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Geneva, Switzerland, WHO, 2017. 12 p. (Summary Brief WHO/RHR/17.20)Contraception is an inexpensive and cost-effective intervention, but health workforce shortages and restrictive policies on the roles of mid- and lower-level cadres limit access to effective contraceptive methods in many settings. Expanding the provision of contraceptive methods to other health worker cadres can significantly improve access to contraception for all individuals and couples. Many countries have already enabled mid- and lower-level cadres of health workers to deliver a range of contraceptive methods, utilizing these cadres either alone or as part of teams within communities and/or health care facilities. The WHO recognizes task sharing as a promising strategy for addressing the critical lack of health care workers to provide reproductive, maternal and newborn care in low-income countries. Task sharing is envisioned to create a more rational distribution of tasks and responsibilities among cadres of health workers to improve access and cost-effectiveness.
Pakistan: increasing access to SRH services in fragile contexts for rural women in hard-to-reach areas.
London, United Kingdom, IPPF, 2015 Sep. 2 p.In some areas of Pakistan, girls and women are vulnerable to harmful traditional practices, like swara (now illegal, a form of reconciliation where a girl or woman is given in marriage to settle a dispute) and early marriage, and many of them face tremendous obstacles to basic services, including sexual and reproductive health (SRH) services.
Under-served and over-looked: prioritizing contraceptive equity for the poorest and most marginalized women and girls.
London, United Kingdom, IPPF, 2017 Jul. 40 p.This report is a synthesis of evidence revealed from a literature review, including 68 reports from 34 countries. The results are dire: the poorest women and girls, in the poorest communities of the poorest countries are still not benefitting from the global investment in family planning and the joined up actions of the global family planning movement. Women in the poorest countries who want to avoid pregnancy are one-third as likely to be using a modern method as those living in higher-income developing countries.
Policy brief on the case for investing in research to increase access to and use of contraception among adolescents.
Seattle, Washington, PATH, 2015 Mar. 4 p.This document outlines why governments and donors should invest now in research to help determine and implement the most effective and efficient ways to enable adolescents to access and use contraception. It summarizes the findings of a longer technical report.
Quality of care in contraceptive information and services, based on human rights standards: a checklist for health care providers.
Geneva, Switzerland, WHO, 2017. 32 p.Unmet need for contraception remains high in many settings, and is highest among the most vulnerable in society: adolescents, the poor, those living in rural areas and urban slums, people living with HIV, and internally displaced people. The latest estimates are that 225 million women have an unmet need for modern contraception, and the need is greatest where the risks of maternal mortality are highest. There is increasing recognition that promotion and protection of human rights in contraceptive services and programs is critical to addressing this challenge. However, despite these efforts, human rights are often not explicitly integrated into the design, implementation and monitoring of services. A key challenge is how to best support health care providers and facility managers at the point of service delivery, often in low-resource real-world settings, to ensure their use of human rights aspects in provision of contraceptive services. The point of service delivery is the most direct point of contact where potential violations/omissions of rights come into play and requires special attention. This checklist covers five areas of competence needed by health care providers to provide quality of care in contraceptive information and services including: respecting users’ privacy and guaranteeing confidentiality, choice, accessible and acceptable services, involvement of users in improving services and fostering continuity of care and follow-up. International and regional human rights treaties, national constitutions and laws provide guarantees specifically relating to access to contraceptive information, commodities and services. In addition, over the past few decades, international, regional and national legislative and human rights bodies have increasingly applied human rights to contraceptive information and services. They recommend, among other actions, that states should ensure timely and affordable access to good quality sexual and reproductive health information and services, including contraception, which should be delivered in a way that ensures fully informed decision making, respects dignity, autonomy, privacy and confidentiality, and is sensitive to individuals’ needs and perspectives. This document presents a user friendly checklist specifically addressed to health care providers, at the primary health care level, who are involved in the direct provision of contraceptive information and services. It is complimentary to WHO guidelines on Ensuring human rights in the provision of contraceptive information and services: Guidance and recommendations, and the Implementation Guide published jointly with UNFPA in 2015. This checklist also builds on WHO vision document on Standards for Improving Quality of Care for Maternal and Newborn Care and its ongoing work under the Quality, Equity and Dignity initiative. The checklist should be read along with other guidance from WHO and also from partners.
Quality of care in contraceptive information and services, based on human rights standards: a checklist for health care providers.
Geneva, Switzerland, WHO, 2017. 32 p.International and regional human rights treaties, national constitutions and laws provide guarantees specifically relating to access to contraceptive information, commodities and services. In addition, over the past few decades, international, regional and national legislative and human rights bodies have increasingly applied human rights to contraceptive information and services. This document presents a user friendly checklist specifically addressed to health care providers, at the primary health care level, who are involved in the direct provision of contraceptive information and services. It is complimentary to WHO guidelines on Ensuring human rights in the provision of contraceptive information and services: Guidance and recommendations, and the Implementation Guide published jointly with UNFPA in 2015. This checklist also builds on WHO vision document on Standards for Improving Quality of Care for Maternal and Newborn Care and its ongoing work under the Quality, Equity and Dignity initiative. The checklist should be read along with other guidance from WHO and also from partners.
Development, updates, and future directions of the World Health Organization Selected Practice Recommendations for Contraceptive Use.
International Journal of Gynecology and Obstetrics. 2016 Dec 13; 7 p.Correct and consistent use of contraception decreases the risk of unintended pregnancy; yet, outdated policies or practices can delay initiation or hinder continuation of contraceptive methods. To promote the quality of, and access to, family planning services, WHO created a series of evidence-based guidance documents for family planning, known as WHO's Four Cornerstones of Family Planning Guidance. The Medical eligibility criteria for contraceptive use (MEC), first published in 1996, provides guidance on the safety of various contraceptive methods in users with specific health conditions or characteristics (i.e. who can use a contraceptive method safely). The Selected practice recommendations for contraceptive use (SPR) is the second cornerstone, outlining how to safely and effectively use contraceptive methods. These two documents can serve as a reference for policymakers and program managers as they develop their own national family planning policies in the context of local needs, values, and resources. The two other cornerstone documents -- the Decision making tool for family planning clients and providers and Family planning: a global handbook for providers -- provide guidance to healthcare providers for applying these recommendations in practice. Between 2013 and 2014, WHO convened a Guideline Development Group (GDG) to review and update the MEC and SPR in line with current evidence. As a result of these meetings, the fifth edition of the MEC was published in 2015, and the third edition of the SPR will be released on December 14, 2016. The purpose of the present report is to describe the methods used to develop the SPR recommendations, research gaps identified during the guideline development process, and future directions for the dissemination and implementation of the SPR among policymakers and family planning program managers worldwide. (excerpt)
Global Plan towards the Elimination of New HIV Infections among Children by 2015 and Keeping their Mothers Alive. 2011-2015.
Geneva, Switzerland, UNAIDS, 2011.  p. (UNAIDS/ JC2137E)This Global Plan provides the foundation for country-led movement towards the elimination of new HIV infections among children and keeping their mothers alive. The Global Plan was developed through a consultative process by a high level Global Task Team convened by UNAIDS. It brought together 25 countries and 30 civil society, private sector, networks of people living with HIV and international organizations to chart a roadmap to achieving this goal by 2015.
New York, New York, UNFPA, 2010. 2 p.This brief argues that despite increases in contraceptive use since 1994, high unmet need for family planning persists. Among the most significant underserved group is a new generation of adolescents. They enter adulthood with inadequate information on sexuality and reproductive health and few skills to protect their health and rights.
From advocacy to access: Uganda. The power of networks: How do you mobilize funds for reproductive health supplies? Fact chart.
London, England, IPPF, 2009 Nov.  p.In Uganda the IPPF Member Association, Reproductive Health Uganda (RHU) coordinated civil society and mobilized advocates and champions to increase the availability of RH supplies and family planning. Results to date include: The Government of Uganda increased funding for RH supplies in the 2010 budget; The Government of Uganda disburses funds directly to the National Medical Stores on an annual basis enabling the bulk purchase of contraceptives; 30 out of 80 districts have committed to increasing their resource allocation for family planning and RH supplies.
Geneva, Switzerland, WHO, 2007. 8 p. (WHO/RHR/07.7)Faced with the challenge of putting into practice the ideals of the Millennium Development Goals, the International Conference on Population and Development (ICPD), and other global summits of the last decade, decision-makers and programme managers responsible for sexual and reproductive health ask how they can: improve access to and the quality of family planning and other sexual and reproductive health services; increase skilled attendance at birth and strengthen referral systems; reduce the recourse to abortion and improve the quality of existing abortion services; provide information and services that respond to young people's needs; and integrate the prevention and treatment of reproductive tract infections, including HIV/AIDS, with other sexual and reproductive health services. (excerpt)
Obstetrics and Gynecology. 2007 Nov; 110(5):999-1002.Family planning plays a pivotal role in population growth, poverty reduction, and human development. Evidence from the United Nations and other governmental and nongovernmental organizations supports this conclusion. Failure to sustain family planning programs, both domestically and abroad, will lead to increased population growth and poorer health worldwide, especially among the poor. However, robust family planning services have a range of benefits, including maternal and infant survival, nutrition, educational attainment, the status of girls and women at home and in society, human immunodeficiency virus (HIV) prevention, and environmental conservation efforts. Family planning is a prerequisite for achievement of the United Nations' Millennium Development Goals and for realizing the human right of reproductive choice. Despite this well-documented need, the U.S. contribution to global family planning has declined in recent years. (author's)
Improving access to quality care in family planning: WHO's four cornerstones of evidence-based guidance.
Journal of Reproduction and Contraception. 2007 Jun; 18(2):63-71.The four cornerstones of guidance in technique service of family planning are established by WHO based on high quality evidences. They have been updated according to the appearing new evidences, and the consensuses were reached by the international experts in this field. The four documents include Medical Eligibility Criteria for Contraceptive Use, Selected Practice Recommendations for Contraceptive Use, Decision-making Tool for Family Planning Clients and Providers and The Global Handbook for Family Planning Providers. The first two documents mainly face to the policy-makers and programme managers and were treated as the important references for creating the local guideline. The other two documents were developed for the front-line health-care and family planning providers at different levels, which include plenty of essential technical information to help providers improve their ability in service delivery and counselling. China paid great attention to the introduction and application of WHO guidelines. As soon as the newer editions of these documents were available, the Chinese version would be followed. WHO guidelines have been primarily adapted with the newly issued national guideline, The Clinical Practical Skill Guidelines- Family Planning Part, which was established by China Medical Association. At the same time, the WHO guidelines have been introduced to some of the clinicians and family planning providers at different levels. In the future, more special training courses will be introduced to the township level based on the needs of grass-root providers. (author's)
Targeting access to reproductive health: Giving contraception more prominence and using indicators to monitor progress.
Reproductive Health Matters. 2007 May; 15(29):186-191.Unmet need for contraception represents a major failure in the provision of reproductive health services and reflects the extent of access to services for spacing and limiting births, which are also affected by personal, partner, community and health system factors. In the context of the Millennium Development Goals, family planning has been given insufficient attention compared to maternal health and the control of sexually transmitted infections. As this omission is being redressed, efforts should be directed towards ensuring that an indicator of unmet need is used as a measure of access to services. The availability of data on unmet need must also be increased to enable national comparisons and facilitate resource mobilisation. Unmet need is a vital component in monitoring the proportion of women able to space and limit births. Unmet need for contraception is a measure conditioned by people's preferences and choices and therefore firmly introduces a rights perspective into development discourseand serves as an important instrument to improve the sensitivity of policy dialogue. The new reproductive health target and the opportunity it offers to give appropriate attention to unmet need for contraception will allow the entry of other considerations vital to ensuring universal access to reproductive health. (author's)
Reproductive Health Matters. 2005; 13(25):106-108.The year 2005 is a pivotal year for ensuring that sexual and reproductive health are fully addressed in the implementation and monitoring of the Millennium Development Goals (MDGs). When the MDGs were developed following the Millennium Summit in 2000, no goal was included on sexual and reproductive health, for reasons that are now history. Matters that have an impact on, or are components of, sexual and reproductive health were included – maternal and child health, HIV/AIDS, gender equality and education – but sexual and reproductive health were left out. This year, however, there are real opportunities to redress the imbalance and to ensure that sexual and reproductive health are there for the rest of the time earmarked for the implementation of the MDGs, i.e. in the ten years to 2015. Targets and indicators were set shortly after the MDGs were agreed. As far as maternal health was concerned the target set was the reduction of maternal mortality by two-thirds and for HIV/AIDS of halting and beginning to reverse the spread of HIV/AIDS, both by 2015. Whole other areas are not included, however, especially access to contraceptive services. There is an increasing trend among donor governments to tie development aid to the MDGs, and to use monitoring of implementation of the MDGs for this purpose. Hence, implementation of the Programme of Action of the International Conference on Population and Development 1994 would be more easily achieved if targets for achieving sexual and reproductive health were fully integrated into the MDG process. (excerpt)
Population 2005: News and Views on Further Implementation of Cairo Program of Action. 2003 Mar-Apr; 5(1):4.Better access to family planning services, contraception and reproductive health services is central in the overall struggle against poverty, according to a United Nations Population Fund report on The State of the World Population 2002 released in New York in January. Jointly launching the report with Stirling Scruggs, UNFPA director for information and external relations, Jeffrey Sachs, director of the Earth Institute, said the report showed how reproductive health, family planning, population and policy fed into all eight Millennium Goals. (excerpt)
[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.
In: Eye to eye, [compiled by] International Planned Parenthood Federation [IPPF]. London, England, IPPF, 2001. 16-21.Through the use of clinics, youth centers, retail outlets, integrated facilities and other means, International Planned Parenthood Federation (IPPF) is ensuring that for the first time in many countries, young people can now access youth- friendly sexual and reproductive health services designed for young people where no other organization is providing them. There are a number of strategies to attract young people to services or to take services to young people but in each case the factors for success are linked to quality and the attributes of youth friendliness. IPPF affiliates have also shown how a broader approach to youth development can be used to achieve sexual and reproductive health related goals. (excerpt)
SUSTAINABILITY MATTERS. 1995 Dec; 1(3):6-7.In July 1995, the President of Peru, Alberto Fujimori, announced in his inaugural address that increased access to family planning information and services would be part of his administration's strategy to reduce poverty. Conservative circles in alliance with the Catholic Church attacked the government's position; however, the press sided with the president and educated the public about the benefits of sex education and reproductive health services. Demand increased among the poor, and the legitimization of family planning made it more acceptable for these people still influenced by church dogma. The Ministry of Health, the Social Security Agency, and the education sector expanded their activities related to reproductive health by providing increased funding. Legal restrictions to obtaining voluntary sterilization were lifted by amending the National Population Law. Even the Catholic Church stated that it was in favor of family planning but opposed what it considered to be unnatural methods and sterilization. Scientific evidence was provided to disprove the opposition's allegations about the dangers and risks of modern contraceptives. This tactic isolated the small ultraconservative group in the legislature who had opposed the amendment. A workshop held in Lima also provided a prominent forum to highlight the benefits of family planning as they related to progress. The President had supported family planning for many years and stated his views in 1988. He also designated 1991 the Year of Family Planning. The country had to overcome severe social and economic problems symbolized by the Shining Path insurgency before the family planning policy could be fully implemented. In 1991, IPPF named President Fujimori Outstanding Individual Contributor to Family Planning. The Peruvian family planning association for its part continued informing the press and opinion makers about the issue. An effective program with promotion of sex education has been put in place, which will be expanded to cover the whole country.
PEOPLE COUNT. 1994 Nov; 4(10):1-4.The UN Population Fund (UNFPA) can be optimistic about achieving the goals adopted for it at the 1994 International Conference on Population and Development because its accomplishments of the past 25 years overcame strong obstacles. In 1969, there was little appreciation of the importance of population factors, population was a controversial element in the development debate, it was difficult to achieve funding for population programs, less than 10% of couples (versus 55% today) used family planning (FP), and population growth was more than 2% per year (it is 1.5% today). The proposed UNFPA program for the Philippines for 1994-98 aims to help the Philippine government achieve population growth and distribution which is consistent with sustainable development by 1) broadening awareness of and support for population programs, 2) improving FP services, 3) improving service delivery through nongovernmental organizations, 4) integrating population perspectives into development plans, 5) improving the quality of population data, 6) integrating gender and environmental concerns into population policies and programs, and 7) coordinating program implementation with other donors. Specific goals of the proposed program are to improve the health of women and children through maternal/child health and FP services, to increase contraceptive prevalence by 10%, to extend FP services to remote areas and provide a wide array of methods, to support IEC (information, education, and communication) activities, to strengthen data collection and analysis capabilities at a cost of $500,000, to provide $2.4 million to efforts to promote greater consideration of population factors in policy making and development planning, to contribute $700,000 to research on population dynamics, and to provide $3.7 million to improve the status of women. The program will be managed by the government and monitored in accordance with standard UNFPA guidelines with a mid-term review scheduled for 1996.
[Unpublished] 1994. Presented at the meeting of the USAID cooperating agencies, Washington, D.C., February 22-24, 1994. 6,  p.Elements of quality of care according to the Bruce/Jain framework include: choice of methods, information given to clients, technical competence, interpersonal relations, mechanisms to ensure follow-up, and appropriateness of services. Access to family planning (FP) services and quality of care shape the image of the FP program in the eyes of potential clients. There are 4 barriers to seeking out services: 1) economic (the cost to the client of reaching the service delivery point and obtaining the contraceptive services and supplies); 2) administrative (unnecessary rules and regulations that can inhibit contraceptive choice and use, e.g., restricted clinic hours for family planning services, age/parity criteria for the use of certain methods, spousal consent); 3) cognitive (lack of knowledge of the existence of FP services, of the location of such services, or of the methods available); 4) psychosocial (psychological, attitudinal, or social factors that inhibit motivated potential clients in seeking out family planning services); 5) elements of quality of care (choice of methods, information given to clients, technical competence, interpersonal relations, mechanisms to ensure follow-up, continuity, appropriate constellation of services). In addition, there are medical barriers as a subset of access and quality: inappropriate contraindications (quality), process/scheduling hurdles (access), eligibility criteria, such as age, parity, spousal consent (access), limits on providers to provide certain methods (access), provider bias (quality), regulatory barriers (access), location of services (access), and how side effects are managed (quality). Other concerns about quality of care and medical barriers are: demedicalizing FP may remove protective safeguards to health; the removal of medical barriers may inadvertently limit reproductive health care for some women; the focus on access could orient managers to quantity (of clients generated) rather than quality (of services provided); and medical barriers could consume resources that should be used for improving quality of care.
WASHINGTON POST. 1994 Jan 12; A4.Foreign policy changes in the US mean that the objective of the Clinton administration will be to provide family planning (FP) services worldwide by the year 2000 to every woman who desires contraception. Current funding of $500 million will need to be doubled in order to meet universal access needs. The concern is that the world's present population of 5.5 billion will double in the next 35-40 years before leveling off. This population growth will jeopardize the present level of quality of life and respect for individuals and will threaten the natural environment. The policy changes reflect a refocusing on "new global realities." The aim is improvement in the well-being of the world's have-nots and environmental protection. The State Department Counsel Timothy E. Wirth states that population control, the environment, human rights, counter-terrorism, and anti-drug efforts will be a priority. FP objectives will be addressed at the International Conference on Population and Development scheduled for September 1994 in Cairo. The conference is expected to be as important as the Rio de Janeiro environmental conference was in 1992. Egypt is an appropriate conference site for addressing rapid population growth issues and cultural norms favoring large families. Muslim leaders and predominately Catholic nations have actively opposed government FP programs. The US will follow through with its objectives by increasing its population control funding for fiscal year 1995.
[Unpublished] 1994. Presented at the International Conference on Population and Development [ICPD], Cairo, Egypt, September 5-13, 1994.  p.In her address to the 1994 International Conference on Population and Development (ICPD), the representative of Pathfinder International described her non-profit family planning (FP) organization as being committed to increasing the number of people in developing countries who have access to the voluntary use of FP services. Pathfinder has its headquarters in Boston, Massachusetts, and has regional offices in Kenya, Turkey, and Mexico as well as 11 country offices. Since 1957, Pathfinder has supported more than 2000 programs in more than 60 countries at a cost of nearly US $300 million. Pathfinder is working today in nearly 30 countries to provide service delivery models, training programs, technical assistance, programs for adolescents, and integrated FP and HIV/AIDS/sexually transmitted disease prevention programs. The most important lessons Pathfinder has learned are that 1) nongovernmental organizations, governments, and their international partners must work cooperatively to build programs with local support and that "South-south" cooperation is essential; 2) that the focus must be on securing the health and well-being of women and men with clinics providing a full range of reproductive health services; and 3) that community-based strategies are often the most cost-effective and significant ways of serving hard-to-reach populations. In addition, Pathfinder considers the empowerment and equality of women to be essential for the world's development and future. Having devised an ICPD Plan of Action which represents the result of effective dialogue and broad-based consensus, we must now turn our attention to its implementation.
IPPF COUNTRY PROFILES. 1992 Aug; SAR 19-24.In 1984 in Pakistan, the government's Council of Islamic Ideology banned contraception unless pregnancy would jeopardize a woman's life. The government soon realized that its 2.9% population growth rate was too high to achieve social and economic development, so it implemented a national population policy, hoping to reduce population growth to 2.5% by 2000. The policy calls for a multisectoral approach, emphasizing mobile services to promote birth spacing and maternal and child health and providing family planning services through the public and private sector and family welfare centers. The policy also aims to increase literacy, reduce unemployment, and improve health care. It targets rural areas where 72% of the population lives. In 1989, only 9.1% of 15-49 year old married women used contraceptives and 58.6% wanted to control their fertility but did not have access to family planning information and services. Pakistan depends greatly on the family planning services of the nongovernmental organization. Family Planning Association of Pakistan (FPAP). FPAP introduced family welfare centers, social marketing, and reproductive health centers to Pakistan. It continues to introduce new contraceptives. FPAP's major projects include educational programs in population, family planning, and nutrition; family planning training; promotion of family planning and maternal and child health; programs emphasizing male involvement in family planning; information, education, and communication; and lobbying Parliament for more funding for family planning and for improvement in women's status.
Guidelines on improving delivery and evaluation of population and family planning programmes in African countries.
Addis Ababa, Ethiopia, United Nations Economic Commission for Africa, 1991 Dec. vi, 82 p. (ECA/POP/TP/91/2 [1.2(ii)])In December, 1991, the UN Economic Commission for Africa (UNECA) released guidelines geared toward professionals involved in population and family planning programs in Africa. By this time, many African countries had adopted such programs either for health and human rights reasons or to influence demographic trends. Yet several countries still had laws against family planning from the colonial days. UNECA stressed that programs should be central to socioeconomic development planning, since changes in population affect socioeconomic development and vice versa. It also emphasized the importance of planning and formulation of programs and policies. This included political commitment and leadership; involvement of women, men, youth, and communities; consideration of resource allocation, institutional arrangements, and infrastructure; and wide discussion of policies and programs at all levels including the grass roots levels. UNECA pointed out the need for policy makers and program managers to clearly state objectives and that the objectives be tied with socioeconomic development and improvement of the welfare of the people. It encouraged population and family planning professionals to give consideration to the delivery and evaluation of programs. For example, they should incorporated information, education, and communication efforts designed to improve attitudes and encourage quality services into these programs. Leaders should strive to reform legislation which acts against population and family planning programs. UNECA also stressed the need to integrate evaluation activities into these programs. The guidelines ended with experiences on implementation of programs from Botswana, Ghana, Kenya, Mauritius, Tunisia, Zimbabwe, China, and Thailand.