Improving delivery and uptake of Family Planning services through supply-side strategies Operations Research Mapping Report

The E4D activity is a five-year initiative that is built around three intermediate results: 1) operations research (OR) and triangulation activities; 2) capacity building of regional and local institutions to implement OR and evaluations; and 3) dissemination of research and evaluation findings locally, regionally, and internationally. USAID/WA's Regional Health Office (RHO) reaches 21 countries in West and Central Africa, all of which have access to the E4D activity. The initial focus is on six target countries, namely: Togo, Burkina Faso, Côte d'Ivoire, Niger, Cameroon, and Mauritania. In Togo, a lack of research-based evidence to improve access to and utilization of FP services necessitates operations research (OR) to generate sound evidence for key stakeholders. Evidence generated locally through the Agir pour la Planification Familiale (AgirPF) project has the potential to catalyze the adoption of best practices for FP service delivery in Togo. The operations research (OR) protocol, improving delivery and uptake of Family Planning (FP) services through supply-side strategies, was implemented between July 2016 and May 2017 in Lomé, Togo. The OR aimed to assess the effectiveness of the AgirPF intervention as compared to service delivery in non-intervention sites. The OR was a combination of exploratory/diagnostic research and evaluation, conducted while the AgirPF intervention was ongoing in the research sites. To ensure long-term impact of interventions and programs, evidence from Togo should be reviewed to gain insights and better understand gaps and opportunities in family planning service delivery. Overall, this OR aims to provide evidence on the effect of the FP delivery model employed by AgirPF in Togo with the following specific objectives: 1) Assess the effectiveness, including costs, of the AgirPF program in improving uptake of contraception, quality of services delivered by providers, and the availability, accessibility, and acceptability of services within intervention areas; and 2) Identify contributing factors that might explain the relative effectiveness of the AgirPF model of delivery and explore its long-term sustainability. A mapping exercise for the family planning (FP) operations research (OR) study was conducted in August 2016 to understand whether there were partners implementing FP activities in the facilities or catchment areas of the health facilities included in the E4D FP OR. This exercise aimed to understand whether improved contraceptive uptake and higher quality FP service provision in intervention areas can be attributed to AgirPF, or if activities by other FP organizations in the region contributed to changes in the measures of association between intervention and non-intervention groups, as measured by the OR study. A representative from the E4D Project visited all health facilities included in the OR, in both intervention and non-intervention sites, to collect information on which organizations were working with those facilities and within their catchment areas. Information was collected on which non-governmental organizations (NGOs), private entities, and other groups apart from AgirPF the 16 study facilities had partnered with between January 2013 and August 2016. The list of 11 intervention (AgirPF) facilities and 5 non-intervention (non-AgirPF) included in the OR study is listed below in Table 1. A meeting was arranged with the manager or lead provider of each family planning department in these health facilities between August 1st and August 5th, 2016. The FP provider interviewed was asked to list out the types of activities and FP services each organization implemented or funded within their facility and/or catchment area.