To support the realisation of all women’s and girls’ sexual and reproductive rights and support them to take up the FP method that meets their needs and aspirations, MSS addresses key barriers identified in Pakistan by using the evidence-based Behavior Change Communication (BCC) and community mobilisation strategy, IRADA, developed in-house by demand generation (DG) experts at MSS and adapted for scalability in Pakistan in DRHR. The approach involves strengthening the traditional marketing approach, with participatory learning tools. MSS also addresses financial barriers to access for women, including women in low income households and women with little control over household finances.
BCC and community mobilisation: FHEs are recruited in the catchment areas of the Suraj SF providers are subsequently trained in Participatory Reflection and Analysis (PRA) tools and community mobilisation. FHEs establish Community Health Committees (CHCs) that facilitate their work in the communities and help them in identifying and recruiting male and female Community Health Volunteers (CHVs) in their respective catchment areas. Moreover, CHVs and CHCs facilitate FHEs in conducting neighbourhood (Mohalla) meetings, advice meetings (Mashvara), and household visits to non-using MWRA in their respective communities. CHCs supervise and support CHV activities, which include mobilising demand in their communities by visiting households and disseminating Information, Education, and Communication (IEC) material, as well as conducting follow-up visits for obtaining client feedback from women who have received services at Suraj centres.
Our FHE’s are also trained in the usage of psychometric tools developed during one of MSS’ previous donor funded projects to segment MWRAs and tailor key messages based on their responses to these simple psychometric questions derived from the larger behaviour change model that has been validated for the target population (Gul et al., 2016c; Gul et al., 2016d).
Voucher distribution: To increase MWRA’s personal agency to access FP services, removing financial barriers to accessing long-acting reversible contraceptives (LARCs), and promoting demand-side financing FHEs will also distribute referrals and vouchers to poor MWRA in communities. MWRA can then subsequently redeem these vouchers at the Suraj SF centres for IUCDs as per the established MSS voucher management system (VMS), with detailed operational protocols documented in the Client Management System developed during DRHR. MSS has robust and comprehensive monitoring and fraud prevention mechanisms to ensure quality and transparency in its voucher distribution, redemption and overall management.
Project data from one of our previous programme’s indicates that vouchers, while effective in driving demand and enhancing women’s uptake of modern FP, have been effective at reaching women and girls who, despite being in households that are not in the lowest wealth quintile, have limited access to financial resources.
However, the intervention has been less effective at reaching the poorest of the poor. Under its more recent projects, MSS will strengthen its distribution activities to support the FHE in identifying and reaching the poorest women. Local residents, trained as social volunteers will identify poor women in their communities and connect them with FHEs for provision of vouchers. These volunteers will also help the FHEs to engage more men within their communities.
To capitalise on the value of the voucher as a call-to-action, during DAFPAK MSS will also pilot a male voucher for couples’ counselling and FP services. Vouchers will be distributed to men, with a focus on young men, in the catchment areas of SF providers, redeemable at the Suraj clinic for a long acting reversible contraceptive of choice.