This brief provides an overview of diverse service delivery models for providing implants services.

The entry of new contraceptive implants and the exit of Norplant leaves family planning programs to decide whether to add one of the new implants to their method mix and if so, which one to introduce—Jadelle, Implanon, or Sino-implant (II). Programs evaluate a variety of factors in deciding which implant to introduce. This brief discusses these factors, including regulatory approval, cost, and service delivery issues.

This brief discusses some of the key issues to consider when developing a work flow for provision of implants.

This brief gives an overview of the cadres of health professionals that can provide hormonal implants. Enabling various types of health care personnel to provide implants services helps to increase the availability and uptake of implants services.

Reorganizing skills among cadres is called task shifting (moving skills from one cadre to another) or task sharing (increasing the number of cadres able to perform a skill). Based on a review of the literature and country examples, the brief describes why task shifting is important and highlights some key steps in planning for, developing, and supporting cadres involved in task shifting. The guidance in this brief can be applied to task sharing for implants programs, which is needed to meet the high demand demonstrated by implants programs.

Comparison of hormonal implants, including manufacturer, formulation, mean insertion and removal time, labeled duration of product use, availability of trocars, per unit cost, cost per year (if used for duration) and WHO prequalification (PQA). Note: 2010 prices.

This report looks at two key questions relevant to increasing availability of long-acting and permanent methods (LA/PMs) worldwide: (1) How can LA/PMs, which require trained providers and clinical settings for administration, be made more widely accessible even in rural or other low-resource settings? and (2) How can sustainable LA/PM provision be achieved? Costs of providing implants compared with other methods are provided from a number of countries.

This e-bulletin discusses the introduction of a new, lower-cost contraceptive implant, theSino-Implant (II), including cost implications, quality assurance and programmatic considerations, among others.

This document contains a set of checklists provided by Population Services International (and adapted from Jhpiego and manufacturer materials) to help their country programs assess providers' knowledge and skills in relation to implants service delivery. Also included is a facility audit checklist to ensure the proper supplies and instruments are available.

As part of a training needs assessment to identify gaps in performance of providers and/or systems, data on the actual performance of service providers and on the supervision of providers should be collected. The sample provider interview guide collects data on three areas of learning that demonstrate performance: knowledge, skills, and attitude. The sample supervisor interview guide collects information about frequency of supervision visits, activities performed during supervision, and resources needed to perform appropriate supervision.

This paper distills lessons from recent efforts to improve the supervision of family planning and health programs in developing countries and identifies approaches that may be more effective and sustainable. It describes supportive supervision, an approach to supervision that emphasizes joint problem-solving, mentoring, and two-way communication between supervisors and those being supervised.

In contrast to traditional supervisory systems, facilitative supervision emphasizes mentoring, problem solving, and continuous communication between the supervisor and those being supervised. This working paper presents the key components of facilitative supervision and describes the steps a program can take to move from a traditional to a facilitative supervisory system.

From the U.S. Agency for International Development (USAID), this web page explains what couple years of protection (CYP) is, how it is calculated, and the CYP coversion factors that USAID uses for various contraceptive methods. For implants, USAID uses 2.0 CYP per Implanon implant and 3.5 CYP per Jadelle implant.

This tool was developed by Marie Stopes International for use by its country programs that provide a high volume of IUDs or implants. The tool is intended to track IUD and implant-related indicators in order to identify potential problems with high discontinuation rates as well as to estimate levels of switching from short-acting to long-acting family planning methods. Included in the tool are indicators to track this information as well as an example data collection sheet.

The general objective of this Compendium is to encourage program evaluation and to improve the quality of work in this area. To this end, the Compendium provides a comprehensive listing of the most widely used indicators for evaluating reproductive health programs in developing countries.

This field guide provides a framework and methodology to guide program managers and health facility staff in adapting and implementing similar programs tailored to their own settings. The aim of this field guide is to present a step-by-step process, practical tools and other resources for improving performance and quality of health services using the standards-based management and recognition approach (JHPIEGO's practical approach for performance and quality improvement). 

Recognizing the gap between the rhetoric and the reality of informed choice, EngenderHealth developed an expanded conceptual framework for informed and voluntary sexual and reproductive health (SRH) decision making, which is the basis of this practical tool kit. Field-tested in several countries, Choices in Family Planning consists of four sections:

COPE® is an ongoing quality improvement (QI) process used by health care staff to assess and improve the quality of care they provide. This COPE® toolbook describes the COPE® process which has four tools--Self Assessment Guides, a Client-Interview Guide, Client-Flow Analysis, and the Action Plan.

COPE®, which stands for "client-oriented, provider-efficient" services, is a process that helps health care staff continuously improve the quality and efficiency of services provided at their facility and make services more responsive to clients' needs. COPE® provides staff with practical, easy-to-use tools to identify problems and develop solutions using local resources, and it encourages all levels of staff and supervisors to work together as a team and to involve clients in assessing services.

Partnership Defined Quality (PDQ) is a methodology to improve the quality and accessibility of services with community involvement in defining, implementing, and monitoring the quality improvement process. Partnership Defined Quality links quality assessment and improvement with community mobilization. This manual offers tools that can be used by project managers, health service managers, or facilitating agencies. It can also be used by health workers or community advocates, who would like to work to make a difference in the quality of health services available in their area.

These briefs provide an overview of how quality of care can be implemented in reproductive health programs; describe clients' perspectives and the barriers clients may encounter in seeking care; and look at providers' concerns in providing services that reflect the quality of care concept. The series also discusses the various definitions of quality of care in the context of reproductive health and suggests tools for measuring it. The series also includes a short literature review on best practices in client-provider interactions in reproductive health care.

This paper is intended to provide guidance to family planning programs on how to improve the quality of CPI. It synthesizes the

In this paper, we are speaking to the program leaders and donor agencies that are responsible for allocating resources for service delivery programs. We provide guidance on the actions that must take place to improve the quality of reproductive health and child survival programs. This guidance is based on the field experiences of members of the Management and Supervision subcommittee of USAID’s Maximizing Access and Quality (MAQ) Initiative.

The Integrated Family Health Program (IFHP) is a five-year USAID-funded program to promote an integrated model for strengthening maternal and child health, family planning (FP), and reproductive health services for rural and underserved populations in Ethiopia. Led by Pathfinder International and John Snow, Inc. in partnership with the Consortium of Reproductive Health Associations, IFHP has pursued scale-up of community-based provision of Implanon since 2009.

In 2008, Marie Stopes Sierra Leone and BlueStar Sierra Leone, working in conjunction with the Ministry of Health Services, began a national expansion programme to provide contraceptive access to women in every chiefdom in the country. Central to the expansion plan was being able to offer all women an increased range of contraceptives to choose from when they desire to prevent or delay a pregnancy.

Faced with the challenge of putting into practice the ideals of the Millennium Development Goals and other global summits of the last decade, decision-makers and programme managers responsible for sexual and reproductive health ask how they can: improve access to and the quality of family planning and other sexual and reproductive health services; increase skilled attendance at birth and strengthen referral systems; reduce the recourse to abortion and improve the quality of existing abortion services; provide information and services that respond to young people’s needs; and integrate