The HTSP Implementation Kit

Section 2: Understand the Local Situation for AMA and HP Pregnancies

Programs developed with a complete understanding of the issue being addressed, the people affected and their environment are likely to have greater impact than programs that are not. To understand the local situation for AMA and HP, it is helpful to answer key questions about your community before starting an HTSP program, such as:

  • What proportion of births are AMA? What proportion are HP? What proportion are both?
  • How have the rate of AMA or HP pregnancies changed over the years in your community, and why have these changes occurred?
  • What size family do women and men desire? At what life stage do women and men start planning their family, start having children, or make decisions on whether or not to use FP?
  • How much do women at risk of AMA and HP pregnancies, their male partners, providers and other audiences know about the risks of AMA and HP?
  • What is the typical profile of a woman who has an AMA or HP pregnancy?
  • Why do women have AMA or HP pregnancies?
  • How common is it for a woman or couple to not have an AMA or HP pregnancy in your community? What is the typical profile of such women or couples (e.g., education, income, social status)? How does the community perceive such women or couples?
  • What are the perceived barriers to modern FP method access and use? How do these barriers differ for AMA or HP women, or women approaching AMA or HP?
  • Under what circumstances is it acceptable for women at risk to use modern FP methods?
  • Who are the stakeholders and gatekeepers who influence FP use among women at risk?
  • What are the main challenges for providers regarding provision of modern FP methods to women at risk?
  • Do providers offer clients long-acting reversible contraception and permanent methods (LARC/PM) as part of a range of available contraceptive options?
  • Are AMA and HP clinical and counseling guidelines available?
  • Through what channels (including media and interpersonal) do providers, women and their partners prefer to receive health-related information?
  • What communication materials and programs already exist related to AMA and HP?
  • What gaps in tools exist, especially related to preferred communication channels?

Where to Find This Information

Answers to these questions can often be found in existing data, such as Demographic and Health Surveys (DHS) or Multiple Indicator Cluster Surveys (MICS), quantitative and qualitative research conducted by NGOs, or private sector market research.

If existing data – particularly on the non-structural factors that drive behavior – are not sufficient, are outdated or do not provide enough insight, you may want to conduct your own formative research through surveys, focus groups or interviews.



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