Strengthen the Tuungane Project by Intentionally Using HIPs

The Tuungane PHE project is led by Pathfinder International and The Nature Conservancy in 24 remote villages beside Lake Tanganyika in an ecologically rich area of western Tanzania.9 The project aims to improve access to reproductive health services while also assisting community members to better manage natural resources to ensure their livelihoods are sustainable and their community is healthy.10

An extensive review of Tuungane reports and correspondence with project staff identified components of the project that use elements of HIPs.

Family Planning High Impact Practices (HIPs) Implemented in the Tuungane Project

Volunteer community health workers (CHWs)—recruited from the community—conduct door-to-door education on reproductive health and provide family planning counseling and guidance for first-time mothers.11

Mobile health clinics conduct outreach to remote communities every quarter.

CHWs visit hospitals to provide family planning counselling to pregnant and postpartum women.

In conjunction with the Tanzanian government, Pathfinder staff have identified policy barriers and are supporting the government’s intentions to implement a state-sponsored CHW program.

Project implementers provide capacity building to local government leaders to support and promote high impact family planning and reproductive health services. The project has also researched local governance, social cohesion, and participation, conducting interviews with villagers on their satisfaction with government services.

Project implementers monitor and restock contraceptive stocks at health facilities and pharmacies to support CHWs in their ability to provide products like pills and condoms to clients. The project also advocates for supply availability to ensure a reliable supply chain of contraceptives.


Nighttime campfires stimulate discussions about family planning, prenatal care, and good hygiene.12

Mobile applications monitor contraceptive stock availability and allow CHWs to access counseling support information and more easily and accurately enter data about their counseling sessions.

Source: USAID et al., “Family Planning High Impact Practices (HIPs) Briefs”; and personal communication with Pathfinder International and The Nature Conservancy staff.


The recommendations below suggest a starting point for the project as it continues to strive for strong family planning outcomes as part of its overall objectives. These recommendations also serve as an example of how other PHE projects that currently use elements of HIPs could further strengthen their family planning activities through a more robust application.

Strengthen Social and Behavior Change

The Tuungane project found that although access to and use of contraception has increased in the project area, desired family size has not changed.13 Increasing knowledge about comprehensive reproductive health services and facilitating dialogues about optimal birth spacing for family health and prosperity could help community norms evolve. Strengthening Tuungane’s social and behavior change activities may enhance these efforts. Tuungane staff should use the forthcoming Interpersonal Communication HIP alongside the Community Group Engagement and Mass Media HIPs. Additionally, the use of the Social and Behavior Change HIPs may facilitate a change in family planning behaviors and the social norms that drive them.14

Use HIP Enhancements to Support Community Health Workers and Improve Supply Chain Management

Tuungane staff appreciate the value of digital technology as a cost-effective option for remote support and supervision of CHWs. They have developed mobile applications that allow CHWs to easily access information and accurately enter data about family planning counseling sessions. Tuungane has also developed a mobile application that collects data on contraceptive stock availability to reduce past problems of commodity stock-outs and avoid this issue in the future. PHE projects implementing or hoping to use digital technology—including Tuungane—should consider using the Digital Health for Systems HIP Enhancement to improve family planning digital technology options.