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[The role and responsibility of volunteers in context of APFs] Papel e responsabilidade dos voluntarios no contexto das APFs.
Sexualidade e Planeamento Familiar. 2001 Jan-Jun; (29-30):37-9.The International Planned Parenthood Federation (IPPF) is considered the primary organization in the world in the area of sexual and reproductive health, however, potential donors have viewed it as too rigid. The IPPF organized a task force to confront this charge and come up with recommendations for improvement. Their proposal was that IPPF should be comprised of a diverse collection of volunteers in terms of age, sex, socioeconomic origin, occupation, performance, race, creed as well as linguistic and geographical representation in such a way that this can represent the communities in which they function.
Community-based distribution (CBD) of low cost family planning and maternal and child health services in rural Nigeria (expansion).
In: Operations research family planning database project summaries, [compiled by] Population Council. New York, New York, Population Council, 1993 Mar.  p. (NGA-02)A community-based distribution (CBD) project has been in operation since 1980 in Oyo State, Nigeria. As a result of word-of-mouth communication among health professionals, television coverage of graduation ceremonies, and positive political feedback from the pilot area, the state government requested assistance in expanding the program. In collaboration with the State Health Council, the Pathfinder Fund, University College Hospital, and the Center for Population and Family Health of Columbia University, the program was expanded in 1982 at a cost of US $237,517. In each of the 4 health zones of the expansion area, a Primary Health Center (PHC) became the training and supervisory center. The expanded program was modified in light of experience in the pilot area. Monthly stipends to CBD workers were eliminated and, because of government policy, no fees were to be charged for services. (This policy was later reversed.) Also, a full-time CBD supervisor was assigned to each zone, rather than relying on individual maternity staff members for supervision. Each zone was limited to 100 CBD workers. Data collection included baseline and post-intervention knowledge, attitudes, and practice surveys and a village documentation survey to estimate the service population. The project also carried out in-depth CBD worker interviews, structured observations of training, mini-surveys, analyses of supervision records and service statistics, and a case study of the impact of the CBD program in which villagers were interviewed about the educational and clinical roles of the CBD workers. Although initial family planning (FP) acceptance was low, ever use of a modern method has increased from 2 to 25% in the pilot area. About half of the married women of reproductive ages in the project area are not sexually active at any one time because of postpartum abstinence. Most of the acceptance of modern contraceptives replaces use of traditional abstinence. Male promoters have proved to be an asset to male acceptance of FP services. Individual monetary incentives are not required to motivate CBD workers; however, once incentives are given, difficulties are created if they are stopped, as they were in the pilot area. The CBD approach has changed the concept of health care from that of providing services to clients who come to a fixed site to reaching out to provide services to all people living within a particular catchment area. The expanded project was subsequently extended into additional areas of Oyo State by the State Health Council. In addition, a conference to discuss the project, held in January 1985, was attended by health program managers and policymakers from all parts of Nigeria. The conference stimulated planning by State and Federal Ministries of Health to undertake CBD as a major strategy for primary health care in rural areas.
JOICFP NEWS. 1997 Oct; (280):6.In cooperation with local nongovernmental organizations (NGOs), the JOICFP Integrated Project in Solola State, where it is implemented by the Family Welfare Association of Guatemala (APROFAM), has been refocused on reproductive health (RH) and family planning (FP) within the predominately Mayan communities of Panajachel, San Pedro la Laguna, and San Lucas Toliman. Emphasis has been placed on sensitivity to cultural and gender issues. Mayan professionals, including a Mayan doctor who provides 2 days of service to clinics on a rotational basis, are employed. A clinic has been added in San Pedro la Laguna and another in Panajachel; the latter serves as the project's headquarters. Training of traditional birth attendants (TBAs) and of community-based distribution agents (CBDs) has been increased in order to broaden project coverage. 31 CBDs have been recruited from project communities to counsel and to educate clients in the local language, to provide referrals, and to sell low-cost contraceptives. A Japanese public health nurse serves as a Japanese Overseas Cooperation Volunteer at the APROFAM clinic in Solola. Six TBAs have received follow-up training in natural and modern FP. The project's Mayan doctor works closely with these health personnel. 28 CBDs have been trained to provide Depo-Provera; acceptance of this method has increased by 42%. Contraceptive acceptance between January and June of this year is greater than the total for all of 1996. Two UN Population Fund (UNFPA) representatives, Dr. Sergio de Leon (program officer) and Dr. Ruben Gonzalez (national coordinator of the project to reduce maternal mortality), visited during a monitoring/technical support mission in July and August.
[Save the Children, Honduras. Incorporation of reproductive health services into Save the Children of Honduras's social development strategy. Second semiannual technical report] Asociacion Save the Children de Honduras. Integracion de la salud reproductiva dentro de la estrategia de desarrollo social de Save the Children de Honduras. Segundo informe tecnico semestral.
Tegucigalpa, Honduras, Asociacion Save the Children de Honduras, 1992 May 30. , 17,  p. (HON-4)The second semiannual technical report of the project to incorporate reproductive health services into Save the Children's social development strategies in Honduras summarizes project activities in its first year. Funding of US $95,053 was provided by the Population Council. Activities have been carried out in 2 rural areas (24 communities in Pespire, Choluteca, and 20 communities in La Esperanza, Intibuca) and 1 marginal urban area (5 colonias of Tegucigalpa). The report summarizes project objectives and activities, problems encountered and proposed solutions, and planned next steps. A series of annexes provides greater detail. Training in reproductive health, lactation, and family planning (FP) for community workers, volunteers, and counselors began in December 1991 in the 3 project areas. The training was provided by the Save the Children coordinating team with occasional assistance from other organizations. The course on reproductive health for health volunteers lasted 3 days, while the course for counselors lasted 5 days. Pre/post-tests and other methods were used to evaluate learning by participants. Manuals of reproductive health were developed for health promoters and for volunteers and counselors based on existing materials. The promoters have been giving a monthly talk on reproductive health in their assigned communities. The Save the Children promoters visit each of their 3-5 assigned communities once a week to assist the health volunteers and the maternal-child health counselor. The health volunteers began reporting home visits in March 1992. The health volunteers advise fertile-aged women about contraceptive methods and, in March, began making referrals to community distribution posts of the Honduran Family Planning Association (ASHONPLAFA). They also refer users or possible users of contraception and women with mastitis to health centers of the Ministry of Health (MOH). 44 counselors trained in lactation and FP are active in the 3 project areas. The counselors make home visits but their main activities take place in the 46 supplementary feeding centers in Pespire and La Esperanza, where they provide information and make referrals for high-risk pregnancies. Counselors, like health volunteers, refer potential clients to community distribution posts and MOH centers. Counselors and health volunteers are expected to begin making referrals in June or July for IUD insertions, tubal ligations, and cytologic studies to be offered in 1-day campaigns. 10 health microposts were installed in each of the 2 rural project areas beginning in May 1992 with UNICEF funding. The microposts contain 14 common generic drugs and are expected to begin offering contraceptive supplies in June or July. Poverty and shortages of trained personnel and supplies are hampering the goal of making IUDs available.
Joicfp Review. 1985; (9):12-7.In 1970, a Dutch medical team began work in the city of El Kef in Tunisia on a project designed to bring family planning into rural areas. The project aimed to persuade the rural people to use urban health centers, but this approach failed partly because of the remoteness of the communities and their reluctance to discuss personal matters with strangers. Funded by UNFPA, a new project began to recruit and train local girls as home health visitors or aides-familiales, an approach which became the central focus of the El Kef project. The International Planned Parenthood Federation (IPPF) took over the project and expanded it to include nutrition, health care, health education, family planning, disease prevention and domestic crafts. 4 goals were fixed for the project: total vaccination coverage for children; elimination of severe malnutrition; reduction of infant mortality; and use of family planning practice by at least 1/2 the women of childbearing age. An efficient recordkeeping system enabled the project to be carefully evaluated and provides much-needed data, showing where it has achieved its aims and where new efforts should be directed. The project resulted in large numbers of women receiving ante-natal advice, child care and family planning from their local health centers. 860 pregnant women were followed up during the 3-year study period. Some 57% of pregnant women went for advice; only 15% went for postnatal care, but 50% of the women under 50 attended child welfare sessions during the study period for weight checks, nutrition advice, vaccination and treatment for minor ailments. Over the 3 years, the number of contraceptive users more than trebled, from 14% to 54%. The IUD was the most popular method. The most successful aspect of the project was the emphasis on maternal and child health, and the home visits were the most motivating feature. Vaccination became more popular. A further aspect of the project was the training in home improvement skills, like sewing, knitting and gardening. After 4 years in the field the aides familiales were a valuable resource of skill and experience. Family planning was integrated with maternal and child health in the government program through the health infrastructure.
London, IPPF, 1981 Dec. 24 p.This paper discusses Community-Based Distribution (CBD) programs as a strategy for delivering family planning services at the community level whether through health and other extension workers or lay distributors. Commercial marketing is not discussed. IPPF member family planning associations (FPAs) have been pioneers in establishing CBD programs. In 1979, approximately 40 FPAs were involved in CBD, representing about 80 projects and accounting for 34% of all new acceptors. About half of the projects and half of the new acceptors were in the Western Hemisphere region, where 95% chose oral contraceptives (OCs). OCs were selected by 68% of all new nonclinical clients. The cost per new acceptor in 1979 in CBD programs (with one exception) ranged from 78Z in Thailand to $16.50 in Mexico. Program issues involving the availability of CBD services include: 1) a comprehensive approach to service delivery including adequate and appropriate back up; 2) community participation in the design and delivery of CBD programs; 3) expanding coverage to reach less accessible and disadvantaged populations; and 4) monitoring and evaluating the impact of CBD programs through data collection and constant communication with program participants. The credibility of the distributor in the community is a key factor in ensuring the program's success. The report recommends that OCs of 50 mcg or less be used. Screening of potential acceptors by checklist is adequate; pelvic examination is not needed. CBD projects in Brazil, Colombia, India, Lebanon, South Korea, Thailand, China, Egypt, and the Philippines are described as are projects for 1979. The November 1981 IPPF policy statement supporting community-based family planning services is included.
London, IPPF, l977. 73 p.This document contains case studies of ll programs in sex, population, and family life education for youth, which were initiated by family planning associations in several developing countries. The current emphasis on developing educational programs oriented toward young people stems from the recognition that it is the young who will bear most of the negative consequences, which are associated with rapid population increases, such as uemployment and resource shortages. Youth programs in El Salvador, Hong Kong, Pakistan, Philippines, and Thailand provide training for young people who in turn go out into the community as paid or volunteer family planning and population educators. Programs in other countries stress counseling for school dropouts, provide youth information centers, or conduct education programs for various groups of young workers or students. Based on the experiences gained from these programs, a number of suggestions are made for developing effective youth education programs. Suggested guidelines are: 1) youths, themselves, should be encouraged to participate in the planning, implementation, operation, and evaluation of these programs; 2) the programs should be developed in accordance with the needs expressed by the target population; 3) the cost effectiveness of the programs should be improved by utilizing volunteer workers and through the use of mass media; 4) staff members should be adequately paid and all the expenses incurred by volunteers should be paid for by the program in order to reduce the drop out rate; and 5) evaluation procedures must be built into all phases of program development and operation.
World Health. 1979 Jan; 16-9.In 1968 the Planned Parenthood Federation of Korea in conjunction with the Monistry of Health and Social Affairs began to organize mothers' clubs at the village level for the purpose of distributing oral contraceptives. The effect of these clubs on the life of Korean village women has been revolutionary. Prior to the establishment of the clubs village women spent most of their time confined to their homes, were accorded little status, and had little influence in village affairs. The clubs provided women with an opportunity to visit together and to talk about their common problems. As a result, they were inspired to develop a variety of self-help cooperative activities. For example the women of Chultongwon initiated a savings union and a cooperative store. The money they earned from these activities was used to bring electricity to their village. Some clubs have also developed their own health insurance plans. These activities have not only enhanced the status of women in the villages but have improved the quality of life for all villagers. These changes in turn have had a positive effect on family planning endeavors. By 1977 almost 70,000 local clubs had been established with a membership of approximately 2 1/2 million women.
Front Lines 17(6):4-5. March 15, 1979.In 1969, the government of Indonesia threw its full support behind a family planning program for the country. Since that time, more than 1/2 the women on the islands of Java and Bali have accepted family planning. In 1978, more than 1/4 of the married women of child-bearing age on the 2 islands were practicing some form of contraception. The fertility rate has dropped by 15% and planners hope for 50% acceptance by 1982. These successes are more remarkable when the poverty and cultural backwardness of the country is considered. Reasons for the extraordinary success of the program are: 1) total commitment of the government with interdepartmental organization; 2) adequate financing and technical support from outside sources; 3) detailed organization; 4) local involvement; 5) support of the country's major religious groups; and 6) the flexibility of the program's young administrators. Outside financing, especially by USAID, is discussed. Population density in Indonesia is so severe that success of the program is indispensable to future development of the country.
New York, UNFPA, June 1979. (Report No. 13) 151 pThis report is intended to serve, and has already to some extent so served, as part of the background material used by the United Nations Fund for Population Activities to evaluate project proposals as they relate to basic country needs for population assistance to Thailand, and in broader terms to define priorities of need in working towards eventual self-reliance in implementing the country's population activities. The function of the study is to determine the extent to which activities in the field of population provide Thailand with the fundamental capacity to deal with major population problems in accordance with its development policies. The assessment of population activities in Thailand involves a 3-fold approach. The main body of the report examines 7 categories of population activities rather broadly in the context of 10 elements considered to reflect effect ve government action. The 7 categories of population activities are: 1) basic data collection; 2) population dynamics; 3) formulation and evaluation of population policies and programs; 4) implementation of policies; 5) family planning programs; 6) communication a and education; and 7) special programs. The 10 elements comprise: 1) decennial census of population, housing, and agriculture; 2) an effective registration system; 3) assessment of the implications of population trends; 4) formulation of a comprehensive national population policy; 5) implementation of action programs integrated with related programs of economic and social development; 6) continued reduction in the population growth rate; 7) effective utilization of the services of private and voluntary organizations in action programs; 8) a central administrative unit to coordinate action programs; 9) evaluation of the national capacity in technical training, research, and production of equipment and supplies; and 10) maintenance of continuing liason and cooperation with other countries and with regional and international organizations.
Presented at the National Conference on Population Management as a Factor in Development including Family Planning, Maseru, Lesotho, April 26-29, 1979. 7 pWomen in many parts of Africa have low status, low literacy levels, feel isolated, and are not recognized for their contributions to national development. If programs can be designed to offer women in developing countries an alternative to motherhood, their status can be raised and the birth rate dropped at the same time. Women should be included in all development planning. Family planning programs should be integrated into other, broader programs. Women should be provided with family planning education, allowed to discuss with and motivate each other, and taught the skills and knowledge to communicate family planning to young people. Family planning programs could be integrated with maternal and child health, nutrition, and literacy programs. The work of women's organizations in these areas is cited. Examples of programs which have successfully integrated family planning into other development areas are cited. The International Planned Parenthood Federation has long been involved in promoting the role of women in family planning development.
Asian and Pacific Population Programme News. 1977; 6(4):24-25.In Nepal the promotion of activities aimed at improving the skills and status of women was formerly the task of the national organization, Mahila Sangathan, but is now the responsibility of the newly created Subcommittee for Women's Affairs. The subcommittee operates under the guidance of the Co-ordinating Council for Social Services under the sponsorship of Her Majesty the Queen. The subcommittee cooperates through chapters located in each of the country's 75 districts. Many of these chapters are actively engaged in 1) promoting family planning via door to door campaigns and through training local women for family planning motivational work; 2) stimulating the production and marketing of crafts made by women; 3) providing legal assistance to women; and 4) conducting literacy programs for approximately 10,000 women. A new headquarters for the subcommittee is being built with UNESCO assistance. The committee hopes to establish a library in the new building since a lack of reading material is hindering progress in its literacy program.
CBFPS (Community-based Family Planning Services) in Thailand: a community-based approach to family planning.
Essex, Connecticut, International Council for Educational Development, 1978. (A project to help practitioners help the rural poor, case study no. 6) 91 pThis report and case study of the Community-Based Family Planning Service (CBFPS) in Thailand describes and evaluates the program in order to provide useful operational lessons for concerned national and international agencies. CBFPS has demonstrated the special role a private organization can play not only in providing family planning services, but in helping to pioneer a more integrated approach to rural development. The significant achievement of CBFPS is that it has overcome the familiar barriers of geographical access to family planning information and contraceptive supplies by making these available in the village community itself. The report gives detailed information on the history and development of the CBFPS, its current operation and organization, financial resources, and overall impact. Several important lessons were learned from the project: 1) the successful development of a project depends on a strong and dynamic leader; 2) cooperation between the public and private sectors is essential; 3) the success of a project depends primarily on the effectiveness of community-based activities; 4) planning and monitoring activities represent significant ingredients of project effectiveness; 5) a successful project needs a sense of commitment among its staff; 6) it is imperative that a project maintain good public relations; 7) the use of family planning strategy in introducing self-supporting development programs can be very effective; 8) manning of volunteer workers is crucial to project success; and 9) aside from acceptor recruitment in the short run, the primary purpose of education in more profound matterns such as childbearing, womens'roles in the family, and family life should also be kept in mind. The key to success lies in continuity of communication and education.
People. 1975; 2(4):5-11.A survey of selected countries to illustrate the variety of approaches used in supplying contraceptives through the community is presented; and the agencies involved are listed. The various types of community-based distribution schemes in 33 countries of Latin America, Africa and Asia are identified and briefly described. The personnel and methods utilized in individual countries include rural community leaders, fieldworkers, satisfied contraceptive users, paramedical and lay distributors, women's organizations, commercial marketing, education programs, market day strategies, and government saturation programs. The community-based program for distributing oral contraceptives with technical assistance from BEMFAM, an IPPF affiliate, in northeastern Brazil is described in detail, with emphasis onsocial marketing techniques and the mobilization of resources. In addition to IPPF, other agencies working in community-based distribution include Family Planning International Assistance, International Development Research Centre, Population Services International, The Population Council, UNFPA, USAID, and Westinghouse Health Systems Population Centre.
London, England, IPPF, 1983. 19 p.This paper reviews the policies of the International Planned Parenthood Federation (IPPF), assesses the lessons learned, raises key issues influencing policy formulation and program development, and identifies the options available at all levels of IPPF to meet the fertility related needs of young people, be they boys or girls. (IPPF considers young people to range from ages 10 to 25). Young people are an increasing percentage of the world's population and are perplexed by profoundly changing social enviornments and by how to deal with pregnancy. IPPF programs include fertility related services such as counseling and contraceptive services, and education in family planning. The paper stresses that sex education needs to start before young people become sexually active. It is essential that youth participate in the family planning movement; 1 major problem is that parents and many other adults feel that provision of family planning services for adolescents encourages promiscuity. The report documents IPPF collaboration with kindred international nongovernmental organizations. It recommends that family planning associations mobilize community resouces by lobbying policy and decision makers to get them to respect the rights of youth for family planning services. Future directions for the IPPF include youth related activities, influence on government policies and programs, pilot projects, and research data collection.