Our Programs

KARMA—Strengthening PPFP and PAFP

India

| 2017-2021

With funding from the Bill & Melinda Gates Foundation, this program strengthened institutional capacity for sustainable delivery of high-quality postpartum family planning (PPFP) and postabortion family planning (PAFP) methods in Karnataka and Maharashtra.

According to FP2020, the modern contraceptive prevalence rate among all women in India was 39.3% in 2017, with approximately 76.2% of women selecting sterilization as their method of choice, as cited in the 2015–2016 National Family Health Survey.

The Strengthening Institutional Capacity in Karnataka and Maharashtra for the Sustainable Delivery of Quality Postpartum Family Planning and Postabortion Family Planning Methods (KARMA) program worked in 144 facilities in 36 districts across these two states. We supported these two state governments to improve strengthen policies, guidelines, and standards related PPFP and PAFP. To reach underserved populations, the program worked in hard-to-reach areas.

KARMA strengthened the capacity of state- and district-level institutions to train service providers and health facility managers on a variety of contraceptive methods, including PPFP and PAFP. The program also established a pool of master trainers to conduct training on the provision of comprehensive intrauterine device (IUD) services and we trained community health workers to provide comprehensive, client-centered family planning (FP) counseling. EngenderHealth provided orientation and on-the-job supervision and mentoring to 521 facility staff in using Family Planning Logistics Management Information Systems software to streamline the supply FP commodities supply and prevent stock-outs.

We also advocated with the state governments who in turn issued guidance to district health authorities to improve and expand access to newer contraceptive services, including IUD services, in persistently low-performing sites. The program supported training for 818 providers in comprehensive IUD services; 1,985 providers in injectable contraceptive services; and 2,800 facility staff oriented on full, free, and informed FP and sexual and reproductive health (SRH) services. In addition, the program conducted virtual training for 4,500 providers and 9,000 accredited social health activists to deliver FP and SRH care during the COVID-19 pandemic.

The KARMA program averted approximately 250,331 unintended pregnancies, 152,204 abortions, and 1,274 child and 224 maternal deaths. It also provided 493,613 couple years’ protection and saved $6.9 million in direct healthcare costs.