How to provide mobile services during a pandemic
Written by Muhammad Aslam, Peace Foundation Pakistan
This guide was written in 2020 in response to the COVID-19 pandemic.
Some of the information will not be so relevant to the current situation, but we think this guide offers useful advice to SRHR advocates.
Please describe the context in which your work has highlighted these learnings:
We are a development organisation working in remote rural and desert areas of two districts of Sindh province, Pakistan. During the COVID-19 pandemic, many changes have put SRH at risk. Young men who travel to work in cities are returning home without income. Women and girls have limited access to SRH services because of poverty and lack of transport with the lockdown. In this crisis we built on our safe-abortion mobile service experience to offer family planning and general medicine. We shifted our AmplifyChange project work in services oversight to help plan and ensure quality.
What did you discover about the challenges that advocates face in this situation?
Due to COVID-19, the issues arising from lockdown have resulted in increases in teenage and unwanted pregnancies, malnutrition, lack of vaccinations and prenatal care. Other issues increasing are rates of unsafe abortion, domestic and sexual violence, maternal mortality and mortality of children under 5. People in remote areas cannot reach their usual source of family planning services, and neither can these health centres travel out at this time to see clients.
Would you like to tell us more about the challenges you saw advocates facing in this situation?
- Clients are frightened; they think that we are checking if they have the virus and that we will take them to an isolation center. We and our village focal person assure them about what we have come to offer.
- We have to pass though police check points. We make them understand about our services and the permission we have from the government.
- In practical terms, it has been challenging to visit during Ramzan (Fasting), and also in the hot summer days.
How were those challenges tackled – what was achieved?
We are providing easy, free and accessible family planning services at the doorstep of women and girls living in remote villages. We will reach 800 to 850 women and girls living in 12 villages per month. We are also organising free mobile family planning camps.
The District Office of the Sindh Government Population Department and our 10 Women Watch Dog Groups (AmplifyChange project) share with us a list of villages needing services. We buy supplies at the local market and have our own medical equipment, vehicles and drivers.
We visit these villages and nominate one woman and her brother/husband as focal persons, who receive a small honorarium for helping and set the date and venue for our camp. To reassure the community and clients about our visit we meet men in the village beforehand and distribute informative leaflets about our services and the Peace Foundation.
During our visits, we take care to prevent the spread of infection. Our staff wear protective suits and are equipped with goggles, gloves, N-95 masks, soap, tissues and sanitising liquid. They also use infrared thermometers to check temperatures. We follow strict social distancing guidelines. Clients are served one at a time and our focal person in camp ensures that they have washed their hands and are sprayed with sanitiser beforehand. We also wash daily our van, tables and other equipment.
After providing family planning services we guide our clients to go to their usual service providers for follow-up after 2 or 3 months.
What did advocates learn from this experience?
It helped to get permission from the local department in villages we visited. We found clients hesitate sometimes, and also ask for other things like food and general medicine. Our team faced challenges during visits by law enforcing agencies.
What are your tips for someone facing the same or similar issues?
- Collect data on family planning (FP) client numbers and the population from the district population welfare department/family planning centres, so you know the best venues to hold mobile camps.
- Nominate one focal person in each camp, for service planning, scheduling and record keeping. Thus, there will not be a rush on services.
- Engage the local community. Help from village notable persons has enabled us to meet clients easily, given us free rooms, electricity, water and security.
- Ensure to take appropriate protective measures for service providers and service users.
Did advocates use any external resources to help this solve this issue that you would recommend to other organisations?
We drew help from the Population Welfare Department and used the safety guidelines issued by the Government of Sindh.
Muhammad Aslam, Peace Foundation Pakistan
Muhammad Aslam has 10 years’ experience in project development, fundraising and partnership, working around expanding sexual and reproductive health (SRH) service coverage. He has a masters degree in Economics and a diploma in Culture and Sexuality from the university of Amsterdam and has been Director of Programs at Peace Foundation Pakistan for the last three years. He has skills in coordinating and building working relationships with donor agencies and emergency response sectors.
