Adapting an Employer-Based Approach to Support Increased Access to and Use of LA/PMs

The initiative targeted men and women of reproductive age who have an unmet need for family planning or are using a method that is not well-suited to their childbearing intentions. The project aimed to leverage the private sector to improve workers' access to information and services for LA/PMs. The employer-based initiative built on the global trend among companies to establish health promotion programs that support improved health and well-being for their employees. Such programs encourage increased employer financing and support for services by making a business case to employers that providing access to a broader range of health care services is cost-effective and that offering these services can help to increase productivity and reduce employee turnover and absenteeism. The RESPOND Project's Supply-Enabling Environment-Demand (SEED) Programming Model served as a pillar of the project's design, ensuring the availability and quality of services for LA/PMs, fostering an enabling environment for sexual and reproductive health-seeking behavior, and improving knowledge about and demand for services among employees. The project recruited 10 companies from various industrial sectors, representing more than 5,000 employees. Employers were expected to provide support to the initiative in several ways, including providing the venue for health talks, covering time off for employees who decide to accept a method, designating a health coordinator, and placing signage developed by the project in well-trafficked areas of the company. The most critical issue was the scheduling of health talks, as some companies did not fully support holding multiple health talks during working hours. The project's key interventions included conducting health talks among small groups of employees, staffing health desks to provide one-on-one information, distributing information, education, and communication (IEC) materials, identifying and training company-based health coordinators, and identifying referral sites for LA/PM services. Health talks were group sessions conducted during normal working hours, facilitated by the RESPOND LA/PM Program Officer, and included a 45-minute orientation on all family planning methods, with an in-depth discussion of LA/PMs. The health talks reached 2,835 employees, with participation varying between 30 and 50 employees per health talk. The health desks consisted of a small table with informational materials, placed in well-trafficked areas of the company for several hours on different days of the week. The health desk was staffed by the RESPOND program officer or by a trained counselor. The health desks allowed RESPOND to have an on-site presence without engaging a large number of employees at one time and provided a venue for employees who had questions about family planning methods but may have been reluctant to ask questions in a large-group setting. From January 2011 to June 2012, RESPOND organized and staffed 86 health desk sessions that reached 1,995 employees. The project also designed and produced a series of IEC materials on family planning and LA/PMs, including posters and standing displays promoting male sterilization, female sterilization, and the IUD, as well as an all-method brochure that provided in-depth information on LA/PMs in general. The brochure was distributed during health talks and health desks, and the posters and standing displays were placed in visible, well-trafficked areas of the participating businesses. To assess the impact of its on-site activities with employees, RESPOND conducted a retrospective endline survey among employees of the participating companies. The survey results showed that the project's activities had a significant impact on increasing knowledge about and use of LA/PMs among employees. The project's findings suggest that the employer-based approach can be an effective strategy for increasing access to and use of LA/PMs among men and women of reproductive age in India.