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  1. 1

    Monitoring AIBEF's service expansion through situation analysis.

    Association Ivoirienne pour le Bien-Etre Familial; Population Council

    In: Operations research family planning database project summaries, [compiled by] Population Council. New York, New York, Population Council, 1993 Mar. [2] p. (IVO-05)

    The number of family planning (FP) service delivery points (SDPs) in Cote d'Ivoire is increasing rapidly with the assistance of several USAID projects: SEATS for overall management assistance, INTRAH for clinical training, Johns Hopkins University/PCS for information, education, and communication (IEC), and the Africa operations research/technical assistance (OR/TA) project for the management information system (MIS). For example, during 1991, the Association Ivoirienne pour le Bien-Etre Familial (AIBEF) increased its SDPs from 3 to 19. By the end of 1992, 33 AIBEF-assisted public sector maternal and child health centers will become FP SDPs. This is the first step in a longterm program to increase the government's FP service delivery capacity and is a model for future activities. This study, which cost US $29,392, will monitor the management information system (MIS) to define its impact and role in the expansion. The MIS project will provide data on contraceptive use, reproductive intentions, and community flow but it will not describe several service delivery functions or information relative to the client, such as provider relations and IEC activities. The MIS data, therefore, must be complemented by data on 1) the quality of provider-client interactions, 2) the SDPs functional capacity for providing FP services (both physical and human resources), and 3) the user's experiences with FP services. This study will adapt a situational analysis methodology developed by The Population Council. Information will be collected from all operational SDPs (approximately 20). Of the 13 SDPs observed, 4 serviced 1200 to 1800 new and continuing users in 3 months. 3 other clinics serviced between 22 and 37. 24,221 clients accepted modern methods during that time, with 19% (mainly men) choosing condoms and 81% selecting prescription methods (85% oral contraceptives (OCs), 11% injectables, and 3% IUD). All clinics had a system for ordering contraceptives, yet all experienced stock-outs. Only 8% of clinics had an appropriate storage system. 55% of clinics held discussions about FP and reproductive health with service providers and clients. The study also revealed that 25% of all clients interviewed had had an abortion. In terms of personnel, there was a lack of FP educators disseminating IEC, and most clinics needed updated IEC materials. The record-keeping land logistics departments needed improvement as stock-outs were common. International management meetings and external supervisory visits were infrequent. For the most part, clients were satisfied with the FP services, although some mentioned a long wait and a lack of privacy. Numerous recommendations were made in order to provide FP services in clinics including: development of FP activities, improvement of quality of services, and development of counseling and interpersonal communication skills.
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  2. 2

    Fortieth report and accounts, 1971-1972.

    Family Planning Association [FPA]

    London, FPA, 1972. 48 p.

    Currently, public authorities pay for almost 2/3 of the family planning consultations conducted by the Family Planning Association, and this is the most significant development since the publication of the last Family Planning Association Report. Additionally, more local health authorities are operating direct clinic and domiciliary services. The Family Planning Association handed over the management of 39 clinics to public authorities in the 1971-1972 year. However, despite this progress, family planning service provision by public authorities throughout England continues to be uneven in quality and extent. Spending by local health authorities for each woman at risk varies from 1 penny per woman at risk in Burnley (excluding the city of London) to 179 pence at Islington. In addition to the problem of inconsistency in spending, there appears to be no immediate prospect of a comprehensive family planning service - one that is available to all, is free of charge, and is backed by an adequate education campaign. Although government help for the extension of domiciliary family planning service is impressive, it should not obscure the false economies in spending on other contraceptive delivery services such as general practitioners, specialist clinics, and specialized advisory centers. Until the government announces the details of its plans for family planning services within the National Health Service beginning April 1974, the Family Planning Association's own detailed planning cannot be exact. The Association's basic policy continues to be to turn over the responsibility for the management of clinic and domiciliary contraceptive services as quickly and as smoothly as possible to the public authorities. Already there is concern that some clinic services managed by public authorities may become less attractive, particularly to young people, and that differences in the quality of service will increase under local public management as well as that backup services will be neglected. Also existing is the realization that the public authorities do not do enough to attract people to the use of contraception.
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  3. 3

    Family planning in poverty-ridden Nicaragua.

    Jaimes R


    The percentage of people living in poverty in Nicaragua's cities has increased significantly in recent years and reflects an increase in the number of households headed by women. Among the nongovernmental organizations created to help meet the needs of Nicaragua's population is Profamilia, the International Planned Parenthood Federation affiliate founded in 1971. Profamilia offers high quality sexual and reproductive health services at regional clinics operating in 9 out of 16 political subdivisions and manages a nationwide network of over 1000 community-based contraceptive distribution posts. Knowledge of modern contraception is almost universal in Nicaragua, and a 1992-93 health survey revealed that almost half of women of reproductive age were using contraception. Profamilia uses the mass media and other means to advertise its services, which are preferred by many over the free government services. In the communities, trained volunteer promoters distribute contraceptives and provide counseling. Because adolescent pregnancy and fertility rates are high, Profamilia has developed services, including educational workshops, that target youth. These workshops offer information on responsible sex behavior and ways to reduce the risk of pregnancy or infection. In addition, Profamilia offers training courses for teachers and educational sessions for parents, pregnant adolescents, and adolescent parents.
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  4. 4

    Meeting the needs: Uruguay. A clinic for the disadvantaged.

    FORUM. 1997 Jul; 13(1):19.

    This article describes a Model Clinic of the Uruguayan Family Planning Association (UFPA) that received support from UNFPA during 1994-96. The Model Clinic includes an operating room that permits voluntary surgical sterilization, which is new to Uruguay. The Clinic is located in the Pereira Rossell Hospital in Montevideo, which makes it accessible to many people. The Hospital includes the largest maternity ward in the country and provides 80% of the nation's public health services. The UFPA also operates a clinic in Santa Rita, an area which has the lowest income in metropolitan Montevideo. The UFPA expected in 1994, to provide services for 2000 new family planning (FP) acceptors and 5000 return visits to the Model Clinic and 600 new acceptors and 1800 return visits to the Santa Rita Clinic. It was anticipated that the clinics would recover 30% and 25% of their costs, respectively. Findings indicate that, in 1996, outcomes exceeded expected returns. At the Model Clinic, there were 4394 new acceptors. At the Santa Rita Clinic, there were 2787 return visits. Santa Rita, an impoverished area, recovered 46% of costs, which was double the estimates. The program aims to integrate FP services within existing government health services and to improve FP for low-income populations. A by-product of this program was the staff experience of learning how to share and collaborate with government programs. The UFPA exceeded its projections and is expected to continue service provision in these clinics regardless of possible UNFPA funding withdrawal.
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  5. 5

    The use of service statistics in PROFAMILIA.

    Ojeda G

    [Unpublished] 1993. Presented at the Expert Meeting on Information Systems and Measurement for Assessing Program Effects, Washington, D.C., September 9-10, 1993. Sponsored by National Academy of Sciences Committee on Population. [4] p.

    Profamilia has been affiliated with the International Planned Parenthood Federation since 1967, and it objectives are to promote family planning (FP) in Colombia with information and services. 70% of couples using modern methods obtained them from Profamilia. 69% of Colombian women of reproductive age are current users of FP. There are 47 Profamilia clinics, 8 of which offer FP only to men. Surgical contraception was offered to men starting since then. The 1990 Demographic and Health Survey indicated that female sterilization led the way in FP methods, followed by oral contraceptives and the IUD. About 80% of new acceptors choose sterilization and the IUD, and they have become progressively younger. In 1970 Profamilia started community-based distribution of OCs and condoms and inaugurated social marketing in 1974. OCs and condoms donated by foreign agencies are sold in pharmacies at low prices. The Evaluation and Research Department comprises the Service Statistics, Evaluation, and Research Sections. Monthly reports are produced on FP services provided, based on total number of new acceptors per clinic and per method, total number of follow-ups, sociodemographic characteristics of new acceptors, number of male and female sterilizations, number of couple years of protection per program and per clinic, educational activities, finances, and supplies used. Service statistics are used for client care, program operation, administrative monitoring, measurement of program activity, supervision, evaluation, and research. Volume indicators measure services rendered and the number of clients served; coverage indicators measure the extent of services provided to various groups; quality indicators include measures of comprehensiveness, timeliness, continuity, and satisfaction; effectiveness indicators measure the achievement of objectives; and efficiency indicators relate to inputs such as cost and facilities.
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  6. 6

    For the public good. A history of the Birth Control Clinic and the Planned Parenthood Society of Hamilton, Ontario, Canada.

    Bailey TM

    Hamilton, Canada, W.L. Griffin, 1974. 35, [1] p.

    The history of the Planned Parenthood Society of Hamilton, Ontario, Canada has been prepared to recognize the fact that the Society is the oldest of its kind in Canada. It is approaching its 50th Anniversary, and it still plays a prominent role in Hamilton as well as being one of the founding members of the Family Planning Federation of Canada. The Federation is a member of the International Planned Parenthood Federation. The Society was founded by Mary Elizabeth Hawkins with the help of Albert R. Kaufman. Mr. Kaufman alleviated the plight of wives of the unemployed who were having unwanted children. The constitution of the Society had 2 parts: (1) "to establish and maintain a birth control clinic in Hamilton where free instruction will be given to married women in cases where there are definite physical or mental disabilities in order that the public good may be served." (2) "To educate the public as to the true aims of the birth control movement and its beneficial effect upon the race." In 1932 Mrs. Hawkins and Miss Burgar went to the Wentworth County Court House in Hamilton to talk to the Crown Attorney Ballard about the legality of operating their clinic. At the time the Criminal Code had prohibitions against "every one having for sale or disposal any means of instructions or any medicine, drug or article intended or represented as a means of preventing contraception." The result of the meeting was a letter from George Ballard that openly supported their activities and wished them success. The early days were the hardest because of a lack of money, most of which came from the founding members. There was also a great deal of opposition from the local community. However, it was the work of Society that helped make contraception legal in Canada today.
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  7. 7

    A major challenge. Entrepreneurship characterizes the work of the Soviet Family Health Association.

    Manuilova IA

    INTEGRATION. 1991 Sep; (29):4-5.

    The work of the Soviet Family Health Association (SFHA) is described. Created in January, 1989, the organization boasts 25 state-paid workers, and as of June 1991, membership of 15,000 corporate and individual members. Individual annual membership fee is 5 rubles, and entitles members to counseling and family planning (FP) services. The SFHA works in cooperation with the Commission on Family Planning Problems of the USSR's Academy of Sciences, and has been a member of the International Planned Parenthood Federation (IPPF) since 1990. Association activities include lectures for students, newly-weds, adolescents, and working women on modern contraceptive methods; research on attitude regarding sex, sex behaviors, and the perceived need for effective contraception; clinical trials of contraceptive suitability for women; and the training of doctors in FP and contraceptives. Problems central to the SFHA's operations include insufficient service and examination equipment, a shortage of hard currency, and the small number of FP specialists in the country. Solutions to these obstacles are sought through collaboration with the government, non-governmental organizations in the Soviet Union, and international groups. The SFHA has a series of activities planned for 1991 designed to foster wider acceptance of FP. Increased FP services at industrial enterprises, establishing more FP centers throughout the Soviet Union, and studying FP programs in other countries are among Association targets for the year. Research on and promotion of contraceptives has been virtually stagnant since abortion was declared illegal in 1936. Catching up on these lost decades and remaining self-reliant are challenges to the SPHA.
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  8. 8

    Report on the evaluation of the UNFPA funded project on labour and family welfare education in organized sector in Zambia (September-October 1986).

    Valdivia LA; Friedman M

    Arlington, Virgina, Development Associates, 1986. iii, 71 p.

    This report evaluates the UNFPA-funded Labor and Family Welfare project in the Organized Sector of Zambia, Africa. The project targeted 3 key elements of the Organized Sector--motivation of leaders, training of educators, and in-plant workers' education. The project laid the groundwork for a major expansion of education and services at the workers' level. It has also led to a National Population Policy formulation. 18 recommendations are suggested with priority given to factory-level education and family planning service delivery. Additional funding for companies to motivate and educate workers regarding acceptance of family planning services is suggested, as well as increased training for economics, teachers, psychology teachers, and social workers to enable them to incorporate population education into their curriculums. Training activities were a major focus of the project. Increased training and educational materials about family planning, in the form of posters and handouts, should be produced and disseminated at the factory level, as well as to medical personnel. UNFPA, in accord with the Ministry of Health of Zambia, should ensure an adequate supply of contraceptives to the factories. Existing record keeping, reporting and scheduling practices should be improved, as well as the International Labor Organization (ILO) disbursement system. Short-term ILO consultants should be recruited to improve the project and its management, and 2 additional staff members, provided by the government, could help to implement the program at the plant level. 2 new vehicles should be purchased for full-time field staff to ensure availability to carry out project activities. In addition, the present accounting and recordkeeping of the ILO Lusaka office should be restructured to achieve more accurate monitoring of the use of project funds.
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  9. 9

    Turkey's workforce backs family planning.

    Fincancioglu N

    PEOPLE. 1987; 14(2):33.

    3 agencies in Turkey are placing family planning centers in factory settings: the Family Planning Association of Turkey (FPAT), the Confederation of Trade Unions (TURK-IS), and the Family Health and Planning Foundation, a consortium of industrialists. The FPAT started with 27 factories 7 years ago, educating and serving 35,000 workers. The 1st work with management, then train health professionals in family planning, immunization, infant and child care, maternal health, education, motivation techniques, record-keeping and follow-up. Worker education is then begun in groups of 50. New sites are covered on a 1st-come-1st-served basis. This program is expected to be successful because newcomers to city jobs are beginning to see the need for smaller families, and accept family planning. TURK-IS has conducted seminars for trade union leaders and workers' representatives and provided contraceptives in 4 family planning clinics and in 20 hospitals run by Social Security, a workers' health organization. They have distributed condoms in factories and trained nurses to insert IUDs in factory units. The businessmen have opened family planning services in 15 factories, with support from the Pathfinder Fund, and hope to make the project self-supporting.
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  10. 10

    Yozgat MCH/FP Project: Turkey country report.

    Coruh M

    [Unpublished] 1979. Paper prepared for the Technical Workshop on the Four Country Maternal and Child Health/Family Planning Projects, New York, Oct. 31-Nov. 2, 1979. (Workshop Paper No. 2) 10 p.

    An integrated health care system which combined the maternal/child health with other services was undertaken in the Yozgat Province of Turkey from 1972-77. The objective was to train midwives in MCH/FP and orient their activities to socialization. The first 2 years of the program was financed by UNFPA. 52 health stations were completed and 18 more are under construction. The personnel shortage stands at 33 physicians, 21 health technicians, 30 nurses, and 67 midwives. Yozgat Province is 75% rural and has about a 50% shortage of roads. The project was evaluated initially in 1975 and entailed preproject information studies, baseline health practices and contraceptive use survey, dual record system, and service statistics reporting. The number of midwives, who are crucial to the program, have increased from an average 115 in 1975 to 160 in 1979. Supervisory nurses are the link between the field and the project managers. Their number has decreased from 17 to 6. Until 1977 family planning service delivery depended on a handful of physicians who distributed condoms and pills. The Ministry of Health trained women physicians in IUD insertions. The crude death rate in 1976 was 13.2/1000; the crude birth rate was 42.7/1000. The crude death rate in 1977 was 14.8/1000; birth rate, 39.9/1000. Common child diseases were measles, enteritis, bronchopneumonia, otitis, and parasitis.
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  11. 11

    Kenya's project for the improvement of rural health services and the maternal child health and family planning programme.

    Kanani S

    In: Korte R, ed. Nutrition in developing countries. Eschborn, Germany, German Agency for Technical Cooperation, 1977. 29-37.

    This report focusses on a project for the improvement of rural health services and development of 6 rural health training centers in Kenya. The Ministry of Health has the responsibility of managing the health centers and dispensaries throughout the country. After a study by experts and funding by international agencies, a project to provide postbasic training to health center staff was undertaken. The major health conditions affecting the community were: family health problems; communicable disease; inadequate sanitation diseases; and, malnutrition and undernutrition. The most overwhelming problem was family health which necessitated a maternal and child/family planning project. The program is directed at women aged 15-49 with a "Super-Market" approach whereby all services (antenatal care, maternity care, postnatal care, child welfare, family planning and health education) will be available on a daily basis in an integrated system. 5 new training schools for nurses are being built. Education in both health and family planning will be emphasized in the project in the future. With a view to uplifting the general quality of life, the Kenya projects are seen as part of the total socioeconomic development of the country as a whole.
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  12. 12

    Draft National Health Policy: comments and suggestions of the Indian Medical Association.

    Indian Medical Association

    JOURNAL OF THE INDIAN MEDICAL ASSOCIATION. 1979 Mar 16; 72(6):137-43, 148.

    The International Conference on Primary Health Care called for urgent and effective national and international action to develop and implement primary health care throughout the world. All government agencies should support primary health care by channelling increased technical and financial support to health care systems. Any national health policy designed to provide for its people should recognise the right to health care as a fundamental right of people. The sociocultural environment of the people should be upgraded as a part of health care. The government's expenditure on health should be regarded as an investment, not as a consumption. Health should be a purchasable commodity. Medical education should be reoriented to the needs of the nation. The government should establish as its ultimate goal the provision of scientific medical service to every citizen. Industrial health and mental health disciplines should establish clear-cut methodologies to achieve the same objectives as medical science. Practitioners of indigenous systems of medicine should be allowed to practice only those systems in which they are qualified and trained. Integration of the modern and traditional systems has failed. In order to encourage people to adopt small family size, facilities for maternal and child welfare clinics, coupled with immunisation and nutrition programs, are needed.
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  13. 13

    Overview of the medical and clinical activities performed by the family planning associations of the Western Hemisphere Region.

    Gutierrez HF

    N.Y., International Planned Parenthood Federation Western Hemisphere Region, 1973. 103 p

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  14. 14

    Nutrition counseling at planned parenthood centers.


    Public Health Reports. 1979 May-Jun; 94(3):239-242.

    A questionnaire was developed to elicit information on nutrition available to family planning clients, the acceptability of the nutrition education, and awareness among family planning personnel about the relationships between nutrition and oral contraceptives. Questionnaires were sent to the 31 Planned Parenthood Federation of America centers in New Jersey and Pennsylvania, for distribution to family planning counsellors. Usable questionnaires were returned from 22 centers, with 94 individuals responding. 1/2 the counsellors reported that nutrition information was available at their centers, in the form of handouts, audio-visual materials, and counseling. Information was in 3 categories -- general nutrition, nutrition and oral contraceptives, and nutrition during pregnancy -- but information in all 3 categories were rarely available in any 1 center. Weight control was a major concern in all 3 categories. Nutrition information was generally provided by the counsellor or by a nurse or physician. Nutritionists supplied information in only 2 centers. The attitude toward providing the information was mixed, with those already doing so most favorable. The majority of counsellors saw a need for data on general nutrition and nutrition and oral contraceptives, but less than 1/2 saw a need for nutrition and nutrition and oral contraceptives, but less than 1/2 saw a need for nutrition and pregnancy information. 60% of respondents knew of a connection between nutrition and oral contraceptives and more than 1/2 of these considered the relationship significant. 60% of counsellors whose clients had asked about the relationship indicated an awareness of the problem. This was, however, found to be the most neglected area of information encountered in the survey.
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  15. 15

    Report to donors: October 1976.

    International Planned Parenthood Federation [IPPF]

    London, England, IPPF, 1977. 428 p.

    This report describes IPPF's world-wide program from 1975-77. Financial and statistical statements are accompanied by narrative texts. In 1975 the number of family planning acceptors increased by about 5% or 1.8 million reached directly by IPPF-funded service programs. Between 1971 and 1974 the overall acceptance rate for organized family planning programs in countries with government programs was about 35/1000 women aged 15-44. The acceptance rate of IPPF-supported programs increased from 2.1 to 2.7/1000. IPPF's contribution was about 8% of the 1974 total. As a distributing and purchasing agency for contraceptive supplies and medical equipment, IPPF purchased $8.5 million worth of commodities in 1975, $7.5 million in 1976, and $7 million in 1977. About 2/3 represent oral contraceptives and condoms. The world summary of projected expenditures, 1977, includes 20.7%/information and education, 21.6%/medical and clinical, 20.4%/administration, 14.2%/commodities, 7.6%/community-based distribution, 6.2%/training, 3.2%/evaluation, and 1.6%/fund raising. Regional reports include a program description of the regional office, financial statements, clinic service statements, program descriptions of grant receiving associations, and a brief summary of expenditure.
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  16. 16

    National Population Agency of Costaguay.


    In: International Committee on the Management of Population Programmes (ICOMP). 1975 Annual Conference Report: expanding role of the population manager, Mexico City, July 14-17, 1975. (Mahati, Philippines, 1976). p. 102-108

    A case report of the development of family planning services in Costaguay, Latin America, is presented as a basis for class discussion under the auspices of the case development program of the International Committee for the Management of Population Programmes. The official population agency of Costaguay is NPAC which was legalized by an executive decree in February 1968 as an interinstitutional body with representatives of several cabinet ministries and an ex-officio representative from the Costaguayan Family Welfare Association. In 1972 a technical mission from the U.N. visited Costaguay to make recommendations in the field of population. The 4 operating components of the U.N. Assistance Project were: 1) clinic services, 2) information and education, 3) training, and 4) research and evaluation. In May 1974 there were about 80 family planning clinics in Costaguay, serving 30,000 users. There were 5 categories of facilities: 1) hospitals, 2) provincial health centers with afternoon shifts, 3) provincial health centers with integrated services, 4) municipal subcenters, and 5) rural clinics. A new information system was being used by May 1974 which utilized a ''daily report'' for use with a mechanical tabulator or computer.
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  17. 17

    Family planning in health services.

    World Health Organization [WHO]

    Geneva, WHO, 1971. (WHO Technical Report Series No. 476) 65 p.

    This report on family planning programs in health services is divided into 5 broad categories: 1) introduction; 2) general considerations (including a review of programs, legislation and goals); 3) planning; 4) implementation; and 5) evaluation. Many developing countries which emphasize family planning have poor health care delivery systems. The situation may be complicated by political factors such as regional autonomy. If demographic goals create a sense of urgency within the national government, considerable financial resources may be used solely for family planning. A single purpose campaign is not likely to succeed without a sound health infrastructure. Family planning workers are often more acceptable to the local community when they work under the auspices of a general health team. Some family planning can be integrated into whatever health services are available. Maternal child health services are particularly desireable and effective. All health personnel should be trained in the principles of family planning; it should be standard curricula. The scope and training of indigenous workers in family planning should be defined. Practical indicators of service inputs should be used to evaluate programs. Field studies, de monstrations, and pilot projects are useful and desireable both as a preliminary measure and a training method.
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  18. 18

    The context of population policy formation in Peru.

    Clinton RL

    In: McCoy, T.L., ed. The dynamics of population policy in Latin America. Cambridge, Massachusetts, Ballinger Publishing Company, 1974. p. 353-375

    Peru has the problems created by a 3.1% annual growth rate and heavy rural-to-urban migration, but the Peruvian government has not formulated a population policy. There is a feeling of complacency because of the vast unused tracts of land. In Peru there has been a long-term commitment to social and economic development. With the military take-over in 1968, the few government-sponsored family planning clinics were discontinued. The ruling military aims at a mixed capitalistic-socialistic state while maintaining national sovereignth. Since 1968, there have been a few unofficial, foreign-supported family planning programs. What is needed is leadership, coming neither from the United States nor from the local elite, to convince the Peruvian government to embrace family planning. Population growth must be perceived as a threat to adequate development.
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  19. 19

    The population work of the World Bank.

    Baldwin GB; Zaidan GC; Muncie PC

    Studies in Family Planning. November 1973; 4(11):293-304.

    The World Bank's philosophy and approach to family planning development assistance are presented. A detailed review of the Bank-assisted population projects in Indonesia and India is given. Recognizing that the rapid population growth most countries are now experiencing undermines, and often cancels out, efforts to improve living standards, in 1970 the Bank began to finance projects designed to limit excessive population growth. In addition to making money available to the governments that come with population projects, the Bank assists the governments in developing effective programs by providing technical assistance for both the development and implementation of projects. The Bank also attempts to educate opinion leaders to an awareness of the problem. The Bank has conducted sector reviews in 7 countries, resulting in a report submitted to the government in question. The Bank conducts sector reviews to develop the background knowledge necessary to identify and prepare a project it will assist. The Indian and the Indonesian projects are among the largest of the 7 projects so far assisted by the Bank. The Indonesia project is aimed at scaling up its present national program. New activities are being introduced and organizational changes are being made. Outside technical assistance is being provided for a specified period. The principal aim of the India project is to discover new methods of increasing the number of acceptors in a program that has reached a plateau. Different combinations of program inputs are being experimented with to see what works best and to measure what different activities cost.
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