Reproductive Health Service Promotion Project Office

This office, which is affiliated to local health commissions and has a rather lengthy name, is neither a "setter" that specializes in forwarding policies, nor is it a management department with administrative approval powers. Its core positioning is as a "filler" - filling the gap between policy requirements and the real needs of the people in reproductive health services in the past, turning "you need to receive services" into "we will deliver the services you need to your doorstep."

Last month, I followed a mobile service vehicle to visit a location in a town in western Guangdong. I felt particularly deeply about this positioning. I met a 28-year-old mother of two children. She thought she could only go to the county town to get the ring, and she had to go back and forth for a long time and have to deduct a day's wages. This time we coordinated with the county's mother and child doctor to come down in the car, and the operation was completed in ten minutes. By the way, she did free cancer screening and HPV testing. Before leaving, she forced us to half a bag of home-grown yellow skin, saying, "I always thought these services were just slogans, but I didn't expect them to be delivered to our doorsteps."

However, from the establishment of this office at the national level in 2021 to now, there have been two completely different voices in the industry regarding its functional positioning. One group feels that this position is too "empty" and has no real administrative power. Even to assign tasks to the grassroots, you have to borrow the official seal of the Health Commission. In many cases, it is just a mouthpiece for statistical reports and forwarding notices. This is really not nonsense. In the first half year of our establishment, the directors of the three community health centers we contacted had a headache when they saw our work on WeChat. Eight times out of ten contacts, they had to fill in a new service ledger. The other group believes that the power of the office should be directly expanded. It is best to set up an independent administrative department, complete the establishment, open up the docking ports of medical insurance, women's federation, education and other departments. This is what a pilot in a district in Zhejiang did. Last year, they launched a project to introduce adolescent reproductive health to high schools, with a coverage rate 47% higher than the provincial average. However, the problem is also very realistic: most districts and counties simply cannot come up with additional establishment and funding, and this model cannot be replicated in batches.

To be honest, those of us working on the front line rarely struggle with these positioning disputes. We mostly solve problems when we encounter them. At the beginning of the year, we introduced free contraceptives to the business district. At first, we copied the experience of going into the community before. We put the pill boxes at the service counter of the shopping mall and waited for half a month before we took out 3 boxes. Later, when we chatted with the business district operators, they rolled their eyes and said, "Are you going to take condoms in front of the shopping guide? Put them in the self-service cabinet at the door of the toilet." We changed the location on the same day and added a QR code to scan and leave a message. In the second month, more than 120 boxes were delivered. Many people left messages asking if they could add emergency contraceptive pills. We quickly contacted the pharmaceutical company to replenish the stock, and it was replenished in less than a week.

Of course, there are still hard issues that cannot be overcome, such as reproductive health services for the elderly. It took us more than half a year to make some progress. Last month, I went to a community in the old city for a free gynecological examination for women over 60 years old. Only 7 people signed up at the beginning. We followed the grid workers and knocked on the door. A 62-year-old aunt pulled me and hid in the kitchen and said, "Girl, I have been postmenopausal for ten years. Why do you check this?" What, people will laugh at me if the news spreads." It took almost half an hour to persuade her to go to the spot. Finally, she was found to have chronic cervicitis. It has been delayed for almost three years. Now she has been followed up for half a year. The aunt has been able to take the initiative to tell the old sisters in the community, "You should get it checked, there is no shame."

At the weekly meeting last week, a post-2000 manager who had just joined the company for half a year held up her mobile phone to show us a store visit video she had seen. She said that young people now spend their weekends in script-killing shops and livehouses, and always put up posters in the community. Who would read them? It is better to put promotional leaflets and free reproductive health testing kits in these spots. Now we have connected with two local chain script-killing stores, and we will pilot it this month.

In fact, there is no established template for doing this work. To put it bluntly, it is just to deliver reproductive health services that everyone was embarrassed to mention and had no place to find before, to places within reach of everyone. After all, reproductive health is never a shameful matter. It is a public service that everyone needs, just like colds and fevers.