Evaluation of mobile education and service units in increasing accessibility and acceptability of family planning methods India. Final report.

The Family Planning Association of India supports 39 mobile education/service units each of which provides maternal-child health and family planning services to rural or urban slum populations of 50000-80000 residents. To assess the utilization effectiveness and acceptability of this approach the Indian Institute of Health Management Research studied mobile units in Bihar Karnataka Orissa and Uttar Pradesh. Over half of the women in the study sites had been visited at home by a worker from the mobile unit and 10-20% had attended group meetings. Mobile teams serve 1300-1900 new family planning acceptors per year most of whom select birth spacing methods. The availability of a medically trained worker in the unit determines whether sterilization and IUDs can be offered. Identified by staff and clients was a need for female physicians to perform pelvic examinations. Contraceptive prevalence rates in areas served by mobile units (generally 15-18%) were no higher than those in primary health care centers. Mobile units tend to provide acceptors with more comprehensive information about the various contraceptive methods than health centers but this information is often incorrect. The cost per new acceptor varied from 37 Rupees in Orissa (where condom use is high) to 198 Rupees in Karnataka (where sterilization is selected by 40%). Overall the annual cost of operating a mobile unit is under US$10000 80% of which is for staff salaries. Recommended is strengthened program management to eliminate the existing variability in service delivery and improve the quality and scope of care.