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[Unpublished] 1981 Aug 28. 222 p. (AID/LAC/P-085)The background, goals, projected activities and beneficiaries, financial requirements, and implementation plans for a Family Planning Outreach Project in Haiti are detailed. The project is intended to assist the Government of Haiti to establish a cost-effective national family planning program. Population growth continues to accelerate in Haiti, despite high infant and child mortality, significant emigration, and declining fertility. The government does not have an articulated population policy. Although family planning and maternal and child health services have been in existence since 1971, there is no effective access to these services. This project is viewed as a means of achieving a substantial and sustained reduction in family size and improving health status. It is also a means of strengthening the Haitian family so it can participate more directly in the national development process. The purpose of the project will be accomplished through the following activities: 1) improvement of the organization and management of the national family planning program; 2) improvement of the quality and quantity of maternal and child health and family planning services; 3) expansion of the participation of private and voluntary organizations, other governmental, and local community groups in service provision; 4) increase in the availability of contraceptives at reasonable prices through rural and urban commercial channels; and 5) formulation of appropriate population and family planning policies. By the end of the project, all government health facilities and 75% of private facilities will actively counsel and provide family planning services; integrated models of community health and family planning services will have been developed to serve 60% of the population; basic drugs and contraceptives will be available at reasonable subsidized prices throughout the country; and 25% of women ages 15-45 at risk of pregnancy will be continuing users of effective contraceptive methods. The project will be implemented by the existing infrastructure of private and public organizations, primarily by the Department of Public Health and Population and its Division of Family Hygiene. The US Agency for International Development (USAID) is providing US$9.615 million (54%) toward the estimated US$17.980 million cost of the 5-year project. An additional US$6.555 million (36%) will be provided by the Government of Haiti.
[Unpublished] 1991.  p.Jose G. Rimon, II, Project Director for the Johns Hopkins University Population Communication Services (JHU/PCS) Center for Communication Programs, visited Finland to attend a NORPLANT planning meeting. Meeting discussion focused upon issues involved in expanding NORPLANT programs from pre-introductory trials to broader national programs. Financing and maintaining quality of care were issues of central importance for the meeting. Participants included representative from NORPLANT development organizations, the U.S. Agency for International Development, the World Bank, and other donor agencies. Mr. Rimon was specifically invited to make a presentation on the role of information, education, and communication (IEC) on NORPLANT with a focus upon future IEC activities. The presentation included discussion of the need to develop a strategic position for NORPLANT among potential customers and within the service provide community, the feasibility of global strategies positioning in the context of country-specific variations, the need to identify market niches, the need for managing the image of NORPLANT, and the need to study IEC implications in terms of supply-side IEC, content/style harmonization, materials volume, and language and quality control. Participants collectively agreed to develop an informal group to address these issues, concentrating upon universal issues potentially addressed on a global scale. A meeting on strategic positioning is scheduled for August 19-20, 1991.
[Unpublished] 1989 Nov. 126 p. (A/E/BD/4/Sec. II)UNFPA has published a comprehensive document on the state of the art of maternal and child health and family planning (MCH/FP) worldwide. This paper mostly focuses on family planning because that is UNFPA's mandate, but since MCH/FP services are often delivered in an integrated fashion the recommendations and strategies for the management and administration of FP in this paper can also apply to MCH services. This document is a practical and useful historical analysis that traces past, current and future trends in family planning. It discusses issues and strategies, controversies, conflicts, advantages and disadvantages of population/FP issues by region and between developed and developing countries. The reader gets a comprehensive overview in MCH/FP during the past 3 decades. Major conferences, policies and events focusing on MCH/FP issues are interwoven into the multiple factors involved in FP practice and future needs. There are 9 chapters and 14 tables of valuable data. The chapters include: 1) Introduction; 2) Current FP practice and future needs in developed and developing countries; 3) Macro-environmental factors affecting provision of services; 4) Approaches to service delivery in the public and private sectors; 5) Current and future contraceptive technology; 6) Strategic issues; 7) Administrative issues; 8) Special challenges; and 9) Future priorities.
New York, New York, FPIA, 1985. 206 p.Summarizing the work of the Family Planning International Assistance (FPIA) for the past 14 months, with emphasis on 1985, this document contains both regional and country reports for Africa, Asia and the Pacific, and Latin America. FPIA's strategy in Africa during 1985 was to focus on small, high-risk projects which call for extensive technical assistance. Project Assistance accounted for 48.8% of the total value of FPIA assistance to the region; Commodity Assistance accounted for 47.5% of the total value of FPIA assistance to the region. Special Grants accounted for slightly over 2.1% of the total assistance to Africa. In the Asia and Pacific Region, components of the FPIA strategy include: consolidate support and provide technical assistance to those agencies whose family planning services can be institutionalized and serve to complement and influence the goals, objectives, and program procedures of their governments' national family planning programs; problem solve with grantee agencies approaches to innovative delivery of temporary method services; provide training opportunities and technical assistance to project management and staff as well as to influential nonproject persons; and establish how FPIA commodities can complement supplies available to nongovernmental organizations through their government warehouses and bilateral supported community retail sales program. Project Assistance accounted for 47.1% of the total value of FPIA assistance in the region; Commodity Assistance accounted for 50.8% and Special Grants slightly over 1% of total assistance to the region. In Latin America, FPIA's program goals respond to agency goals of promoting family planning services in areas of unmet need, upgrading existing family planning service models, and encouraging service continuation following the phase-out of FPIA support. Project Assistance accounted for 46.8%, Commodity Assistance 52.2%, and Special Grants less than 1% of total FPIA assistance to the region. The combined value of all types of assistance provided worldwide during 1985 totaled over $18 million: $7.2 million in direct support to 128 funded projects in 39 countries; and $10.1 million in commodities shipped to 218 institutions in 66 countries. Oral contraceptive and condom shipments alone were sufficient to supply 2.4 million contraceptors for 1 year.
Report on the evaluation of various family life education projects with particular emphasis on youth in the English-speaking Caribbean: country reports.
New York, New York, United Nations Fund for Population Activities [UNFPA], 1984 Nov. xiv, 89 p.UNFPA has provided funding for various family life education (FLE) projects with particular emphasis on youth in the English-speaking Caribbean since the mid-1970s; this report is an independent evaluation of the projects in Antigua, Barbados, Dominica, Jamaica, St. Lucia, and St. Christopher and Nevis. Although birth rates are relatively low in the English-speaking Caribbean, the incidence of adolescent pregnancy and the number of births to women under the age of 20 is an important problem in the region. The Mission concluded overall that the projects have contributed to pioneering and groundbreaking efforts demonstrating that it is possible to initiate and make considerable progress in the implementation of FLE/FP programs for adolescents even when adolescent pregnancy and births are still highly sensitive and controversial issues and when there are no official policies in favor of such programs. The Mission concluded also that project design had improved over the years and projects have moved from addressing a wide variety of broad issues to a more focused consideration of adolescent fertility. All the projects included in the evaluation have contributed to the training in FLE/FP of a large number of family life educators, teachers, and nurses and, as a result, have significantly strengthened professional national capability. The projects have shown that despite the lack of official policy approving FLE in schools and generally overcrowded curricula, FLE can be introduced into schools. In the area of FP service delivery, the projects included in the evaluation have contributed to making FP services generally available through integration with the government maternal and child health services. The main management issues across the projects were similar and included staffing, coordination, supervision, monitoring and evaluation. There is a need to adjust project design so that gender separation is minimized and that the FLE content deals better with issues such as self-awareness, sex roles, and self-esteem. The wider impact of the projects included in this evaluation, to be reflected, for example, in reduced incidence of teenage pregnancy, reduced maternal and infant/child morbidity and mortality, and more generally in the life patterns of women, cannot yet be measured.
New York, New York, FPIA, 1984 Mar. , 113 p.Family Planning International Assistance (FPIA) initiated strategic planning in 1983, including mission statement, objectives, means, and tactics commonly used to reach the objectives and considerations for strategy development. This document contains background information, FPIA's rationale for developing a 3-year strategic plan, the plan's method, a strategic plan summary, and country plans for countries in the Caribbean, Central America, South America, Asia, and Africa. FPIA's rationale for developing a 3-year strategic plan is as follows: to address AID/W's ongoing need for a clear rationale for continued funding in a time of limited resources; to increase FPIA's capability to make decisions systematically; to organize efforts to carry out decisions and to measure decisions through systematic feedback; to increase FPIA's capability to monitor progress in reaching objectives; to increase FPIA's control over its environment; to continue to address 1981 evaluation findings; and to decrease time involved in plan preparation by planning over a longer time period. FPIA's tactic statements describe the basic approaches to be used in carrying out a predetermined strategy by: extending existing family planning services of government and nongovernment institutions to new geographic areas or to new populations; initiating family planning service in institutions not currently involved in service provision; providing parallel or complementary services; transferring management technology; training staff; working with resistant populations, adolescents, utilizing local resources; and supplying family planning commodities to projects and nonproject institutions. Once objectives were set, the regions were ready to write a strategy for each country. To facilitate writing the strategies, each region received the following series of strategic considerations: state of development of the family planning program in each country; government plans, AID, and USAID mission strategies; type of program FPIA, AID/W, and USAID currently is funding; and rationale for continued private voluntary organization/FPIA support to the country. The strategic plan summary (1984-86) includes FPIA's goals, policy, and philosophy and FPIA's mission, goals, and objectives.
Studies in Family Planning. 1984 Nov-Dec; 15(6/1):253-66.This paper critically analyzes claims for the effectiveness of the Billings method of natural family planning and raises questions about the wisdom of actively promoting this method. The Billings method, developed in Australia, is based on client interpretation of changing patterns of cervical mucus secretion. Evaluation of the method's use-effectiveness has been hindered by its supporters' insistence on distinguishing between method and user failures and by the unreliability of data on sexual activities. However, the findings in 5 large studies aimed at investigating the biological basis of the Billings method provide little support for the claims that most fertile women always experience mucus symptoms, that these symptoms precede ovulation by at least 5 days, and that a peak symptom coincides with the day of ovulation. Although many women do experience a changing pattern of mucus symptoms, these changes do not mark the fertile period with sufficient reliability to form the basis for a fully effective method of fertility control. In addition, the results of 5 major field trials indicate that the Billings method has a biological failure rate even higher than the symptothermal method. Pearl pregnancy rates ranged from 22.2-37.2/100 woman-years, and high discontinuation rates in both developed and developing countries were found. Demand for the method was low even in developing countries where calendar rhythm and withdrawal are relatively popular methods of fertility control, suggesting that women of low socioeconomic status may prefer a method that does not require demanding interaction with service providers and acknowledgment of sexual activity. The Billings method is labor-intensive, requiring repeated client contact over an extended time period and high administrative costs, even when teachers are volunteers. It is concluded that although natural family planning methods may make a useful contribution where more effective methods are unavailable or unacceptable, many of the claims made for the Billings method are unsubstantiated by scientific evidence.