FPA India provides sexual and reproductive health (SRH) services directly through static- and outreach-based service delivery points (SDPs). Services are also enabled through associated clinics based on a partnership agreement.
Static model of service delivery
Reproductive Health and Family Planning Clinics
Reproductive Health and Family Planning Clinics (RHFPC) are static clinics which provide sexual and reproductive health services. These services include sexuality counselling, contraceptives services including emergency contraception, safe abortion care, management of reproductive tract infections / sexually transmitted infections and HIV, gynaecological services, antenatal and postnatal care, and sexual and gender-based violence screening and counselling.
Outreach model of service delivery
These are SDPs, located close to the community, staffed by trained providers delivering a limited range of SRH services within the scope of their training and experience, and infrastructure limitations of the facility. These facilities function on the lines of an ‘outpatient department’, and can be loosely defined as structures which fill in the gaps between ‘sub-centres’ and ‘primary health centres’ under the public health system of India.
Satellite clinics are defined by a smaller area and fewer number of service providers as compared to the static clinics or RHFPCs. The services offered include counselling, consultation, examination, basic laboratory tests (relevant to the services) and treatment as required. Subject to availability of qualified providers, a comprehensive range of SRH services can be offered with the exception of surgical procedures.
The clinics enable patients to spend less time, energy and money, and they increase access to wider geographic areas and sections of the population. The Quality of Care policy ensures there is no dilution of quality and the quality norms remain the same as for RHFPCs.
Mobile outreach units
These are defined as offsite SDPs managed by branches and run by full and / or part-time branch staff.
- Mobile outreach services through equipped vans
Services are provided through equipped vehicles reaching fixed locations at fixed times. Contraceptive and other SRH as well as non-SRH services may be provided. This approach increases access to services delivered depending upon the resources available in the vehicle. In some vehicles, space is demarcated to provide counselling while maintaining audio-visual privacy. An examination / folding gynaecological table can be fitted in the vehicle to facilitate general and local (abdominal and pelvic) examination of patients and related procedures. Distribution of contraceptives and dispensing of medicines and other commodities are done through such mobile vans.
- Mobile outreach services without van
These operate in previously established healthcare facilities of other organisations. The setup is similar to the satellite clinics, but the facilities are built, owned and operated by other organisations. The financial investment is minimal. The infrastructure and some of the staff members may be ‘borrowed’ for specific purposes. This widens the reach of the services provided by FPA India.
Based on whether or not regular deployment of staff for demand generation and community mobilisation happens, service sessions are planned and delivered by the mobile outreach team — delivered as fixed-day or special service sessions.
Fixed-day service sessions, as the name suggests, are offered on fixed days and at fixed timings in a month. The community is aware of the scheduled days when the mobile team visits. Such scheduled service sessions are generally offered within the existing operational area.
Special service sessions may be conducted within or beyond the operational area, in an area of high need specially identified during assessment of needs.
- Community-based distributors or providers
These are community volunteers trained and supported to conduct home visits for identifying and following up with target populations for the distribution of contraceptive products and other SRH-related commodities. They also offer referrals to outreach or static clinics of FPA India for family planning and SRH services. They are considered as non-clinic-based SDPs.
Associated clinics are a model for enabling services through a partner clinic, where the scope of partnership is defined through a memorandum of understanding. Working with an already established system in the form of a privately-run clinic or hospital in the area can help maximise outreach without stretching the limited resources required to set up an SDP fully managed by FPA India. This can also enhance the local ownership for the project, favourably influencing the project sustainability.
An associated clinic is defined as a clinic-based SDP belonging to private individuals, organisations or the public sector. Before the clinic is accepted as an associated clinic, the infrastructure is assessed for quality on mutually agreed parameters. An associated clinic is not managed by FPA India.
Branches have an agreement to provide support, monitoring, quality of care and overview. FPA India may provide contraceptives and other SRH commodities to the associated clinics for distribution, including IUCDs and injectables. Syndromic management of sexually transmitted infections is offered. Vaccinations, referral services and follow-up of surgical cases is also done at the associated clinics.
- Associated clinics