Details for Reform Option "Involvement of private sector in providing reproductive and child health services, Uttar Pradesh"
State Innovations in Family Planning Services Project Agency (SIFPSA), funded by USAID, works with NGOs (voluntary organisations, trusts run by the corporate sector and cooperative societies) to provide family planning services to the rural areas of Uttar Pradesh.
After an NGO has been selected, it recruits a network of Community-based Distribution (CBD) volunteers who are trained at a training centre managed by SIFPSA.
The CBD worker is a married woman from the village where she is to work. She looks after a population of 2,000 and her work includes: identifying and counting eligible couples, supplying condoms and pills, family planning counselling and referral for sterilisation.
She is given an honorarium of Rs. 600 per month and incentives based on the sale of condoms/pills.
The CBD volunteer also maintains two sets of records - a daily diary and a family card. She also prepares a monthly progress report to be submitted to her supervisor.
CBD volunteers are monitored by a network of supervisors. A supervisor is in charge of 6-8 CBD workers. Supervisors are monitored by a project coordinator and, when the population is more than a lakh, an assistant project coordinator assists him. The project coordinator reports to the project director.
The CBD gives her monthly progress report (MPR) to the supervisor who in turn compiles the data and gives the MPR to the project coordinator who gives it to the project director.
At the end of the quarter, a physical progress report is sent to SIFPSA along with a quarterly expenditure report. Only then can money be released to the project.
In addition to these internal evaluations, there are regular external evaluations. Extensions are based on the NGO’s performance.
As of January 2004, there were 76 ongoing projects.
There are four types of projects under SIFPSA’s private sector division:
(i) Grassroots NGOs working at block level using CBD approach
(ii) Dairy cooperatives in 13 districts, again following the CBD approach but restricted to the villages that fall on the milk route.
(iii) The employer sector consisting of two components – the factory component where an employee of the factory called the ‘factory health motivator’ plays the role of the CBD worker on the factory premises and the community component where CBD volunteers work in the vicinity of the factory.
(iv) Indian Systems of Medicine Practitioners (ISMPs) are trained as family planning counsellors. Though they are given supplies for distribution, unlike the CBD volunteers, the ISMPs are not given any honoraria.
Estimated cost: A typical two year project of one block comes to about INR 25-30 lakhs.
Thirty three districts of Uttar Pradesh, since 1994.
Information not available.
Uses private sector capacity: Involves the private sector in providing RCH services to the masses.
Community-friendly: Because the CBD workers are women from within the community or from other community-owned institutions such as the dairy cooperatives, they are accepted by the community.
Empowerment: It enhances the confidence of rural, illiterate women who, once trained, often encourage others to do the same.
Cost: Tends to be slightly expensive as door-to-door service delivery is involved.
NGO reliant: There is a lack of credible NGOs to take part.
Capacity building of NGO staff/volunteers.
Funds for programme management.
Mechanism for monitoring field level activities and feedback.
Who needs to be consulted
Executive Director, SIFPSA
(i) Charging a fee for services.
(ii) The sale of contraceptive social marketing (CSM)/RCH products.
(iii) Corpus fund.
(iv) Capacity building of private providers in contraceptive technologies.
Chances of Replication
Information not available.
Dr. S. Krishnaswamy, General Manager, SIFPSA, March 2004.