Dr. Surendra Sharma
After studying Public Health from Harvard, I was enthusiastic in applying my newly acquired understanding of the subject to my home state. Chhatisgarh is one of the six high focus states decided by govt. of India with TFR of 2.7 and mCPR of 57.2 (2012). With only 120 PPIUCD insertions between 2010 -2012, the challenge was daunting. My strategy was 3 pronged; establish training centers, quality counselling services for eligible couple and strengthen system for service delivery. Working closely with state government, I could establish 4 divisional training centers where 142 doctors and 224 staff nurses were trained. By Dec 2013, PPIUCD insertion jumped to 5684 and by next year it further rose to 10327. I was rewarded with a team of 12 people to make further inroads in all 3 types of IUCDs.
Working with WHO, I witnessed firsthand evils of unplanned births which often resulted in injury/death of newborn as well as mother. Studying public health, I was convinced that better family planning programs are a must in developing world to ensure each pregnancy is desired and not accidental. Linkage between proper spacing between births with improved health and survival of mothers and children prompted me to join Jhpiego and contribute to my society, a decision which has proven its merit.
Myths among the community and biases among the medical fraternity on FP methods, especially IUCD!
I employed 3 tactics: evidence, advocacy and follow up. Strong evidences endorsed by professional bodies helped in facilitating providers to offer PPIUCD services. Using local dialect and common example during counselling connected the program with community. Regular follow-up in ANC visits dispelled myths among women and their families who in turn adopted PPIUCD.
Access to quality services due to HR and infrastructure scarcity is the biggest challenge faced by my state and country at large. Capacity building of nursing cadre (staff nurses and ANMs) to ensure round the clock services (by task shifting), optimal utilization of resources using NHM funds and focusing on low cost, high reach intervention like integrated IUCD services with institutional deliveries, while upholding quality are the immediate measures which can address these challenges.
I foresee increasing equitable access to family planning services till the last mile by capacity building of ANMs and staff nurses, replacing camp mode approach for tubal ligation services to fixed day services to ensure quality and increasing umbrella of FP choice. Having gained experience in integrating IUCD services with maternal health, I aim to look for opportunities to integrate FP services with other care, which already has a good reach, for example child-immunization.