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From policy to performance: Shaping national policy and protocols to strengthen and support primary providers

Pape Gaye, MBA and Laurie Noto Parker, MPH. IntraHealth International, 1700 Airport Rd., Suite 300, CB 8100, Chapel Hill, NC 27599-8100, 919-962-6846, dnelson@intrah.org

During a five-year global initiative to improve the performance of primary providers of family planning and reproductive health (FP/RH) services, the PRIME II Project helped to develop, revise and promote national RH policies and protocols that support primary-level health care. These efforts included drafting the first national RH policy in post-genocide Rwanda, expanding the role of primary RH providers in Armenia, involving multiple levels of stakeholders in an evaluation of Paraguay’s RH policy, and field-testing national family health protocols in Benin. While necessitating an in-depth and sometimes lengthy process, a participatory approach that ensures the buy-in of local stakeholders and partners as well as government officials is essential for developing policy and protocols that are most likely to be implemented and used. Clearly stated, widely disseminated national FP/RH service policy is a powerful facilitating factor in defining expanded roles and creating clear job expectations for providers working at the most local level. National service delivery protocols, when emanating from national policy and accompanied by effective learning interventions and job aids, are a useful framework for improving primary provider performance. PRIME often found it necessary to work back and forth along the policy to performance continuum, advocating for revision and dissemination of existing policy to support expanded roles or authorities for primary providers as well as translating new policy into performance expectations. These and other lessons learned from the PRIME Project offer valuable insights into the relationship between national-level policy and improving decentralized, primary-level FP/RH services in low-resource settings.

Learning Objectives:

Keywords: Policy/Policy Development, Primary Care

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

Improving Reproductive Health Program Quality and Outcomes

The 132nd Annual Meeting (November 6-10, 2004) of APHA