Using CLA to Reach More Family Planning Clients in Tanzania

The MOMENTUM Integrated Health Resilience project in Tanzania aims to improve access to quality reproductive health services and strengthen community and health facility systems. The project observed challenges in the provision of family planning (FP) services due to shortages of providers, equipment, and supplies. To address this, the project implemented a Collaborating, Learning, and Adapting (CLA) approach.

The CLA approach involved analyzing data on FP services, conducting site observations, and engaging key stakeholders, including health care providers and managers. The project identified the limitations in comprehensive counseling and the provision of a full range of FP methods, particularly long-acting reversible contraceptives (LARCs) and permanent methods (PMs). As a result, the project initiated facility-based FP special service days (FP-SSD) at selected health facilities with high client numbers and limited competent providers. Trained providers from higher-level facilities were brought to these remote areas to offer services, while demand generation activities were conducted to raise awareness. The project also provided on-site mentorship to enhance collaboration and peer learning among providers.

The implementation of the FP-SSD model improved the quality of FP services. The method mix shifted to include a higher proportion of LARCs and permanent methods. The number of clients served and couple years of protection generated at project-supported health facilities also increased significantly. Enabling conditions, such as a clear mandate for adaptive learning, project leadership support, and capacity building efforts, facilitated the CLA approach. However, challenges included a shortage of trained surgeons for voluntary surgical contraception and limited budget for scaling up the approach in remote areas.

Overall, the CLA approach contributed to the project's development outcomes by improving FP service quality and increasing access to a wider range of methods. The project advises others to address challenges through capacity building, resource allocation, and continuous learning and collaboration.