Designing, Implementing, and Evaluating Evidence-Based, Holistic Programs :
Applying SEED :



Holistic Approach Enhances Family Planning Programs: RESPOND’s Experience with the SEED Programming Model™ (Project Brief No. 27)
The Supply–Enabling Environment–Demand (SEED™) Programming Model is a holistic model developed by EngenderHealth to apply globally and locally to guide the design, implementation, and evaluation of family planning programs. RESPOND designed and implemented its activities using the SEED model as its principal programming and conceptual framework. This paper describes how SEED was used to frame global initiatives to advocate, promote, and support family planning as an essential primary health care intervention. It also presents specific country examples of how SEED enhanced and improved the outcomes of family planning programming, especially when all three elements worked in synergy.
Available in English (PDF, 3.1 MB)

Reaching Young Married Couples in Bangladesh: An Underserved Population for Long-Acting Methods of Contraception (Project Brief No. 18)
In Bangladesh, more than 70% of married adolescents become pregnant before their first anniversary, and the mean age at first pregnancy is 16.4. Young couples rarely use contraception before the birth of their first child. An 18-month project to provide young married couples with better information and services on family planning trained peers to be the main source of information for young men and women in the community and to serve as a link between the community and a facility. An evaluation revealed a small increase in contraceptive use and a shift to more effective methods (the intrauterine device [IUD] and hormonal implants), as well as higher levels of communication about family planning between spouses.
Available in English (PDF, 3.4 MB)

Introducing Postpartum Family Planning in Maternal Health Services in Low-Performing Areas of Bangladesh (Project Brief No. 17)
A holistic programming effort to mainstream postpartum family planning services through the public-sector health care system was implemented between June 2009 and September 2013 in 21 disadvantaged project districts in Barisal, Chittagong, and Sylhet divisions in Bangladesh. A total of 111 facilities introduced postpartum family planning services where these were previously not available. Overall, uptake of these services increased over time (particularly for tubal ligation), due both to increased demand and to greater availability at more facilities. Integrating postpartum family planning with maternal health services can contribute significantly to increasing postpartum contraceptive use.
Available in English (PDF, 3.3 MB)

Strengthening National Family Planning Information Systems through Data Quality Assessment: Lessons from Bangladesh (Project Brief No. 16)
Data quality assessment (DQA) was used in Bangladesh to strengthen the public-sector management information system (MIS). An auditing process for assessing the quality of the reported data/statistics, DQA identified duplication of LA/PM performance reporting; transcription errors and data inconsistencies; and weak record keeping and reporting of drop-out. DQA also revealed that the MIS underreported use of long-acting and permanent methods. EngenderHealth provided technical assistance to help strengthen the capacity of Directorate General of Family Planning staff to manage and report data.
Available in English (PDF, 3.4 MB)

Achieving Positive Policy Changes for Family Planning in Bangladesh (Project Brief No. 8)
While contraceptive prevalence in Bangladesh has increased nearly eight-fold over the past 30 years and the total fertility rate has fallen, policy barriers and outdated medical eligibility criteria still sometimes impede clients' access to the method of their choice—particularly long-acting and permanent methods. Using EngenderHealth's Supply-Enabling Environment-Demand (SEED) programming model, the RESPOND/Mayer Hashi project worked with the Directorate General of Family Planning to improve the policy environment around LA/PM use, through a careful, structured process that relied heavily on consultation with local partners about critical obstacles in the field. Regulations on access to tubal sterilization and to implants were loosened, clinic registration procedures were streamlined, and postpartum family planning services were introduced into private facilities.
Available in English (PDF, 3.2 MB)

Preventing Postpartum Hemorrhage: Community-Based Distribution of Misoprostol in Tangail District, Bangladesh (Project Brief No. 2)
Deaths related to postpartum hemorrhage (PPH) present a major challenge to health systems, particularly in rural areas of Bangladesh, where infrastructure is poor and health care facilities often lack skilled staff, drugs, and equipment. Misoprostol is a proven uterotonic drug that is increasingly used in clinical and home delivery settings to prevent and manage PPH. This project brief discusses the implementation of a pilot project in the Tangail District of Bangladesh to determine the effectiveness of using government and nongovernmental field workers at the community level to distribute misoprostol tablets and ensure that women take the drug immediately postpartum. In addition to the programmatic intervention strategies, it looks at health outcomes, women's views and experiences, as well as lessons learned and recommendations for moving forward.
Available in English (PDF, 3.3 MB)

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COPE, Men As Partners, and MAP are registered trademarks of EngenderHealth. SEED is a trademark of EngenderHealth.
Photo credits: M. Tuschman/EngenderHealth; A. Fiorente/EngenderHealth; C. Svingen/EngenderHealth.

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The RESPOND Project Digital Archive, Version 2.0