provider behavior change approaches to improve family ...€¦ · a landscaping review appendices....
TRANSCRIPT
FEBRUARY 2020
LANDSCAPE REVIEW
Provider Behavior Change Approaches to Improve Family Planning Services in the Ouagadougou Partnership Countries: A Landscaping Review
Appendices
Breakthrough RESEARCH is made possible by the generous support of the American people through the United States Agency for International Development (USAID) under the terms of cooperative agreement no. AID-OAA-A-17-00018. The contents of this document are the sole responsibility of the Breakthrough RESEARCH and Population Council and do not necessarily reflect the views of USAID or the United States Government.
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©2020 The Population Council. All rights reserved.
Cover photo by ©2006 Richard Nyberg, Courtesy of Photoshare
Suggested CitationSpielman, Kathryn, Elizabeth Tobey, Martha Silva, and Leanne Dougherty. 2020. "Provider behavior change approaches to improve family planning services in the Ouagadougou Partnership Countries: a landscaping review," Breakthrough RESEARCH Final Report. Washington DC: Population Council.
Contact4301 Connecticut Avenue NW, Suite 280 | Washington, DC 20008 +1 202 237 9400 | [email protected] breakthroughactionandresearch.org
AcknowledgmentsWe acknowledge the teams from Pathfinder International, YLabs, and Breakthrough ACTION for their insights, particularly Theo Gibbs and Rebecca Hope of YLabs and Jessica Vandermark of Camber Collective for their contributions to the case studies and their overall review. We acknowledge Paul C. Hewett and Sanyukta Mathur of Population Council for their technical guidance and review. We acknowledge Mariko Hewer and Sherry Hutchinson of Population Council, who provided editorial and design support. We acknowledge Hope Hempstone, Lindsay Swisher, Joan Kraft, and Jaqueline Devine with the United States Agency for International Development (USAID), who provided valuable feedback during the development of this report.
Provider Behavior Change Approaches to Improve Family Planning Services in the Ouagadougou Partnership Countries: A Landscaping Review
Appendices
LANDSCAPE REVIEW FEBRUARY 2020
Kathryn Spielman1 Martha Silva2
Elizabeth Tobey1 Leanne Dougherty1
1Population Council 2Tulane University
These appendices are part of a larger report which is available on the Breakthrough ACTION+RESEARCH website at breakthroughactionandresearch.org/wp-content/uploads/2020/03/PBC-Landscaping-FP-OP.pdf.
BR E A K THROUGH R ESE A RCH | FEBRUA RY 2020 I
Appendices
II PBC A PPROACHES TO IMPROV E FP SERVICES IN THE OP COUNTR IES: A L A NDSCA PING R E VIE W
Appendix 1: List of sites searched for literatureCamber Collective: http://www.cambercollective.com/
Care: https://www.care.org/
EngenderHealth: https://www.engenderhealth.org/
International Conference on Family Planning Scientific Program: https://2018.fpconference.org/program/scientificprogram/
Pathfinder International: https://www.pathfinder.org/
Population Services International: https://www.psi.org/
Sommet Francophone pour le Changement Social et de Comportement: https://sommetcsc.fr/programme/
Springboard for SBC: https://springboardforsbc.org/
University Research Co., LLC: https://www.urc-chs.com/
USAID Development Experience Clearinghouse: https://dec.usaid.gov/dec/home/Default.aspx
YLabs: https://y-labs.org/
BR E A K THROUGH R ESE A RCH | FEBRUA RY 2020 I I I
FIRST AUTHOR
PROJECT NAME
YEAR
COUNTRY
HEALTH TOPIC
BARRIER
FACTOR AFFECTING PERFORMANCE
PBC APPROACH
TYPE OF PBC APPROACH - CATEGORIZED
EVALUATION DESIGN
EVALUATION DESIGN - CATEGORIZED
OUTCOME/S MEASURED
COST EFFECTIVENESS Y/N
WITHIN LAST 5 YEARS
ONGOING
PRIME ORG
DONOR
PUBLISHED/GREY
KEY FINDING(S)
CLIENTS RECEIVED FP COUNSELING
FP UPTAKE
IMPROVEMENT IN PROVIDER ATTITUDE/
KNOWLEDGE
FACILITY-LEVEL OUTCOMES
COMMUNITY-LEVEL OUTCOMES
The
ACQU
IRE
Proj
ect
The
ACQU
IRE
Proj
ect
2008
Guin
eaFP
(L
APM
)Kn
owle
dge/
com
pete
ncy
Expe
ctat
ion,
ab
ility
Heal
th c
are
work
ers
were
trai
ned
in
coun
selin
g, in
fect
ion
prev
entio
n, a
nd
IUD
inse
rtion
and
rem
oval
. A "w
hole
-site
tra
inin
g" a
ppro
ach
was
used
to tr
ain
prov
ider
s on
site
, to
ensu
re m
ultip
le p
ro-
vider
s we
re tr
aine
d at
eac
h si
te. T
hose
wh
o we
re tr
aine
d we
re re
spon
sibl
e fo
r sh
arin
g kn
owle
dge
and
skill
s an
d tra
in-
ing
othe
rs. S
elf-a
sses
smen
t app
roac
hes
were
use
d an
d tra
inin
g wa
s su
ppor
ted
by
faci
litat
ive s
uper
visio
n. P
rovid
ers
were
al
so s
uppl
ied
with
job
aids
on
coun
selin
g m
essa
ges,
IUD
elig
ibili
ty c
riter
ia, a
nd
side
effe
cts.
Trai
ning
and
ed
ucat
ion,
m
anag
eria
l ap
proa
ches
, in
divid
ual
proc
ess
im-
prov
emen
ts,
supp
lem
en-
tary
pa-
tient
-faci
ng
mat
eria
ls
Pre-
post
us
ing
rout
ine/
mon
itorin
g da
ta
non-
ran-
dom
ized,
in
terv
entio
n ef
fect
s co
m-
pare
d wi
th
prev
ious
/hi
stor
ical
in
form
atio
n
New
IUD
user
s an
d co
uple
year
s pr
otec
tion,
reca
ll of
cam
paig
n m
essa
ges
NoNo
NoEn
gend
er-
Heal
thUS
AID
Grey
700
new
IUD
user
s we
re
serv
ed in
inte
rven
tion
faci
li-tie
s in
200
6, c
ompa
red
with
37
in 2
004
and
82 in
200
5,
the
two
year
s pr
eced
ing
the
surv
ey. T
his
num
ber d
ropp
ed
to 2
25 b
ut re
mai
ned
high
er
than
pre
vious
year
s af
ter t
he
inte
rven
tion
in 2
007.
Coup
le
year
s of
pro
tect
ion
(3.5
per
IU
D) a
lso
incr
ease
d fro
m 1
30
in 2
004
and
287
in 2
005
to
2,45
0 in
200
6.
+
USAI
D AS
SIST
M
ali
USAI
D As
-si
st M
ali
2016
Mal
iPP
FPKn
owle
dge/
com
pete
ncy
Expe
ctat
ion,
ab
ility
Regi
onal
trai
ners
and
dis
trict
-leve
l hea
lth
prov
ider
s we
re tr
aine
d on
a q
ualit
y im
-pr
ovem
ent a
ppro
ach
and
key s
tand
ards
in
pro
vidin
g PP
FP s
ervic
es. Q
uarte
rly
coac
hing
vis
its, le
arni
ng s
essi
ons
with
qu
ality
impr
ovem
ent t
eam
s, an
d be
st
prac
tice
sess
ions
to e
xtra
ct le
sson
s le
arne
d we
re im
plem
ente
d fo
llowi
ng th
e tra
inin
g.
Trai
ning
and
ed
ucat
ion,
m
anag
eria
l ap
proa
ches
Diag
nost
ic
proc
ess
was
impl
e-m
ente
d to
m
easu
re
the
qual
ity
of s
ervic
es
offe
red.
Ro
utin
e da
ta w
as
used
to
mon
itor
prog
ress
.
non-
ran-
dom
ized,
in
terv
entio
n ef
fect
s co
m-
pare
d wi
th
prev
ious
/hi
stor
ical
in
form
atio
n
Perc
enta
ge o
f PP
wom
en w
ho
rece
ived
FP
coun
selin
g be
-fo
re le
avin
g th
e fa
cilit
y, Pe
rcen
t-ag
e th
at a
dopt
ed
a m
etho
d af
ter
coun
selin
g.
NoYe
sNo
URC
USAI
DGr
ey
Perc
enta
ge o
f pos
tpar
tum
cl
ient
s re
ceivi
ng P
PFP
coun
-se
ling
each
mon
th in
crea
sed
from
<10
% to
ove
r 90%
afte
r th
e in
terv
entio
n, th
e pr
opor
-tio
n le
avin
g wi
th a
n FP
met
h-od
afte
r cou
nsel
ing
incr
ease
d fro
m 0
% to
ove
r 80%
++
Boss
yns
Alaf
ia
Proj
ect
2002
Nige
rFP
Know
ledg
e/co
mpe
tenc
y, St
ruct
ural
/co
ntex
tual
, at
titud
inal
Oppo
rtuni
ty,
abili
ty, a
ttitu
-di
nal
A th
ree-
part
inte
rven
tion
pack
age
to
impr
ove
resp
onsi
vene
ss o
f FP
serv
ices
: St
ruct
ural
cha
nges
: abo
lishi
ng s
peci
al
FP c
linic
s an
d in
tegr
atin
g FP
ser
vices
in
to o
ther
hea
lth c
ente
r act
ivitie
s.
Polic
ies
aim
ed a
t lim
iting
pro
vider
-im-
pose
d re
stric
tions
incl
uded
pro
posi
ng
FP in
all
enco
unte
rs w
ith e
ligib
le w
omen
, pr
opos
ing
FP to
all
wom
en a
ttend
ing
child
hea
lth, a
nten
atal
, and
pos
tnat
al
care
vis
its, a
nd to
all
wom
en w
ho a
re
brea
stfe
edin
g, a
re m
alno
uris
hed
or h
ave
an il
l or m
alno
uris
hed
child
, and
thos
e wh
o ha
ve p
revio
us tw
in p
regn
anci
es,
hist
ory o
f STI
, or h
isto
ry o
f pat
holo
gica
l de
liver
y. Pr
oced
ural
inte
rven
tions
incl
ud-
ed p
rovid
ing
six c
ycle
s of
ora
l con
trace
p-tiv
es a
t a ti
me,
re-p
rovid
ing
wom
en w
ith
cont
race
ptive
s ev
ery t
ime
they
pre
sent
at
the
faci
lity,
prov
ide
non-
men
stru
at-
ing
wom
en w
ith c
ontra
cept
ives
with
ap
prop
riate
inst
ruct
ions
, and
pro
vidin
g 3-
6 cy
cles
at f
irst v
isit
but a
sk w
omen
to
com
e fo
r rou
tine
follo
w-u
p or
whe
n th
ey p
erce
ive p
robl
ems.
Pro
vider
s we
re
also
give
n in
terp
erso
nal c
omm
unic
atio
n tra
inin
g an
d tip
s on
how
to e
ngag
e in
di
alog
ue o
n co
ntra
cept
ives
with
clie
nts.
Infra
-st
ruct
ure
impr
ove-
men
ts, o
r-ga
niza
tiona
l ch
ange
s, tra
inin
g an
d ed
ucat
ion
Pre-
post
us
ing
both
ro
utin
e/m
onito
ring
data
and
cl
ient
-pro
-vid
er o
bser
-va
tion
Non-
ran-
dom
ized,
in
terv
entio
n ef
fect
s co
m-
pare
d wi
th
prev
ious
/hi
stor
ical
in
form
atio
n
Coup
le ye
ars
of p
rote
ctio
n by
pill
s an
d in
ject
able
s, pr
opor
tion
of
wom
en o
ffere
d co
ntra
cept
ion
that
acc
ept,
and
the
prop
ortio
n th
at a
ccep
t tha
t ac
tual
ly re
ceive
a
met
hod
NoNo
NoAl
afia
Pro
ject
Germ
an
Deve
l-op
men
t Ag
ency
Publ
ishe
d
Afte
r the
inte
rven
tion,
29
perc
ent o
f elig
ible
wom
en re
-ce
ived
cont
race
ptive
s on
the
day o
f the
ir vis
it to
a c
linic
, af
ter r
ecei
ving
coun
selin
g an
d ac
cept
ing
a fa
mily
pla
nnin
g m
etho
d. B
efor
e th
e in
terv
en-
tion,
less
than
1 p
erce
nt o
f wo
men
rece
ived
a m
etho
d on
th
e da
y of t
heir
visit.
New
FP
user
s in
crea
sed
from
a ye
arly
aver
age
of 5
22 to
150
9.
+
Appe
ndix
2: M
atric
es o
f pro
vide
r beh
avio
r cha
nge
inte
rven
tions
Tabl
e A.
1 M
atrix
of e
valu
atio
ns o
f pro
vide
r beh
avio
r cha
nge
inte
rven
tions
for f
amily
pla
nnin
g in
Fra
ncop
hone
Wes
t Afr
ica
FIRST AUTHOR
PROJECT NAME
YEAR
COUNTRY
HEALTH TOPIC
BARRIER
FACTOR AFFECTING PERFORMANCE
PBC APPROACH
TYPE OF PBC APPROACH - CATEGORIZED
EVALUATION DESIGN
EVALUATION DESIGN - CATEGORIZED
OUTCOME/S MEASURED
COST EFFECTIVENESS Y/N
WITHIN LAST 5 YEARS
ONGOING
PRIME ORG
DONOR
PUBLISHED/GREY
KEY FINDING(S)
CLIENTS RECEIVED FP COUNSELING
FP UPTAKE
IMPROVEMENT IN PROVIDER ATTITUDE/
KNOWLEDGE
FACILITY-LEVEL OUTCOMES
COMMUNITY-LEVEL OUTCOMES
Bouc
ar
USAI
D AS
SIST
Pr
ojec
t20
16Ni
ger
PPFP
Know
ledg
e/co
mpe
tenc
y, St
ruct
ural
/co
ntex
tual
Abili
ty,
expe
ctat
ion
A qu
ality
impr
ovem
ent a
ppro
ach
was
empl
oyed
to s
treng
then
pos
tpar
tum
FP
(PPF
P) s
tand
ards
. PPF
P gu
idel
ines
wer
e up
date
d na
tiona
lly. T
he a
ppro
ach
incl
ud-
ed s
ettin
g im
prov
emen
t aim
s, de
velo
ping
in
dica
tors
to m
easu
re o
utco
mes
, and
te
stin
g id
eas
by fa
cilit
y-ba
sed
qual
ity
impr
ovem
ent t
eam
s an
d em
phas
ized
capa
city
bui
ldin
g to
cre
ate
owne
rshi
p of
PPF
P im
prov
emen
t effo
rts. S
peci
fic
chan
ges
impl
emen
ted
incl
uded
set
ting
up a
ded
icat
ed, p
rivat
e FP
cou
nsel
ing
stat
ion,
ada
ptin
g da
ta fo
rms
to fa
cilit
ate
data
col
lect
ion,
divi
sion
of F
P ta
sks
amon
g pr
ovid
ers,
inte
grat
ing
PPFP
cou
n-se
ling
into
pre
gnan
t wom
en's
visits
and
re
cord
ing
the
coun
selin
g in
thei
r rec
ords
, de
sign
atin
g a
mid
wife
to m
onito
r FP
activ
ities
, pro
vide
FP c
oupl
e co
unse
ling
on d
ay o
f mat
erna
l dis
char
ge.
Trai
ning
and
ed
ucat
ion,
m
anag
eria
l ap
proa
ches
, in
stitu
tiona
l pr
oces
s im
prov
e-m
ents
, in-
frast
ruct
ure
impr
ove-
men
ts, o
r-ga
niza
tiona
l ch
ange
s
Base
line
asse
ss-
men
t in
clud
ing
obse
rva-
tions
of
clie
nt-p
ro-
vider
inte
r-ac
tions
and
cl
ient
exi
t in
terv
iews
. Ro
utin
e/m
onito
r-in
g da
ta
thro
ugho
ut.
non-
ran-
dom
ized,
in
terv
entio
n ef
fect
s co
m-
pare
d wi
th
prev
ious
/hi
stor
ical
in
form
atio
n
Prop
ortio
n of
wo
men
who
re
ceive
d FP
co
unse
ling
as
part
of ro
utin
e po
stpa
rtum
car
e,
and
the
prop
or-
tion
who
left
with
an
FP
met
hod,
an
d th
e pr
opor
-tio
n of
cou
ples
co
unse
led
for F
P.
NoYe
sNo
Assi
st P
roj-
ect -
URC
USAI
DGr
ey
The
perc
enta
ge o
f pos
tpar
-tu
m w
omen
who
rece
ived
FP
coun
selin
g as
par
t of r
outin
e PP
car
e in
crea
sed
from
9%
to 8
6% a
fter t
he in
terv
entio
n,
the
perc
enta
ge c
hoos
ing
an
FP m
etho
d in
crea
sed
from
le
ss th
an 1
0% to
49%
, and
the
perc
enta
ge th
at le
ft wi
th th
e FP
met
hod
of th
eir c
hoic
e in
crea
sed
from
less
than
10%
to
31%
afte
r the
inte
rven
tion.
+
+
Brad
ley
COPE
2002
Guin
ea,
Keny
a
Child
he
alth
, in
clud
es
FP
Know
ledg
e/co
mpe
tenc
y, St
ruct
ural
/co
ntex
tual
, At
titud
inal
Attit
udes
, ab
ility
, ex
pect
atio
n,
oppo
rtuni
ty
A qu
ality
impr
ovem
ent a
ppro
ach
calle
d CO
PE ("
clie
nt-o
rient
ed, p
rovid
er-e
ffi-
cien
t") w
as im
plem
ente
d to
impr
ove
child
hea
lth s
ervic
es b
y tra
nsfe
rring
the
powe
r of d
ecis
ion
mak
ing
to th
e si
te-
staf
f tea
m b
y usi
ng to
ols
to h
elp
iden
-tif
y pro
blem
are
as. S
elf-a
dmin
iste
red
ques
tionn
aire
s, cl
ient
exi
t int
ervie
ws,
and
a to
ol to
mea
sure
wai
ting
time
were
im
plem
ente
d to
iden
tify p
robl
em a
reas
an
d en
able
iden
tific
atio
n of
pot
entia
l in
terv
entio
ns. A
s a
resu
lt of
COP
E pr
o-ce
ss, in
terv
entio
n fa
cilit
ies
impl
emen
ted
chan
ges
incl
udin
g re
nova
tions
to fa
cil-
ities
, reg
ular
sta
ff m
eetin
gs to
dis
cuss
qu
ality
of c
are,
amon
g ot
hers
.
Trai
ning
and
ed
ucat
ion,
m
anag
eria
l ap
proa
ches
, in
stitu
tiona
l pr
oces
s im
prov
e-m
ents
, in-
frast
ruct
ure
impr
ove-
men
ts, o
r-ga
niza
tiona
l ch
ange
sPr
e-po
st
with
con
trol
non-
ran-
dom
ized,
in
terv
entio
n ef
fect
s co
mpa
red
with
con
trol
grou
p
FP c
ouns
elin
g in
corp
orat
ed in
to
clie
nt v
isits
, as
well
as a
num
ber
of re
spec
tful
care
indi
cato
rs.
Also
pro
vider
an
d fa
cilit
y le
vel o
utco
mes
, as
repo
rted
by
prov
ider
sNo
NoNo
Enge
nder
-He
alth
USAI
DGr
ey
The
perc
enta
ge o
f pro
vider
s wh
o di
scus
sed
FP d
urin
g ch
ild h
ealth
vis
its w
as 1
7% in
in
terv
entio
n si
tes
and
3% in
co
ntro
l site
s. A
spec
ts o
f qua
l-ity
of c
are
were
als
o hi
gher
in
inte
rven
tion
site
s, in
clud
ing
ensu
ring
audi
tory
priv
acy
(61%
vs 4
1%),
visua
l priv
acy
(59%
vs 4
0%),
and
conf
iden
-tia
lity o
f clie
nt re
cord
s (1
00%
vs 9
4%).
Staf
f int
erpe
rson
al
skill
s, in
clud
ing
liste
ning
to
clie
nt, e
xpla
inin
g th
ings
wel
l, an
d co
nfirm
ing
clie
nt u
nder
-st
ood,
wer
e al
so s
igni
fican
tly
high
er in
inte
rven
tion
site
s co
mpa
red
to c
ontro
l site
s, th
ough
exa
ct p
erce
ntag
es
were
not
repo
rted.
+
++
FIRST AUTHOR
PROJECT NAME
YEAR
COUNTRY
HEALTH TOPIC
BARRIER
FACTOR AFFECTING PERFORMANCE
PBC APPROACH
TYPE OF PBC APPROACH - CATEGORIZED
EVALUATION DESIGN
EVALUATION DESIGN - CATEGORIZED
OUTCOME/S MEASURED
COST EFFECTIVENESS Y/N
WITHIN LAST 5 YEARS
ONGOING
PRIME ORG
DONOR
PUBLISHED/GREY
KEY FINDING(S)
CLIENTS RECEIVED FP COUNSELING
FP UPTAKE
IMPROVEMENT IN PROVIDER ATTITUDE/
KNOWLEDGE
FACILITY-LEVEL OUTCOMES
COMMUNITY-LEVEL OUTCOMES
Cam
ber
Qual
ity
Assu
ranc
e Pi
lot E
valu
-at
ion
2016
Nige
rFP
Know
ledg
e/co
mpe
tenc
y, St
ruct
ural
/co
ntex
tual
, At
titud
inal
Abili
ty,
expe
ctat
ion,
at
titud
es
This
inte
rven
tion
intro
duce
d se
nsiti
za-
tion
abou
t FP
by c
omm
unity
hea
lth w
ork-
ers
at h
ealth
cen
ters
and
dur
ing
outre
ach
visits
, impr
oved
wel
com
ing
cond
ition
s at
hea
lth c
ente
rs, s
treng
then
ed F
P co
un-
selin
g th
roug
h tra
inin
g an
d m
ater
ials
on
com
mun
icat
ion,
usi
ng a
seg
men
ted
appr
oach
, and
pro
vided
follo
w-u
p an
d m
onth
ly su
ppor
t for
hea
lth c
are
work
ers
to in
tegr
ate
the
new
appr
oach
and
tool
s.
Inst
itutio
nal
proc
ess
impr
ove-
men
ts, in
-fra
stru
ctur
e im
prov
e-m
ents
, or-
gani
zatio
nal
chan
ges,
train
ing
and
educ
atio
nPr
e-po
st
with
con
trol
non-
ran-
dom
ized,
in
terv
entio
n ef
fect
s co
mpa
red
with
con
trol
grou
p
Clie
nt s
atis
fac-
tion,
awa
rene
ss,
know
ledg
e of
m
etho
ds, a
ccep
-ta
nce
of F
P, us
e of
FP
NoYe
s
Pilo
t co
mpl
et-
ed, M
OH
pick
ed u
p to
sca
le-
up n
atio
n wi
deCa
mbe
rHe
wlet
tGr
ey
In th
e in
terv
entio
n si
tes,
ther
e we
re s
igni
fican
t im
prov
e-m
ents
in s
ome
clie
nt in
dica
-to
rs c
ompa
red
to th
e co
ntro
l si
tes,
incl
udin
g: 9
9% h
ad c
on-
fiden
ce in
hea
lth c
are
work
ers
com
pare
d to
95%
in th
e co
ntro
l, 98%
feel
ing
she
had
enou
gh in
form
atio
n to
mak
e a
good
FP
deci
sion
com
pare
d to
93%
in th
e co
ntro
l site
s, 98
% re
porti
ng th
e he
alth
car
e wo
rker
exp
lain
ed th
e ef
ficac
y of
met
hods
com
pare
d to
94%
in
the
cont
rol, 3
3% fo
und
it ac
cept
able
for w
omen
to
deci
de o
n th
e nu
mbe
r of
child
ren
they
hav
e co
mpa
red
to 2
3% in
the
cont
rol, a
nd
90%
were
cur
rent
ly us
ing
a FP
m
etho
d co
mpa
red
to 8
4% in
th
e co
ntro
l (84
% vs
. 78%
for
mod
ern
met
hods
). +
+
Ciss
eno
ne20
04Se
nega
lPo
st-a
bor-
tion
care
Stru
ctur
al/
cont
extu
alOp
portu
nity
This
app
roac
h fo
cuse
d on
dec
entra
liz-
ing
care
for s
pont
aneo
us a
borti
on, b
y im
plem
entin
g a
new
treat
men
t pro
toco
l fo
r pos
t-abo
rtion
car
e, in
clud
ing
man
ual
vacu
um a
spira
tion,
and
qua
rterly
sup
er-
visio
n vis
its in
eac
h ce
nter
. Dur
ing
the
visits
, the
med
ical
team
exa
min
ed a
nd
asse
ssed
the
qual
ity o
f PAC
ser
vices
ac
cord
ing
to n
atio
nal s
tand
ards
and
im
plem
ente
d a
COPE
exe
rcis
e to
ena
ble
prov
ider
s to
iden
tify p
robl
ems
and
deve
l-op
and
follo
w-u
p on
act
ion
plan
s.
Trai
ning
and
ed
ucat
ion,
m
anag
eria
l ap
proa
ches
, or
gani
-za
tiona
l ch
ange
s
Base
line,
En
dlin
e,
and
6 m
onth
s af
ter i
mpl
e-m
enta
tion.
non-
ran-
dom
ized,
in
terv
entio
n ef
fect
s co
m-
pare
d wi
th
prev
ious
/hi
stor
ical
in
form
atio
n
Num
ber o
f PAC
pa
tient
s tre
ated
, tim
e of
hos
pi-
taliz
atio
n, p
ro-
porti
on re
ferre
d to
hos
pita
ls,
cost
of s
ervic
es,
perc
enta
ge
acce
ptin
g FP
, an
d sa
tisfa
ctio
n wi
th s
ervic
es.
Yes
NoNo
Enge
nder
He
alth
, M
inis
tère
de
la S
ante
, Cl
inic
gy-
néco
logi
que
et o
bsté
tri-
cale
, Dak
ar
Bure
au
Enge
nder
He
alth
au
Sene
gal
Publ
ishe
d
Dece
ntra
lizat
ion
is po
ssib
le
with
out m
ajor
exp
ense
and
im
prov
es c
are
for w
omen
wi
th in
com
plet
e ab
ortio
n. T
he
aver
age
cost
fell
by 3
500
F CF
A. T
he n
umbe
r of p
atie
nts
upta
king
FP
incr
ease
d fro
m 0
to
20%
, and
94%
wer
e sa
tis-
fied
with
qua
lity o
f ser
vices
.+
++
+
Diar
ra
Supp
ortin
g Ac
cess
to
Fam
ily
Plan
ning
an
d Po
st
Abor
tion
Care
2019
Mal
iSR
H
Stru
ctur
al/
cont
extu
al,
Attit
udin
al
Expe
ctat
ion,
at
titud
es,
oppo
rtuni
ty
This
appr
oach
incl
uded
cap
acity
bu
ildin
g of
pro
vider
s, co
ntin
uous
qua
lity
impr
ovem
ent,
and
conn
ectin
g pr
ovid
ers
to c
omm
uniti
es b
y hol
ding
mee
tings
to
disc
uss
powe
r dyn
amic
s, de
fine
qual
ity
serv
ices
, and
ena
ble
the
shar
ing
of d
ata
and
feed
back
from
the
com
mun
ity o
n th
e qu
ality
of s
ervic
es. R
efle
ctio
ns s
hare
d du
ring
mee
tings
wer
e do
cum
ente
d an
d pl
ans
of a
ctio
ns w
ere
crea
ted.
Man
ager
ial
appr
oach
es,
soci
al a
c-co
unta
bilit
yPo
st te
st
non-
ran-
dom
ized,
in
terv
entio
n ef
fect
s co
m-
pare
d wi
th
prev
ious
/hi
stor
ical
in
form
atio
n
New
FP u
sers
, Pe
rcen
tage
of
clie
nts
who
adop
ted
FP,
num
ber o
f clie
nt
com
plai
nts
NoYe
sYe
s, as
of
2018
CARE
Anon
y-m
ous
Grey
57,7
77 n
ew F
P us
ers,
incl
ud-
ing
57%
usin
g LA
RCs;
66
perc
ent o
f 2,91
4 po
st-a
bor-
tion
care
clie
nts
adop
ted
FP;
no c
ontra
cept
ives
were
out
of
stuc
k du
ring
the
inte
rven
tion;
th
ere
was
a re
duct
ion
in
com
mun
ity c
ompl
aint
s fro
m
400
in 2
016
to 4
7 in
201
8.
Ther
e we
re im
prov
emen
ts in
se
rvic
e qu
ality
and
impr
oved
cr
edib
ility
of p
rovid
ers
in
the
com
mun
ity (u
ncle
ar h
ow
mea
sure
d).
++
++
FIRST AUTHOR
PROJECT NAME
YEAR
COUNTRY
HEALTH TOPIC
BARRIER
FACTOR AFFECTING PERFORMANCE
PBC APPROACH
TYPE OF PBC APPROACH - CATEGORIZED
EVALUATION DESIGN
EVALUATION DESIGN - CATEGORIZED
OUTCOME/S MEASURED
COST EFFECTIVENESS Y/N
WITHIN LAST 5 YEARS
ONGOING
PRIME ORG
DONOR
PUBLISHED/GREY
KEY FINDING(S)
CLIENTS RECEIVED FP COUNSELING
FP UPTAKE
IMPROVEMENT IN PROVIDER ATTITUDE/
KNOWLEDGE
FACILITY-LEVEL OUTCOMES
COMMUNITY-LEVEL OUTCOMES
Guey
eTu
tora
t-Pl
us20
16Se
nega
lFP
- LA
RCs
Know
ledg
e/co
mpe
tenc
y Ab
ility
, ex
pect
atio
n
Tuto
ratP
lus
is a
prob
lem
-sol
ving
impr
ovem
ent a
ppro
ach
that
incl
udes
m
ento
rs fo
r pro
vider
s an
d he
alth
wor
k-er
s wh
o pr
ovid
e wo
rksi
te c
oach
ing
and
supe
rvis
ion,
incl
udin
g to
ols
to m
easu
re
and
eval
uate
per
form
ance
. Loc
al o
ffi-
cial
s an
d he
alth
com
mitt
ees
are
invo
lved
in c
reat
ing
actio
n pl
ans
and
eval
uatin
g pr
ogre
ss.
Trai
ning
and
ed
ucat
ion,
m
anag
eria
l ap
proa
ches
Base
line
situ
atio
n an
alys
is,
rout
ine
serv
ice
deliv
ery
data
and
Tu
tora
tPlu
s m
ento
ring
data
.
non-
ran-
dom
ized,
in
terv
entio
n ef
fect
s co
m-
pare
d wi
th
prev
ious
/hi
stor
ical
in
form
atio
n
% of
faci
litie
s ab
le to
offe
r at
leas
t one
LAR
C,
% of
pro
vider
s wi
th a
ccep
tabl
e LA
RC p
erfo
r-m
ance
, Num
ber
of n
ew L
ARC
user
s.
NoNo
NoIn
traHe
alth
, Pa
lladi
umUS
AID
Publ
ishe
d
The
perc
enta
ge o
f pro
vid-
ers
with
acc
epta
ble
LARC
pe
rform
ance
dou
bled
from
32
% to
67%
ove
r the
2 m
ento
-rin
g vis
its. N
ew L
ARC
user
s in
crea
sed
by 8
6%.
++
+
Kaba
USAI
D AS
SIST
Pr
ojec
t20
19Gu
inea
Post
-abo
r-tio
n FP
Stru
ctur
al/
cont
extu
alEx
pect
atio
n,
oppo
rtuni
ty
A qu
ality
impr
ovem
ent a
nd a
ssur
ance
ap
proa
ch w
as e
mpl
oyed
to in
crea
se
FP u
se a
fter p
osta
borti
on c
are.
Pe
rform
ance
sta
ndar
ds (i
nclu
ding
in
fect
ion
prev
entio
n, c
ouns
elin
g an
d pa
in m
anag
emen
t) we
re s
et a
nd w
ere
mon
itore
d us
ing
a ba
selin
e as
sess
men
t an
d on
goin
g su
ppor
tive
supe
rvis
ion
to
asse
ss p
rogr
ess
and
gaps
. M
anag
eria
l ap
proa
ches
Base
line
asse
ss-
men
t and
on
goin
g m
onito
ring
usin
g se
rvic
e st
a-tis
tics
and
ongo
ing
supp
ortiv
e su
perv
i-si
on.
non-
ran-
dom
ized,
in
terv
entio
n ef
fect
s co
m-
pare
d wi
th
prev
ious
/hi
stor
ical
in
form
atio
n
Prop
ortio
n of
wo
men
see
king
po
st-a
borti
on
care
who
leav
e wi
th a
n FP
m
etho
dNo
NoNo
URC
USAI
DGr
ey
The
perc
enta
ge o
f wom
en
rece
iving
a F
P m
etho
d be
fore
leav
ing
the
clin
ic ro
se
from
11%
to 5
9%. Q
ualit
y of
coun
selin
g is
repo
rted
to h
ave
impr
oved
sig
nific
antly
, tho
ugh
data
for t
his
is n
ot p
rese
nted
. +
+
Mug
ore
Evid
ence
to
Act
ion
(E2A
)20
16To
go
Post
-abo
r-tio
n ca
re
/ FP
Know
ledg
e/co
mpe
tenc
y, St
ruct
ural
/co
ntex
tual
, At
titud
inal
Attit
udes
, ab
ility
, exp
ec-
tatio
n
A qu
ality
impr
ovem
ent a
ppro
ach
was
empl
oyed
to in
crea
se u
ptak
e of
fam
ily
plan
ning
afte
r pos
tabo
rtion
car
e. T
he
inte
rven
tion
incl
uded
pro
vider
trai
ning
on
con
trace
ptive
tech
nolo
gy th
at e
mph
a-si
zed
com
pete
ncy f
or p
rovid
ing
impl
ants
an
d IU
Ds, a
nd a
lso
addr
esse
d is
sues
su
ch a
s pr
ovid
er b
ias
towa
rds
clie
nts,
incl
udin
g yo
uth,
the
need
to p
rovid
e co
unse
ling
and
FP m
etho
ds w
heth
er th
e ab
ortio
n wa
s in
duce
d or
spo
ntan
eous
, rig
hts-
base
d ca
re, r
ecor
d ke
epin
g (s
uppo
rtive
sup
ervis
ion
and
train
ing
of
prov
ider
s to
com
plet
e re
gist
ers)
, and
use
of
dat
a.
Trai
ning
and
ed
ucat
ion,
m
anag
eria
l ap
proa
ches
, in
stitu
tiona
l pr
oces
s im
-pr
ovem
ents
, va
lues
cl
arifi
catio
n
Use
of
rout
ine/
mon
itorin
g da
ta
non-
ran-
dom
ized,
in
terv
entio
n ef
fect
s co
m-
pare
d wi
th
prev
ious
/hi
stor
ical
in
form
atio
n
% wo
men
re
ceivi
ng F
P co
unse
ling,
%
wom
en re
ceivi
ng
cont
race
ptive
m
etho
dNo
Yes
No
Path
finde
r In
tern
atio
nal/
Intra
Heal
thUS
AID
Publ
ishe
d
Sign
ifica
nt in
crea
ses
in
cont
race
ptive
cou
nsel
ing
and
upta
ke a
mon
g PA
C cl
ient
s:
Durin
g th
e 5-
mon
th b
asel
ine
perio
d, 3
1% o
f PAC
clie
nts
were
cou
nsel
ed, w
hile
dur
ing
the
13-m
onth
inte
rven
tion
perio
d, 9
1% w
ere
coun
sele
d.
Of a
ll PA
C cl
ient
s co
unse
led
durin
g th
e ba
selin
e pe
riod,
37
% ac
cept
ed a
con
trace
p-tiv
e, co
mpa
red
with
60%
of
thos
e co
unse
led
durin
g th
e in
terv
entio
n pe
riod.
+
++
+
Mug
ore
Evid
ence
to
Act
ion
(E2A
)20
19To
goPo
stab
or-
tion
care
Know
ledg
e/co
mpe
tenc
y, St
ruct
ural
/co
ntex
tual
, At
titud
inal
Attit
udes
, ab
ility
, exp
ec-
tatio
n
A qu
ality
impr
ovem
ent a
ppro
ach
was
empl
oyed
to in
crea
se u
ptak
e of
fam
ily
plan
ning
afte
r pos
t abo
rtion
car
e. T
he
inte
rven
tion
incl
uded
pro
vider
trai
ning
on
con
trace
ptive
tech
nolo
gy th
at e
mph
a-si
zed
com
pete
ncy f
or p
rovid
ing
impl
ants
an
d IU
Ds, a
nd a
lso
addr
esse
d is
sues
su
ch a
s pr
ovid
er b
ias
towa
rds
clie
nts,
incl
udin
g yo
uth,
the
need
to p
rovid
e co
unse
ling
and
FP m
etho
ds w
heth
er th
e ab
ortio
n wa
s in
duce
d or
spo
ntan
eous
, rig
hts-
base
d ca
re, r
ecor
d ke
epin
g (s
uppo
rtive
sup
ervis
ion
and
train
ing
of
prov
ider
s to
com
plet
e re
gist
ers)
, and
use
of
dat
a.
Trai
ning
and
ed
ucat
ion,
m
anag
eria
l ap
proa
ches
, in
stitu
tiona
l pr
oces
s im
-pr
ovem
ents
, va
lues
cl
arifi
catio
n
Pre-
post
tra
inin
g te
sts,
mon
thly
data
co
llect
ion
from
PAC
re
gist
ries.
non-
ran-
dom
ized,
in
terv
entio
n ef
fect
s co
m-
pare
d wi
th
prev
ious
/hi
stor
ical
in
form
atio
n
Impr
oved
atti
-tu
des
and
empa
-th
y tow
ard
youn
g PA
C cl
ient
s, ef
forts
to s
cree
n fo
r exp
osur
e to
se
xual
and
GBV
, wi
lling
ness
to
expl
ore
RH n
eeds
an
d as
sist
clie
nts
in c
hoos
ing
met
hods
. Pe
rcen
tage
of
yout
h ch
oosi
ng
FP m
etho
d.No
Yes
No, s
cale
-up
beg
an
2017
Path
finde
r In
tern
atio
nal,
Intra
Heal
th,
Togo
DM
SI/
PFUS
AID
Publ
ishe
d
Volu
ntar
y con
trace
ptive
up-
take
am
ong
yout
h po
st-a
bor-
tion
care
clie
nts
incr
ease
d fro
m 0
% to
41%
.+
+
FIRST AUTHOR
PROJECT NAME
YEAR
COUNTRY
HEALTH TOPIC
BARRIER
FACTOR AFFECTING PERFORMANCE
PBC APPROACH
TYPE OF PBC APPROACH - CATEGORIZED
EVALUATION DESIGN
EVALUATION DESIGN - CATEGORIZED
OUTCOME/S MEASURED
COST EFFECTIVENESS Y/N
WITHIN LAST 5 YEARS
ONGOING
PRIME ORG
DONOR
PUBLISHED/GREY
KEY FINDING(S)
CLIENTS RECEIVED FP COUNSELING
FP UPTAKE
IMPROVEMENT IN PROVIDER ATTITUDE/
KNOWLEDGE
FACILITY-LEVEL OUTCOMES
COMMUNITY-LEVEL OUTCOMES
The
Fren
ch
Mus
koka
Fun
d
The
Fren
ch
Mus
koka
Fu
nd20
16
Sene
gal,
Guin
ea,
CI, B
F, M
ali,
Togo
, Be-
nin,
Nig
er,
Chad
, DR
C
FP, M
NCH,
Nu
tritio
n,
Gend
er
Know
ledg
e/co
mpe
tenc
y, St
ruct
ural
/co
ntex
tual
Abili
ty,
expe
ctat
ion
Prov
ider
trai
ning
s on
FP
coun
selin
g an
d IU
D se
rvic
e pr
ovis
ion,
on-
site
follo
w-u
p an
d st
reng
then
ing
of s
ervic
es g
iven
by
train
ed p
rovid
ers,
chan
ges
to m
idwi
ves'
train
ing
curri
cula
to in
tegr
ate
gend
er a
nd
hum
an ri
ghts
asp
ects
. Tr
aini
ng a
nd
educ
atio
n
"Pos
ttest
" co
unts
of
the
num
ber
of p
eopl
e re
ache
d
non-
ran-
dom
ized,
in
terv
entio
n ef
fect
s co
m-
pare
d wi
th
prev
ious
/hi
stor
ical
in
form
atio
n
Num
ber o
f new
us
ers,
num
ber o
f CY
Ps, n
umbe
r of
peop
le re
ache
d by
hom
e vis
itsNo
Yes
Yes,
as o
f 20
18
UNIC
EF,
UNFP
A, W
HO,
UN W
omen
Gove
rn-
men
t of
Fran
ceGr
ey
Mal
i: Re
ache
d 10
,000
pe
ople
via
hom
e vis
its; B
enin
: m
oder
n co
ntra
cept
ives
obta
ined
in 2
016
corre
spon
d to
858
,000
Cou
ple
Year
s of
Pr
otec
tion;
Tog
o: C
YP a
t-ta
ined
was
mor
e th
an 2
14,5
00
in 2
016.
Tot
al n
umbe
r of I
UDs
inse
rted
incr
ease
d fro
m 1
94
in 2
014
to 1
,515
in 2
016.
Tot
al
CYP
due
to P
PFP
incr
ease
d fro
m 6
79 in
201
4 to
530
2 in
20
16. F
rom
201
2 to
201
6, th
e to
tal n
umbe
r of n
ew M
C us
ers
acro
ss th
e 8
coun
tries
was
1,1
49,0
00+
Stev
a-no
vic-F
enn
Brea
k-th
roug
h RE
-SE
ARCH
2019
Togo
FP, G
ende
rKn
owle
dge/
com
pete
ncy
Abili
ty,
expe
ctat
ion
Com
mun
ity h
ealth
wor
kers
and
pro
vider
s we
re tr
aine
d on
fam
ily p
lann
ing,
cou
ple
com
mun
icat
ion,
gen
der n
orm
s, an
d in
timat
e pa
rtner
vio
lenc
e. C
HWs
then
im
plem
ente
d ho
me-
base
d, in
divid
ual
or c
oupl
e co
unse
ling
usin
g co
unse
ling
card
s pr
omot
ing
mal
e en
gage
men
t to
stru
ctur
e th
e co
unse
ling.
CHW
s al
so
deliv
ered
gro
up d
iscu
ssio
n se
ssio
ns to
pr
omot
e m
ale
enga
gem
ent a
nd fa
mily
pl
anni
ng.
Trai
ning
and
ed
ucat
ion,
in
divid
ual
proc
ess
im-
prov
emen
ts,
supp
lem
en-
tary
pa-
tient
-faci
ng
mat
eria
ls
In-d
epth
in
terv
iews
we
re c
on-
duct
ed w
ith
prov
ider
s, CH
Ws,
and
coup
les
at
two
time
poin
ts.
Qual
itativ
e/Ca
se s
tudy
Coup
les'
perc
eive
d se
lf-ef
ficac
y to
disc
uss
FP a
nd
cont
race
ptio
n,
CHW
s pe
rcei
ved
self-
effic
acy
to p
rovid
e FP
co
unse
ling
to
coup
les
NoYe
sNo
Inst
itute
for
Repr
oduc
-tiv
e He
alth
, Jh
pieg
o/M
SCP
USAI
DGr
ey
In m
onth
1, t
he C
HWs
were
no
t ver
y con
fiden
t in
man
y of
the
coun
selin
g el
emen
ts,
while
the
prov
ider
s we
re
mor
e co
nfid
ent.
In m
onth
7,
howe
ver,
both
CHW
s an
d pr
ovid
ers
were
very
con
fiden
t in
alm
ost a
ll el
emen
ts o
f co
unse
ling,
whi
ch a
ppea
rs to
be
due
in p
art t
o tra
inin
g an
d su
ppor
t: 10
0% o
f res
pond
ents
fe
lt ve
ry c
onfid
ent i
n th
eir
abili
ty to
pre
serv
e co
nfi-
dent
ialit
y, en
cour
age
and
resp
ond
to q
uest
ions
, and
su
ppor
t cou
ples
in d
ecis
ion
mak
ing.
Am
ong
coup
les,
ther
e wa
s a
cons
ensu
s th
at
the
hom
e-ba
sed
coun
selin
g an
d gr
oup
disc
ussi
on yi
elde
d po
sitiv
e ef
fect
s on
impr
oved
co
uple
com
mun
icat
ion.
Th
e ap
proa
ches
not
onl
y im
prov
ed th
e we
ll-be
ing
and
rela
tions
hips
of t
he c
oupl
es
who
parti
cipa
ted,
but
als
o th
e CH
Ws
and
prov
ider
s wh
o de
liver
ed th
e se
rvic
es.
+
FIRST AUTHOR
PROJECT NAME
YEAR
COUNTRY
HEALTH TOPIC
BARRIER
FACTOR AFFECTING PERFORMANCE
PBC APPROACH
TYPE OF PBC APPROACH - CATEGORIZED
EVALUATION DESIGN
EVALUATION DESIGN - CATEGORIZED
OUTCOME/S MEASURED
COST EFFECTIVENESS Y/N
WITHIN LAST 5 YEARS
ONGOING
PRIME ORG
DONOR
PUBLISHED/GREY
KEY FINDING(S)
CLIENTS RECEIVED FP COUNSELING
FP UPTAKE
IMPROVEMENT IN PROVIDER ATTITUDE/
KNOWLEDGE
FACILITY-LEVEL OUTCOMES
COMMUNITY-LEVEL OUTCOMES
Suh
Sene
gal
Mat
erna
l M
orbi
d-ity
and
M
orta
lity
Redu
ctio
n Pr
ojec
t (P
REM
O-M
A)20
07Se
nega
lRH
Know
ledg
e/co
mpe
tenc
y, St
ruct
ural
/co
ntex
tual
Expe
ctat
ion,
ab
ility
A fo
rmat
ive s
uper
visio
n ap
proa
ch w
as
used
to im
prov
e qu
ality
of s
ervic
es a
nd
to re
info
rce
the
tech
nica
l com
pete
nce
of p
rovid
ers.
For
mat
ive s
uper
visio
n is
a
type
of s
uppo
rtive
sup
ervis
ion
that
co
mbi
nes
obse
rvat
ion
of p
rovid
ers
with
a
prob
lem
-sol
ving
appr
oach
to m
obili
ze
prov
ider
s to
add
ress
clin
ical
, logi
stic
, an
d in
form
atio
n, e
duca
tion
and
com
mu-
nica
tion
(IEC)
pro
blem
s. It
als
o in
clud
es
the
com
mun
ity in
the
supe
rvis
ion
proc
ess
by in
trodu
cing
com
mun
ity re
pre-
sent
ative
s to
a ri
ghts
-bas
ed a
ppro
ach
to
serv
ice
qual
ity a
nd a
sses
sing
com
ple-
tion
rate
s of
act
ion
plan
s de
velo
ped
by p
rovid
ers
and
com
mun
ity m
embe
rs
join
tly.
Man
ager
ial
appr
oach
es,
soci
al a
c-co
unta
bilit
y
Pre-
post
qu
antit
a-tiv
e (n
o co
mpa
rison
gr
oup)
non-
ran-
dom
ized,
in
terv
entio
n ef
fect
s co
m-
pare
d wi
th
prev
ious
/hi
stor
ical
in
form
atio
n
Indi
cato
rs o
f qu
ality
for e
ach
area
of s
ervic
e de
liver
y (4)
: inf
ra-
stru
ctur
e, m
an-
agem
ent o
f sta
ff an
d se
rvic
es,
reco
rd-k
eepi
ng,
tech
nica
l com
pe-
tenc
eNo
NoNo
Man
agem
ent
Scie
nces
for
Heal
thUS
AID
Publ
ishe
d
Tech
nica
l com
pete
nce
in
fam
ily p
lann
ing
impr
oved
by
16%
in L
ouga
dis
trict
and
10
% in
Tiva
oune
dis
trict
. Re
cord
-kee
ping
for F
P pa
tient
fil
es in
crea
sed
by 7
% in
Thi
es
regi
on a
nd 2
2% in
Lou
ga
regi
on, a
nd u
se o
f reg
istri
es
incr
ease
d by
9%
and
16%
in e
ach
regi
on. T
echn
ical
co
mpe
tenc
e in
gro
up c
oun-
selin
g in
crea
sed
by 2
6% in
Th
ies
regi
on, a
nd te
chni
cal
com
pete
nce
in in
divid
ual
coun
selin
g in
crea
sed
by 1
7%
in T
ivaou
ne d
istri
ct, 2
3% in
Ke
bem
er d
istri
ct, a
nd 1
4% in
Lo
uga
dist
rict.
++
+
Tran
Yam
Da
abo
2018
Burk
ina
Faso
PPFP
Know
ledg
e/co
mpe
tenc
y, St
ruct
ural
/co
ntex
tual
Abili
ty,
Expe
ctat
ion
Prov
ider
refre
sher
trai
ning
, a P
PFP
coun
selli
ng to
ol, s
uppo
rtive
sup
ervis
ion
prov
ided
regu
larly
, ava
ilabi
lity o
f con
tra-
cept
ive s
ervic
es in
crea
sed
to s
even
day
s pe
r wee
k, ap
poin
tmen
t car
ds fo
r clie
nts,
and
invi
tatio
ns fo
r par
tner
s of
clie
nts
Man
ager
ial
appr
oach
es,
supp
lem
en-
tary
pa-
tient
-faci
ng
mat
eria
ls,
indi
vidua
l pr
oces
s im
-pr
ovem
ents
, tra
inin
g an
d ed
ucat
ion,
or
gani
-za
tiona
l ch
ange
s
two
grou
p,
mul
ti-in
ter-
vent
ion,
sin-
gle-
blin
ded,
cl
uste
r ra
ndom
ized
cont
rolle
d tri
al
Rand
omize
d co
ntro
lled
trial
Prim
ary o
utco
me
is M
C up
take
at
12 m
onth
s PP
NoYe
sNo
WHO
Gove
rn-
men
t of
Fran
ce/
Mus
koka
Publ
ishe
d
MC
prev
alen
ce a
t 12
mon
ths
was
55%
amon
g wo
men
in th
e in
terv
entio
n gr
oup
and
29%
amon
g wo
men
in th
e co
ntro
l cl
uste
rs (a
dj. p
reva
lenc
e ra
tio 1
.79
(1.3
0-2.
47 9
5% C
I).
Sign
ifica
nt d
iffer
ence
s in
MC
prev
alen
ce w
ere
also
see
n at
6
week
s an
d 6
mon
ths.
+
URC
USAI
D He
alth
Ca
re Im
-pr
ovem
ent
Proj
ect
2012
Mal
i, Af
ghan
-is
tan,
Ug
anda
FP
Know
ledg
e/co
mpe
tenc
y, St
ruct
ural
/co
ntex
tual
Ab
ility
, Ex
pect
atio
n
Disp
layin
g jo
b ai
ds o
n FP
cou
nsel
ing
and
met
hods
, invo
lving
dire
ctor
s of
hea
lth
cent
ers
in a
ctivi
ties
rela
ted
to P
PFP
Orga
ni-
zatio
nal
chan
ges,
indi
vidua
l pr
oces
s im
-pr
ovem
ents
, m
anag
eria
l ap
proa
ches
, su
pple
men
-ta
ry p
a-tie
nt-fa
cing
m
ater
ials
Mon
itorin
g/pr
ogra
m
data
- do
es
not a
ppea
r to
hav
e a
com
paris
on
non-
ran-
dom
ized,
in
terv
entio
n ef
fect
s co
m-
pare
d wi
th
prev
ious
/hi
stor
ical
in
form
atio
n
% wo
men
re
ceivi
ng F
P co
unse
ling
befo
re d
isch
arge
(P
PFP)
NoNo
NoUR
CUS
AID
Grey
The
perc
enta
ge o
f pos
tpar
-tu
m w
omen
who
rece
ived
FP
coun
selin
g in
crea
sed
from
0
to 8
6%, a
nd th
e pe
rcen
tage
of
thos
e wo
men
cou
nsel
ed
who
acce
pted
an
FP m
etho
d in
crea
sed
from
0 to
90%
afte
r th
e in
terv
entio
n.
+
URC
Tran
slat
ing
Rese
arch
in
to A
c-tio
n(TR
Ac-
tion)
2017
Sene
gal
FP,
Hygi
ene,
M
NH, T
B,
HIV
Stru
ctur
al/
cont
extu
al,
Attit
udin
alAt
titud
es,
Expe
ctat
ion
Resu
lts-b
ased
fina
ncin
g pr
ogra
m w
hich
gr
ante
d fin
anci
al a
ward
s to
pro
vider
s an
d fa
cilit
ies
base
d on
atta
inm
ent o
f qu
antit
y and
qua
lity g
oals
.Fi
nanc
ial
ince
ntive
sQu
alita
tive
Qual
itativ
e/Ca
se s
tudy
Prov
ider
def
ini-
tions
of q
ualit
y, ap
proa
ches
to
achi
evin
g qu
ality
, pe
rcei
ved
barri
-er
s to
qua
lity
NoYe
sNo
URC
USAI
D,
NORA
D,
R4D
Grey
Qual
itativ
e fin
ding
s su
gges
t RB
F ha
s im
prov
ed p
rovid
er
beha
vior a
nd q
ualit
y of c
are
and
has
begu
n to
tran
sfor
m
the
cultu
re w
ithin
faci
litie
s to
ward
s m
ore
resp
onsi
ve c
are
with
stra
tegi
c an
d co
llabo
ra-
tive
use
of re
sour
ces.
++
NAM
E OF
PRO
JECT
COUN
TRY
YEAR
SOR
GANI
ZATI
ONDO
NOR
PBC
APPR
OACH
PBC
APPR
OACH
, CAT
EGOR
IZED
USAI
D AS
SIST
Pro
ject
CI, M
ali,
Nig
er, 3
8 to
tal
2012
-201
7U
RCUS
AID
Qua
lity
impr
ovem
ent
Trai
ning
and
edu
catio
n, m
anag
eria
l app
roac
hes
Beyo
nd B
ias
Burk
ina
2016
- Pr
esen
tPa
thfin
der
Gate
sAd
dres
sing
pro
vide
r bia
sTr
aini
ng a
nd e
duca
tion,
man
ager
ial a
ppro
ache
s, in
stitu
tiona
l pro
cess
impr
ove-
men
ts, i
ndiv
idua
l pro
cess
impr
ovem
ents
Yam
Yan
kre
"My
Choi
ce"
Burk
ina
2015
- Pr
esen
tPa
thfin
der
Anon
ymou
s.Tr
aini
ng to
add
ress
judg
emen
t and
bia
sTr
aini
ng a
nd e
duca
tion
Wes
t Afr
ica
Adol
esce
nt
and
Yout
h SR
H P
rogr
amBu
rkin
a, N
iger
, Gui
nea
2012
-201
6Pa
thfin
der
Vario
usAd
dres
sing
pro
vide
r bia
s
TRAc
tion
Sene
gal
2009
- 20
17U
RCUS
AID
Resu
lts-b
ased
fina
ncin
gFi
nanc
ial i
ncen
tives
mM
ento
ring
Burk
ina
2015
- 20
18Jh
pieg
oN
ot li
sted
Men
torin
g an
d su
perv
isio
nM
anag
eria
l app
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