Tupange discovered that limited family planning service provision,
as well as no service provision at all, was contributing to the problem and saw an immediate need to increase provider and staff competence to provide family planning services.
The need for these programs became evident when Tupange examined its baseline household data(2010)
and found low use of LAPMs such as implants, intrauterine contraceptive devices(IUCDs) and male and female sterilization, compared to use of short-term spacing methods.
Before the Tupange program, around 30% of doctors,
clinical officers and nurses could counsel clients about implants and IUCDs but could not provide the methods, and about half could counsel about sterilization but could not performs the procedures.