchise is a network of private health providers linked through contracts to provide socially beneficial services under a common brand. The goals of social franchising include increasing access by increasing service delivery points and services offered; cost-effectiveness, including offering services at equal or lower cost than other providers; providing services that adhere to quality standards; and providing equity by services all population groups and emphasizing those in most need. (Source: Adapted from Clinical Social Franchising Compendium: An Annual Survey of Programs, 2010, the Global Health Group, University of California, San Francisco, May 2010. )
Sustainability refers to the capacity of a health system to continue its activities in the future at the same level and where necessary, for example due to population growth or an epidemiological situation, to expand activities. This covers the sustainability of both resources and health outcomes across time.
A health service is sustainable when operated by an organizational system with the long-term ability to mobilize and allocate sufficient and appropriate resources (manpower, technology, information and finance) for activities that meet individual or public health needs/demands.
The deliberate efforts to increase the impact of health service innovations successfully tested in pilot or experimental projects so as to benefit more people and to foster policy and programme development on a lasting basis. (Source: WHO/ExpandNet, 2009).
Sometimes known as task-shifting—is the systematic delegation of tasks, where appropriate, to less specialized workers in order to maximize the efficient use of resources.
Task-sharing involves training mid- and low-level cadres of health workers—such as clinical officers, auxiliary nurses, and CHWs—to deliver some services offered by higher-level cadres in order to optimize the reach of a limited health workforce.
Source: WHO Optimize MNH Guidance: Recommendations on CHW Provision of Injectable Contraceptives (2012).
Whole market or total market approachA "whole market approach" ensures that all family planning users - including those who require free contraceptives and those who can and will pay for commercial family planning products - are covered through multiple public, non-profit, and private channels (Pandit and Bornbush 2003).