AcQual III

Dates: Initial Phase began in 2014; Current Project: 2018-2021

Role: Prime Recipient

Donors: Bill & Melinda Gates Foundation, David and Lucille Packard Foundation

AcQual (referring to “access” and “quality”) first started in 2014 and now operates in two provinces of the DRC: Kinshasa and Kongo Central. The five specific objectives of the project contribute to the national effort to achieve a modern contraceptive rate of 19.0% by 2020.

OBJECTIVES

  • Implement community-based programming
  • Test innovative strategies
  • Institutionalize promising strategies
  • Conduct programmatic research to inform programming
  • Strengthen local capacity and systems

Implement community-based programming: This project builds on Tulane’s previous work in establishing a large-scale network of community-based FP services in the provinces of Kinshasa and Kongo Central and in training nursing students to deliver family planning services at the community level. Three local partner organizations (SANRU, ABEF-ND, and the National Program for Military Health) implement the primarily service delivery activity – Lelo PF (which means “family planning today” in the local language of Lingala) – in collaboration with the authorities of the local health zones. During this outreach activity which takes place regularly in 34 of the 35 health zones in Kinshasa and 12 of the 31 health zones in Kongo Central, nursing graduates and community-health workers counsel prospective clients on family planning, provide a range of six contraceptive methods (implants, injectables, CycleBeads, condoms, pills, and emergency contraception, as well as implant removal services at the referral facilities); they refer clients to fixed facilities if needed.

Test innovative strategies: Under AcQual II, Tulane conducted three pilot tests in Kinshasa using nursing students as community-based distributors of contraception. The results indicated the potential of this cadre to increase access to family planning services, while gaining valuable experience in service delivery. Replicating and institutionalizing the family planning curriculum into nursing schools remains a primary focus of this project, and this intervention was recently extended to a third province (Lualaba).

Institutionalize promising strategies: Tulane is working with the D6 (Director of the Ministry of Health that oversees the 477 nursing schools in the country) to institutionalize the family planning curriculum into the training of 3rd and 4th year nursing students. As part of the training, these students learn to provide a range of contraceptives at outreach events organized throughout the year, and door-to-door in the community.

Conduct programmatic research to inform programming: Under AcQual III, Tulane has conducted one of the first ever studies of quality of care in family planning service delivery at the community level. Data from three instruments – observation of the client-provider interaction, client-exit interviews, and interviews with the student providers – have yielded important insights into strengths of the program and areas for improvement.

Strengthen local capacity and systems: The project has worked in close collaboration with the National Health Information System to refine the data collection instruments used to monitor FP service delivery in health facilities nation-wide. Through its support to workshops and meetings, the project has contributed to strengthening capacity of many Congolese health professionals in data interpretation and use.