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[Unpublished] 1990. Presented at the Annual Meeting of the Population Association of America, Toronto, Canada, May 3-5, 1990. 11 p.This publication reports on a project designed to analyze and improve patient flow in family planning associations (FPAs) of the International Planned Parenthood Federation, Western Hemisphere Region (IPPF/WHR) located in 7 Latin American countries. Seeking to attract clients who can afford to pay for services, the FPAs have hoped to improve the quality of care and client satisfaction, which largely depends on clinical management capacity and clinic efficiency. IPPF/WHR trained local FPA clinic managers to use Patient Flow Analysis (PFA), a computerized system developed by the Centers for Disease Control which serves to identify problems and improve clinic efficiency. Between 1988 and 1990, trained personnel from 26 clinics (2 in Brazil, 7 in Colombia, 2 in Chile, 10 in Ecuador, 4 in Peru, 1 in Uruguay, and 1 in Trinidad) used PFA to identify efficiency problems. While each clinic had its own problems, PFA revealed 4 commonly observed problems: inappropriate arrival patterns for patients, improper sequencing of patients through the clinic, late staff arrival, and disruptions caused by closing of the clinic for lunch. An example of the positive impact of PFA, the report examines the case of the Quito Clinic in Ecuador. Reviewing the data provided by the analysis prompted the staff in the Quito Clinic to make the following changes: 1) increase staffing (especially in the reception area); 2) operate continuously through lunch by staggering staff lunch breaks; 3) remodel the reception area and provide greater patient privacy and confidentially. An evaluation 11 months later revealed that the number of clients increased by 32%, that average patient time at the clinic decreased by 31 minutes, and that waiting time was cut in half.
In: Country studies on strategic management in population programmes, edited by Ellen Sattar. Kuala Lumpur, Malaysia, International Council on Management of Population Programmes, 1989 May. 1-23. (Management Contributions to Population Programmes Series Vol. 8)Brazil has a population of 144 million with an annual growth rate of 2.1%. Brazil also has the highest economic disparity rate in the world, with 65% of the population living below the poverty line. Despite some degree of governmental acceptance of family planning, the government does not have the resources to support an effective program, and it is therefore up to nongovernmental agencies to expand the population's access to family planning. BEMFAM, the Family Well-Being Civil Society, was founded in 1965 to stimulate the creation of a government family planning program. BEMFAM was affiliated with the International Planned Parenthood Federation in 1967 and was granted recognition as a public utility in 1971. BEMFAM's 1st community program was in Rio Grande do Norte, and it was shortly extended to other northeastern states. As a result of political leadership seminars held by BEMFAM in 1980 and 1981, state legislators took the lead in creating the Representatives Group for Population and Development Studies with the goal of integrating state legislatures to implement a national family planning program. Due to BEMFAM's influence, the northeast is the 1 region where people expect to get contraceptives from government health centers. BEMFAM's work is concentrated in 4 areas: studies and surveys; information, education, and communication; training; and service delivery. According to the results of the Brazil Demographic and Health Survey carried out in 1986, 99% of women know of at least 1 contraceptive method, but only 43% use one. The most used method is female sterilization, followed by the pill (28% and 25% respectively). Brazil's new constitution designates family planning as a basic human right. BEMFAM will implement 6 strategies to increase the level of family planning in Brazil. 1) It will act to influence political leaders to improve family planning programs. 2) It will spread information and knowledge about family planning to the community at large. 3) It will train health professionals in family planning. 4) It will assist government agencies and private programs to maintain standards of service. 5) It will conduct studies and carry out research related to family planning, health, and development. 6) It will continually upgrade its own staff and facilities. BEMFAM has prioritized its efforts according to location, need, and sustainability of the programs.
[Unpublished] 1978. Paper presented at National Workshop on Innovative Projects in Family Planning and Rural Institutions in Bangladesh, Dacca, Bangladesh, Feb. 1-4, 1978. 21 p.The author describes the establishment of a rural health service in Companigonj thana in Bangladesh done jointly by the government and international relief agencies. Provision was made for integrated health services including family planning, child health services, maternal health services, nutrition programs, and both curative and preventive medicine. Field workers, mostly female, were trained to provide medical services not requiring a doctor's presence. The author finds a marked increase in attendance at the health service over a period of years. The government should intensify its participation in the health service component for the program to have a chance of taking hold. Tables to illustrate the experience of the program in money expended; numbers of patients; cost per patient; clinic attendance by age, sex; hospital deliveries; new family planning acceptors; contraceptive usage; mortality and birth rate and causes of death by age; and antenatal follow up.
New York, New York, IPPF, . 6 p.This tabular presentation of data on new acceptors for each IPPF-affiliated program in the Western Hemisphere Region gives the number of clinical, voluntary sterilization, and community based distribution (CBD) acceptors and the total for all methods each year between 1977-1981 for 33 countries. As of 1981, 14 countries had CBD programs. Excluding US totals, the share of new acceptors attributable to CBD programs increased from 316,478 or 35% of the total of 910,766 acceptors in 1977 to 434,986 or 43% of the 1,001,430 new acceptors in 1981. In 1981, the proportion of new acceptors in CBD programs was 62% in Antigua, 88% in Brazil, 60% in Colombia, 50% in Guatemala, 70% in Honduras, 67% in Jamaica, and 58% in St. Kitts-Nevis. The proportion of acceptors of voluntary sterilization increased from 5% in all programs outside the US in 1977 to 7% in 1981 and was particularly high in 1981 in Aruba (26%), Colombia (16%), Dominican Republic (31%), Ecuador (18%), El Salvador (70%), Guatemala (25%), Honduras (14%), and St. Lucia (18%). 10 countries had no voluntary sterilization programs in 1981 and figures were unavailable for several others. Figures were unavailable for the US for 1981. In 1980, 99% of the 560,210 new acceptors chose clinical methods and 1% or 6938 persons underwent voluntary sterilization procedures.
New York, New York, United Nations Fund for Population Activities [UNFPA], 1982 Dec. xi, 44,  p. (Project SWA/75/P01)The long range objective of this project (1976-1981) was to improve and enhance the health and welfare of mothers and children, especially in rural areas. In assessing Project achievements and the degree to which progress toward the long term objective has been accomplished, the Evaluation Mission found that the immediate objectives had, to a large degree, been met within the general framework of the Ministry of Health's (MOH) development program. Service delivery points in governmental, mission private and industrial/plantation health facilities are now widely distributed throughout Swaziland. The integration of preventive and curative is clearly in place in the rural health clinics and health centers. Analysis of service statistics data indicates that a large % of pregnant women attend antenatal clinics. Family planning services are now offered in 86 clinics with 27,094 clinic attendances recorded for 1981. The pill is the most popular method, followed by condoms, injectables and IUDs. An adequate though incipient health education program is functioning. The MOH strengthened the health infrastructure for, and has in place a program of, maternal child health (MCH) and family planning (FP). The strong points of the program are the government's commitment to MCH/FP, the general strategy, the training component, the number and quality of staff involved in service delivery, the number of service delivery points and the system of recruitment and the employment of Rural Health Motivators (RHM). Weak points, which appear to have hindered a more effective program performance, are planning and management, the lack of solid socio-anthropological knowledge to base, the lack of a focal point for FP, supervision at all levels and the lack of monitoring and evaluation which, if properly undertaken, could have led to changes and adjustments in the program. Future activities supported by the United Nations Fund for Population in the organization and management of family planning activities within the MCH program and within other government and voluntary organizations. UNFPA should help the government prepare a new proposal for UNFPA assistance to family planning activities in the country and should consider supporting supervision and training activities.
Hong Kong, Family Planning Association of Hong Kong, 1983.  p.This 1982-83 Annual Report of the Family Planning Association (FPA) of Hong Kong reports on the following: program administration; activities of the International Planned Parenthood Federation (IPPF); personnel; clinical services; surgical services; laboratory services; affiliated volunteer groups; education; information; library services; motivation and promotion; statistics and evaluation; training; the Vietnamese Refugees Project; and the Youth Advisory Service. The Association's services are managed by 133 full-time and 21 part-time staff. The clinic attendance figures quoted are for the 1982 calendar year; otherwise, the report refers to the current financial year. There were 43,818 new cases and 51,031 old cases making a total clinic attendance figure of 257,185. Of the 772 female applicants for sterilization, 599 female clients were treated for sterilization in 1982, 502 having mini-laparotomy and 97 having culdoscopic sterilization. 367 vasectomies were performed, representing an increase of 8.6% over the previous year. Educational efforts took the form of Working Youth's Programs, Sexual Awareness Seminars, Sex in Marriage Seminars, Family Planning Talks, and talks and lectures on various topics related to family planning and sex education. Information activities included exhibitions, columns in newspapers and magazines, media coverage and advertisements, and talks by Association staff to various service clubs and community organizations and universities. Resource development efforts took the form of the production of new family life education resources as well as other resource materials; film, slide, and video production; and audiovisual services. The 1982 Knowledge, Attitude, and Practice Survey revealed that 59.2% of the 1403 currently married women interviewed approved, with or without reservation, of the provision of a contraceptive services to the unmarried. 30.5% disapproved of it, and 10.4% had no idea or gave no answer. Studies of the termination of pregnancy and a family life education survey also were conducted. Training efforts included sex education seminars for social workers, a sex education course for secondary school teachers, a sex education seminar for student guidance officers, and an advanced course on human sexuality for social workers and teachers. Total clinic attendance recorded for the Vietnamese Refugees project was 2680; 580 were new cases. The Youth Advisory Service recorded a big increase in the number of new clients (1723), old clients (270), with a total attendance of 3901.