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Integrating community based family planning education and services with primary health care in two rural areas of Cameroon.
In: Operations research family planning database project summaries, [compiled by] Population Council. New York, New York, Population Council, 1993 Mar.  p. (CMR-01)Cameroon has a relatively high maternal and infant mortality rate coupled with an equally high fertility rate. This was the first study of alternative strategies for improving knowledge, availability, and use of family planning (FP) services in a rural area, especially the integration of FP for birth spacing into existing child survival interventions in a community health program. The Cameroon Field Office of Save the Children Federation (SCF), working with the Ministry of Health, designed and implemented a series of activities in the far north (Doukoula) and central provinces (Ntui). FP information, education, and communication (IEC) activities were integrated into an on-going child survival program and linked with increased availability of and access to birth services. This project, which cost US $227,394, combined a series of measuring and training activities over a 3-year-period using combined intervention and data collection activities. During the first 6 months, personnel were trained. Intervention was implemented over the next 18 months. Data include service statistics from existing government hospitals, health centers, and interviews with traditional birth attendants (TBAs). A family registration system ensured that each family was enrolled and that data were complete and up-to-date. A baseline KAP survey was conducted among a sample of 2600 women. Data were routinely collected on study intervention activities (including village level meetings, individual and home visits, community meetings) and on delivery of health and FP services. The trained TBAs had considerable success in raising FP awareness. Group and individual meetings were organized, condoms and spermicides were disseminated, and referrals were made to health centers for other FP services. Results from the baseline and KAP surveys administered to 2604 women before and 1257 after the intervention indicated an increase of FP knowledge from 9.8 to 65.2%. In addition, more people were able to name a modern contraceptive spontaneously. Interviews with villagers revealed that 80% of the women were satisfied with the FP services they received from the TBAs. 96.2% of the TBAs were enthusiastic about continuing activities and receiving additional training and a constant supply of contraceptives. Nevertheless, the prevalence rate for modern contraceptives remains very low, 0.2% for the IUD and 4.8% for the condom among women. There were many factors that might have contributed to this: false rumors, a constant change in key project staff, a lack of systematic incentives to motivate TBAs, and the inadequate management of contraceptive stock. The results indicate that TBAs can promote FP in rural areas, if they receive adequate training, and the government can now provide FP services in rural regions without first having to formulate a national policy.
African women. A review of UNFPA-supported women, population and development projects in Gabon, Guinea-Bissau, Zaire, and Zambia.
New York, New York, United Nations Population Fund [UNFPA], 1991 Jan. 45 p.In the late 1980s, UNFPA-supported women, population, and development projects in 4 African countries were reviewed during their early stages of implementation. The Gabon project aimed to identify pressing needs of rural women who worked in agroindustries or participated in agricultural cooperatives so the government could know how to integrate rural women into national development and in developing programs benefiting women. It realized that providing women with information about family health and sanitation did not meet their needs unless they first had a minimum income with which to implement what they learned. The Guinea-Bissau project chose and trained 22 female rural extension workers to inform women about sanitation and maternal and child health, nutrition, and birth spacing to improve the standard of living. It also hoped to strengthen the administrative, planning, and operational capacity of the women's group of a national political party to improve maternal and child health. Yet the women's group did not have the needed knowledge and experience in project development to operate a successful extension-based program. Further, it was unrealistic to expect women to train to become extension works when the government would not hire them permanently. In Zaire, women at local multiservice women's centers in 3 rural regions imparted information and education to modify traditional beliefs and behavior norms to increase women's role in development. In Zambia, Family Health Programme workers provided integrated maternal and child health care and family planning services through local health centers countrywide. The projects used scientific field surveys and/or interviews with villagers, local leaders, and organizations to conduct needs assessments. They did not assess the institution's strengths and weaknesses to determine its ability to be a development agency. The scope of all the projects as too limited. The duties of the consultant in 2 projects were not delineated, causing some confusion.
IPPF COUNTRY PROFILES. 1992 Jan; 19-24.A country profile of demographic/statistical data, social and health aspects, and government policies and program in Pakistan particularly as they relate to family planning is presented by the International Planned Parenthood Federation (IPPF). Finding current population growth too high and impeding of development, the government enacted a population policy in 1991 aimed at reducing population growth to 2.5% in 10 years. An integrated approach will stress population education in secondary schools, the use of mobile services to promote birth spacing and provide maternal-child health care, and the provision of services through government facilities and family welfare centers. The Family Planning Association (FPA) of Pakistan was created in 1953, and became a member of the IPPF in 1954. It promotes family planning through education, clinics, and the use of male community institutions, and is the main provider of services. The organization also campaigns for both more government involvement in family planning and improvements in the status of women. 16% of married women practice contraception. Female sterilization is the most popular method, followed by condoms. with husband's consent, sterilization is permitted for married women with at least 2-3 children. Abortion is legal only to save a woman's life. Family planning constraints, education, demographic trends, health issues, status of women, contraceptive availability and accessibility, and the operations and funding of the family planning association are fully discussed.
New York, New York, UNFPA, . ix, 81 p.Rapid population growth is an obstacle to Vietnam's socioeconomic development. Accordingly, the Government of Vietnam has adopted a population policy aimed at reducing the population growth rate through family planning programs encouraging increased age at 1st birth, birthspacing of 3-5 years, and a family norm of 1-2 children. TFR presently holds at 4, despite declines over the past 2 decades. Current mortality rates are also high, yet expected to continue declining in the years ahead. A resettlement policy also exists, and is aimed at reconfiguring present spatial distribution imbalances. Again, the main thrust of the population program is family planning. The government hopes to lower the annual population growth rate to under 1.8% by the year 2000. Achieving this goal will demand comprehensive population and development efforts targeted to significantly increase the contraceptive prevalence rate. Issues, steps, and recommendations for action are presented and discussed for institutional development strategy; program management and coordination and external assistance; population data collection and analysis; population dynamics and policy formulation; maternal and child health/family planning; information, education and communication; and women, population, and development. Support from UNFPA's 1992-1995 program of assistance should continue and build upon the current program. The present focus upon women, children, grass-roots, and rural areas is encouraged, while more attention is suggested to motivating men and mobilizing communities. Finally, the program is relevant and applicable at both local and national levels.
ECONOMIC AND POLITICAL WEEKLY. 1987 Jul 11; 22(28):1099.India's family planning program has been restructured from a massive effort, using multimedia promotion and 2 million volunteers and designed to convey the "small family message" directly to the families concerned, to a smaller scale program emphasizing child survival, delayed marriage, village infrastructure, and birth spacing. The change is due to 2 factors: 1) The terminal approach failed to achieve lower birth rates because people will not accept the small family unless they can rely on the survival of the children; and 2) The terminal approach contained an element of coercion which caused the US to reduce support to the US Agency for International Development (USAID) and the UN Fund for Population Activities (UNFPA). The new scaled-down approach should be more effective, since more couples are now practicing family planning and birth spacing, oral contraceptives, IUDs, and longterm hormonal contraceptives are more appropriate than terminal methods to the present demographic picture.
[Unpublished] 1982. 12 p.UN International Children's Emergency Fund (UNICEF) policies on family planning have evolved over time deriving inspiration from the pioneering efforts of the International Planned Parenthood Federation (IPPF) and other nongovernmental organizations. For UNICEF, the health aspects, particularly maternal and child health, of family planning have always been a major area of concern. This was the case much before a formal policy position on family planning was adopted in 1967 and a decision was made to provide the traditional forms of assistance to maternal and child health (MCH) services through supplies, equipment, transport to primary health centers, subcenters, stipends, and equipment for training of medical and paramedical staff. In 1970 the UNICEF Executive Board gave its consent to the inclusion of contraceptives. In 1972 the Joint Committee on Health Policy recommended to the Board the need for complementary social measures for delivery of family planning services through MCH organizations. Excerpts from a 1975 document best express UNICEF's policy regarding family planning. UNICEF works for population programs for many child oriented reasons, the most important of which are the following: an effective population program which spaces births consequently reduces infant and maternal deaths; an effective population program contributes to better health of children and women; and an effective population program contributes to the proper mental development of children. The contributions of UNICEF in population programs are ingrained in its assistance to training of primary health care workers and traditional birth attendants, increasing the accessibility of health centers and the mobility of MCH workers in nutrition programs. In the past 10 years or so UNICEF has been assisting various governments in East Asia and Pakistan in training traditional birthattendants in improving delivery practices. In this decade the training curriculum has been broadened to include training the traditional birth attendants (TBAs) to motivate mothers to become family planning acceptors and maintain them once they become acceptors. The assistance of UNICEF to primary health care takes various forms, including water and sanitation, expanded programs for immunization, nutrition, and others. UNICEF continues to increase MCH accessibility. UNICEF actively promotes breastfeeding globally. It also assists in various area specific development programs in the region. The various programs focusing on women in the region are supported by UNICEF and contribute toward achieving population goals in various ways.