Gold Circle Project

Project dates: December 1998-Present

Themes: Quality of Care, Community Mobilization, Family Planning/Dual Protection

• Overview
• Partners
• Objectives
• Activities
• Outputs
• Impact
• Unique Features
• Future Plans

Overview

The Gold Circle is a quality of care accreditation initiative of the regional SFPS project. It focuses concurrently on improvements to service delivery (supply side) and on promoting these improvements (demand side). The project goal is to increase consistent use of modern FP methods (higher CPR-contraceptive prevalence rate and CYP-couple year protection) by improving and maintaining the quality of FP services throughout the region. Of the 206 participating SFPS clinics in the project countries, 98 are Gold Circle.

Partners

In addition to the other SFPS CA partners, CCP works with:

• CAFS, Togo
• Mwangaza, Burkina Faso
• CHP, Cameroon
• IRESCO, Cameroon
• National and local radio stations
• National TV

Objectives

• Raise the quality of FP services to meet established quality standards.
• Reward improved and sustained quality by awarding the Gold Circle quality seal to select clinics.
• Promote Gold Circle clinics through mass-media and intensive community mobilization activities around the clinics.
• Ensure sustainability of Gold Circle sites by promoting close collaboration between service providers and community members.

Communication Objectives

• Increase the knowledge of modern FP methods and the benefit of their use.
• Increase use of modern FP methods.
• Increase use of FP services.
• Improve the quality of FP information provided to clients by FP service providers.

Activities

• Formative research with clients and FP providers on their perceptions of "what makes quality FP services."
• Development of messages and materials on modern FP methods and to promote Gold Circle sites.
• Formation of Gold Circle Quality Teams consisting of providers and community members to plan Gold Circle launches and activities and do joint problem-solving for continued clinic improvement.
• Training of Gold Circle Quality Teams in FP/HIV/STI BCC, quality assurance, dual protection, and youth friendly services promotion.
• Training of select service providers in youth friendly IPC/C.
• Annual launches of new (and anniversaries of established) Gold Circle sites.
• Mass-media (radio, TV) campaign and community mobilization events to promote FP providers, modern FP methods, and Gold Circle sites.
• Periodic campaign evaluation to measure exposure to and impact of Gold Circle activities.
• Gold Circle national champions award to reward active community (public and private sector) support to the Gold Circle initiative.
• Service provider radio programs.
  

Outputs

• Gold Circle advocacy brochure.
• Periodic Gold Circle update distributed in all three countries of the project to give Gold Circle actors and partners status updates of project activities.
• Gold Circle community mobilization implementation guide.
• Gold Circle Communication Impact (CCP publication).
• Gold Circle radio and TV spots.
• Four Gold Circle radio and TV FP infomercials, giving details on the pill, injectables, the condom, and an overview of all FP methods together. This series is entitled "Tantie Fatou" (in English, "Auntie Fatou," who is an experienced FP provider well-liked in her community and who provides advice on modern FP methods).
• Print materials, including posters encouraging couple decision making and pamphlets on FP methods, STIs, and HIV/AIDS prevention.
• Promotional materials, including calendars, pen holders, and purses.
• 290 Gold Circle FP service providers trained in interpersonal communication and counseling (IPC/C).
• 20 Gold Circle service providers trained in youth-friendly IPC/C.
• 86 national supervisors trained in quality FP services supervision.
• More than 1,000 people, including Quality Team members and various level service providers, trained in FP/STI/HIV/BCC.
• One IPC/C curriculum for FP service providers.
• One integrated FP/STI/HIV/AIDS curriculum for FP providers.
• One youth-friendly IPC/C curriculum for FP service providers.
• 98 Gold Circle sites with quality FP services.
  

Impact

Research indicates that the campaign has

• improved FP services,
• increased usage of FP service sites, and
• increased use of FP methods.

Omnibus survey in Cameroon

• Approval of FP methods increased to 45% at follow-up, compared to 28% at baseline.
• Among women exposed to the campaign who were previously not using a method, 23% began using a modern method compared to only 8% among those who were not exposed to the campaign.

Panel studies in Burkina Faso and Togo

Client exit interviews in all three countries: 99% of clients said that they were happy with the services received at the Gold Circle sites.

In 2001, an impact evaluation of the Gold Circle campaign was conducted in Togo and Burkina Faso. The evaluation provided data about exposure to the campaign and its positive association with ideational (psychosocial) factors such as:

• approval of FP,
• use of modern FP methods,
• discussion with spouse or friends about FP, and
• personal advocacy for FP (encouraging others to use FP).

In the Togo panel study, campaign exposure was associated with a nearly three-fold increase in the odds of manifesting high-level, positive FP ideation among the 30% of women exposed to the campaign nation-wide.

• Campaign exposure doubled the odds of using modern FP.
• 85% of those exposed to the campaign approved of FP compared with 69% of those not exposed.
• 61% of those exposed to the campaign encouraged someone to practice FP.
• 36% of those exposed had discussed FP with their spouse compared with 25% of those not exposed.

In the Burkina Faso panel study, the campaign was associated with a higher level of knowledge about FP methods, more favorable attitudes towards FP, and a higher level of modern FP method usage.

• 94% of women exposed to the complete Gold Circle campaign (regular Gold Circle sites promotional campaign and Gold Circle FP radio and TV infomercials) approved of FP compared with 74% of those not exposed to the campaign at all.
• 35% of those exposed to the campaign used a modern FP method compared with 9% of those not exposed.
• 72% of married women who were exposed to the campaign discussed FP with their spouse compared with 27% of those not exposed.
• 63% of women exposed to the complete Gold Circle campaign encouraged someone to use FP compared with 17% of those not exposed.

Unique Features

• The MOH in Burkina Faso recognized the benefits of including Gold Circle activities to the regular programming of its Family Health Direction
• National Gold Circle Champion award given to private and public sector groups/individuals who have actively contributed to Gold Circle in presence of the US ambassador in Burkina Faso, Cameroon, and Togo, in presence of the national media, and representatives from the national health authorities.

Future Plans

In February/March 2002, a new round of Gold Circle sites was launched; established sites that have retained their status celebrated their anniversary. Launches will be followed with the implementation of 3- to 5-month community action plans designed by the Quality Teams. Members of the Quality Teams will also be trained in quality assurance, youth-friendly services, and dual protection promotion.

The SFPS project will close in 2003. Phase-out plans will be designed with key partners in the various countries to determine how they can assume project management, including leveraging funds from other donors, continuing the activities of the project, and assuring maintenance to achieved quality standards.

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