Increasing Contraceptive Prevalence (CPR) by repositioning Healthy Timing and Spacing of Pregnancy (HTSP) as an enabling strategy within MCHN programs in Uttar Pradesh, India

In Hardoi District, World Vision integrated HTSP and MCHN messages in the registers that SHG members used in counseling women who were pregnant or had children. Each message was portrayed by a colored icon arranged along the pregnancy to age two timeline to help illiterate members give the right pre and post natal MCHN+HTSP messages at the right time. HTSP messages were given 6 times. Mothers in programs were also counseled on HTSP. Contraceptive use of all married women of reproductive age was recorded monthly by checking the relevant contraceptive icon. Female SHG member counseled adults within a 10 household cluster; male SHG members spoke with men and religious leaders. They worked together to plan and implement community MCHN+HTSP mobilizing campaigns. Couples-counseling-couples was introduced later to ensure that husbands and wives heard the same messages, improve couple communication and reinforce individual counseling. ASHAs, (Accredited Social Health Activist) trained as master trainers in MCHN+HTSP, each trained one male and one female SHG, held monthly meetings, and resupplied members with condoms and pills they ordered from the MOH. In turn, SHGs supplied villagers. This monthly contact also strengthened the quality of the ASHAs services. Result: CPR increased from 44% to 77% in four years. Conclusions: CPR rises when HTSP and MCHN messages are integrated and delivered through SHGs to their communities.