Session 4:

Scaling Up Integrated Services

IBP TRACK: ADDRESSING IMPLEMENTATION AND
SCALING UP CHALLENGES

Anne Pfitzer, JHPIEGO
Salwa Bitar, MSH
Christine Bixiones, PSI
Fabio Castao, MSH
Maxine Eber, PSI
Jeanette Kesselman, Abt Associates
Trish MacDonald, USAID/W
Charlotte Warren, Population Council
Rose Wilcher, FHI360
David Wofford, Meridian Group International


Session Organizers

Understand FP
integration
models and
their scaling up

Discuss
challenges &
strategies to
taking models
from
demonstration
to scale

Offer tools for
implementation
of FP service
integration with
health & non-
health
initiatives

Identify gaps in
evidence/knowl
edge and
resources for
decision-making
on integration
modalities
Session Objectives
1 2
3
4
What are Integrated Services?
the organization and management of health
services so that people get the care they need,
when they need it, in ways that are user friendly,
achieve the desired results and provide value for
money.
World Health Organization
Benefits of Integrating FP
with other Services
Meeting multiple reproductive health needs
of a client simultaneously
Combining several services needed for a
multifaceted health condition
Achieving cost efficiencies through sharing
staff skills, infrastructure, and equipment (still
needs more evidence)
Reducing the stigma associated with providing a
service independently

Key issues for FP Integration
More than training for adding a new service
Need integrated and strengthened health
systems
All building blogs working for FP/RH
Multisectoral approaches, broad audiences,
multitude of reinforcing channels.
Health and non-health programs

Key questions on integrated services
Feasibility
Acceptability
Increased access Vs Quality and Safety
Impact for individuals and populations
Cost
Population Council
Micro
financing
What: health,
non-health
MNCH HIV/PMTCT
Education Workplace
Immunization
Malaria, TB
Environment
For Whom:
target groups
Couples
Youths &
Adolescents
Young married
Women
Women
Rep age
Which
Systems
required
HRH
LMG
Service
Delivery
Supplies Information
Platforms for HTSP integration into MCH
programs
Integration models: the W Approach
Finance
Community
Where
Outreach H. Centers Hospitals
Management Sciences for Health
Men
What: health,
non-health
MNCH
Education Workplace
For Whom:
target groups
Youths &
Adolescents
Young married
Women
Women
Rep age
Which
Systems
required
HRH
LMG
Service
Delivery
Supplies Information
Platforms for HTSP integration into MCH
programs
Integration models: the W Approach
Finance
Community
Where
Management Sciences for Health
Two crucial Ws

When

How




Health facilities

Community
PP
Family
Planning
ART clinics:
PMTCT + FP
Child Clinics:
immunization,
nutrition
Strengthene
d integrated
services
FFSDS
Child Days
Integrated
Outreach
Maternal Child health passport
Integrated home visits - Village Health Teams & drug sellers
Management Sciences for Health
Integration models: the W Approach
How
JHPIEGO and FHI360
Scaling up Integrated Services
Deliberate efforts to increase the impact of
health service innovations successfully tested in
pilot or experimental projects so as to benefit
more people and to foster policy and program
development on a lasting basis.

ExpandNet


Process for
Scaling Up
Defining
Need for
Change
Planning
Demonstration
and Scale-Up
Supporting
Demonstration

Going to
Scale
Building
Block
Leadership/
Governance
Health
Workforce
Service
Delivery
Financing
Products
Technologies
Information

Scaling up Integrated Family planning
Management Sciences for Health
High Impact Practices and Consensus
Statements for FP Integration
.
Interactive
Case Studies

(For Anne to lead the
guidance on group
work)
Gaps for Scaling up FP Integration

Cost and cost-effectiveness
Sustainability
Policy- and decision-makers
support
Performance-based financing and
health systems strengthening for
integration
Providers perspective
Monitoring and Supervision
Pre-service training
Health worker capacity and time
demands
Same provider versus referral
Toolkits for integration
for Anne to describe the tools as she is putting the list
together
Maternal Infant Young Child Nutrition - Family
Planning (MIYCN-FP) Integration Toolkit:
http://www.k4health.org/toolkits/miycn-fp/how-
integrate
Population Council Handbook Assessing Integration
Methodology (AIM)
http://www.k4health.org/sites/default/files/Assessm
ent%20of%20Integration%20Methodology.pdf
K4H: Family planning and immunization integration
toolkit