Program Description:
Social Marketing Company (SMC) is offering Long Acting Reversible Contraceptive (LARC) services through private graduate doctors. Long Acting Reversible contraceptive (LARC) program of SMC has been implemented under USAID’s Marketing Innovation for Health (MIH) Program from July 26, 2012 to July 25, 2016. SMC has been implementing Marketing Innovations for Sustainable Health Development (MISHD, 2016-2021) program funded by USAID which is a follow on of MIH program. This program has been initiated with a view to increase accessibility, availability and utilization of IUD, Implant and Injectable services through private medical practitioners and private health facilities. To support the initiative, USAID has donated IUD and Implants to be delivered through private sector health care provider. SMC is implementing this program by capacity building of OBGYNs (Obs & Gynae specialist) at individual and facility level as well as supply of products at subsidized rate. As a partner of MISHD, EngenderHealth is providing necessary training to doctors to offer these services and is ensuring quality assurance of LARC program. SMC implements the program in close collaboration with the Directorate General of Family Planning (DGFP) and the Obstetrical and Gynecological Society of Bangladesh (OGSB).
Pink Star : Branding LARC Program:
SMC has branded its LARC network as “Pink Star” with a mission to provide the highest quality family planning service through private sector. The signage has been selected through a process of pre-testing among doctors. The program will promote its service delivery outlets as “Pink Star” rather than different individual identity as a source of supply of LARC services in the private sector.
Products and Overbranding:
The need to shift the method mix more in favor of long acting and permanent methods is a policy objective of the Government of Bangladesh. But doing so particularly for methods like IUD is a challenging task considering the image problems emerging from side effects and complications due to lack of proper counseling, screening and infection
prevention process in the past. In addition there are some myths exists in and around with IUD. To overcome some of these perceptual problems, SMC decided on a strategy to reposition IUD and Implant through over branding of
IUD as Relax and Implant as I-Plant. Relax IUD is a TCu 380A that is effective for 10 years once inserted and is manufactured by Injeflex, Brazil. I-Plant is a two-rod implants whose efficacy lasts for 5 years after insertion. It is a progestin only formulation manufactured by Bayer Schering, Germany. Both products have been donated by USAID and as such the pricing has been kept at very affordable levels.
Eligibility to be included in Pink Star:
To be eligible to participate in the LARC training and receive product supplies from SMC, a provider must be a graduate private practitioner either having her/his own chamber or practicing through a private sector clinic or facility or both. These providers are identified by the SMC Program Officers in collaboration with Sales Promotion Officers after extensive mapping. Providers who are found to have large women clientele, good reputation within the community, have adequate space for counseling and insertion, have signed a consent form to participate in the training and purchase IUDs and Implant from SMC are finally selected to be a part of the network.
Capacity Development
Two days long basic training is conducted and organized by MIH partner EngenderHealth. Training follows the national family planning curriculum and utilizes government facilities (e.g., Maternal and Child Welfare Centers, Upazila Health Complexes) as training venue; also utilize OGSB and NGO venues. There is also provision of one day long refresher training for doctors and Family Planning Counseling and Infection Prevention Procedure for assistants. EngenderHealth is also taking initiative in quality assurance and quality improvement process including direct technical support at the time of first insertion.
Demand Generation:
An extensive below-the-line communications campaign is being implemented to create awareness of Relax IUD and I-Plant implant. These include distribution of brochures and leaflets to potential customers and placing signboards, billboards, banners and posters around the catchment area of the health service providers to advertise the availability of the product. SMC also has published advertisements in the major national and regional newspapers that have included the names and addresses of the doctors by districts. Besides, SMC is generating demand through TV commercial and health talk show.
Potential client can get updated information about doctors and adjacent service delivery outlets while visiting www.relax-iplant.com and www.healthtalkbd.org. The program has a face book page named “SMC Pink Star Program” where anyone can get updated information about the program.
Creating awareness through IPC at community level:
Since the demand creation of LARC services through private sector is a challenge, SMC recruited Counselors for strengthening engagement of active provider and ensure continuity of LARC service. This activity has been initiated as a pilot program with a view to create demand among potential LARC clients through direct IPC at household level. Intention of this program is to develop satisfied LARC clients who will further motivate clients and create positive word of mouth about LARC.
OGSB Engagement:
SMC believes that engagement of OBGYN/OGSB can be instrumental in making LARC methods an important component of the reproductive health service provision among its members. Currently 600 doctors are actively involved in Pink Star program to offer IUD and Implant services from their private facility and advocating in various forums for utilizing LARC through private sector.
The initial response to the program is encouraging. The graduate doctors, in many cases, are proactively discussing with the clients on various family planning methods and informing them about the availability of LARC and Injectable services. SMC has observed that the use of Relax, i-plant and injectable (Sayana Press/SOMAJECT administrations are gradually increasing through this network. Currently over 600 doctors are actively engaged in service delivery.
