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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.
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)
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)
Evaluation of the World Health Organization's family planning decision-making tool: Improving health communication in Nicaragua.
Patient Education and Counseling. 2007 May; 66(2):235-242.The World Health Organization has led the development of a Decision-Making Tool for Family Planning Clients and Providers (DMT) to improve the quality of family planning counseling. This study investigates the DMT's impact on health communication in Nicaragua. Fifty nine service providers in Nicaragua were videotaped with 426 family planning clients 3 months before and 4 months after attending a training workshop on the DMT. The videotapes were coded for both provider and client communication. After the intervention providers increased their efforts to identify and respond to client needs, involve clients in the decision-making process, and screen for and educate new clients about the chosen method. While the DMT had a smaller impact on clients than providers, in general clients did become more forthcoming about their situation and their wishes. The DMT had a greater impact on sessions in which clients chose a new contraceptive method, as compared with visits by returning clients for a check-up or resupply. The DMT proved effective both as a job aid for providers and a decision-making aid for clients, regardless of the client's level of education. Job and decision-making aids have the potential to improve health communication, even or especially when clients have limited education and providers have limited training and supervision. (author's)
China: Helping the People's Republic of China introduce a gender perspective in its 'reoriented' family planning program.
Notes from the Field. 2001 Aug; (8): p..International Planned Parenthood Federation, Western Hemisphere Region staff traveled to China to provide technical assistance to the Ford Foundation project "Gender Perspective in Quality of Care in Family Planning." They reviewed some basic concepts of gender and quality, and then examined the six instruments in the manual that is being adapted for China. In July 2001, Judith H., director of IPPF/WHR's Sexual and Reproductive Health Unit, visited with members of the China Population Information and Research Center and the All-China Women's Federation in Beijing to provide technical assistance to the Ford Foundation-supported project, "Gender Perspective in Quality of Care in Family Planning." (excerpt)
Notes from the Field. 2001 Apr; (2): p..A four-person team from International Planned Parenthood Federation, Western Hemisphere Region visited Haiti to provide technical assistance, focusing on project management and reporting, logistics and budgeting. A four-person team from IPPF/WHR was in Haiti on March 4th - 9th to work with two of the country's largest family planning organizations, PROFAMIL and FOSREF. Team members included Eva, a Program Advisor and resource development specialist; Rebecca, an Evaluation Officer; María Cristina, the Regional Supplies Officer; and Marcos, a Financial Advisor. IPPF/WHR monitors PROFAMIL's IPPF Vision 2000 Project to improve quality of care and increase access to SRH services. On this technical assistance visit, the IPPF/WHR team focused on project management and reporting, logistics, and budgeting. (excerpt)
International Conference on Population and Development (ICPD), Cairo, Egypt, 5-13th September 1994. National position paper.
Lusaka, Zambia, National Commission for Development Planning, 1993 Dec. viii, 39 p.Zambia's country report for the 1994 International Conference on Population and Development opens with a review of the country's unfavorable economic and demographic situation. Population growth has been increasing (by 2.6% for 1963-69 and 3.2% for 1980-90) because of a high birth rate and a death rate which is declining despite an increase in infant and child mortality. The population is extremely mobile and youthful (49.6% under age 15 years in 1990). Formulation of a population policy began in 1984, and an implementation program was announced in 1989. International guidance has played a major role in the development of the policy and implementation plans but an inadequacy of resources has hindered implementation. New concerns (the status of women; HIV/AIDS; the environment; homeless children and families; increasing poverty; and the increase in infant, child, and maternal mortality) have been added to the formerly recognized urgent problems caused by the high cost of living, youth, urbanization, and rural underdevelopment. To date, population activities have been donor-driven; therefore, more government and individual support will be sought and efforts will be made to ensure that donor support focuses on the local institutionalization of programs. The country report presents the demographic context in terms of population size and growth, fertility, mortality, migration, urbanization, spatial distribution, population structure, and the implications of this demographic situation. The population policy, planning, and program framework is described through information on national perceptions of population issues, the role of population in development planning, the evolution and current status of the population policy, and a profile of the national population program (research methodology; integrated planning; information, education, and communication; health, fertility, and mortality regulatory initiatives; HIV/AIDS; migration; the environment; adolescents; women; and demography training). A description of the operational aspects of population and family planning (FP) program implementation covers political and national support, the national implementation strategy, program coordination, service delivery and quality of care, HIV/AIDS, personnel recruitment and training, evaluation, and financial resources. The discussion of the national plan for the future involves priority concerns, the policy framework, programmatic activities, and resource mobilization.
In: Operations research family planning database project summaries, [compiled by] Population Council. New York, New York, Population Council, 1993 Mar.  p. (ZAI-10)This project grew out of the need to monitor the quality of care in the various community-based contraception distribution (CBD) projects which were subprojects of the Tulane Family Planning Operations Research Project. The objectives of this activity were to: 1) assure that women who use the services of CBD workers were properly screened for use of oral contraceptives (if that was the method they chose), that they received correct information about the methods and their use, and that they were referred to other levels in the health system when appropriate; 2) to strengthen the position of existing CBD programs if they were to come under attack in the future over the issue of quality of service; and 3) to develop a methodology that could be used in other CBD programs, including those outside of Zaire. The project consisted of a series of activities designed to improve the quality of care in CBD programs, including conducting workshops among project personnel and standardizing medical norms and program procedures. A system for evaluating distributor performance, based on a knowledge test, observation of interactions with clients, and a client survey, was developed and tested in the field. A guide for implementing contraceptive CBD programs and a manual for training CBD distributors were produced to standardize many of the procedures used in the CBD programs and to provide certain norms for service delivery. A methodology was subsequently developed for evaluating distributor performance which included: a knowledge test for distributors to assure that they were able to answer basic questions about the contraceptives and other medications they sold (correct use, side effects, contraindications); an observation guide consisting of a list of points which a distributor should cover during visits to a potential (new) client as well as to a continuing user; and a subjective measurement of rapport between distributor and client. A short questionnaire was prepared for clients to determine whether they knew the correct use of the method chosen and whether they were satisfied with the services of the distributor. This 3-pronged approach to the evaluation of distributor performance was tested at 2 sites: Kisangani and Matadi. The knowledge test was also administered in Mbuyi Mayi and Miabi. While the knowledge test proved to be a quick way to determine whether distributors were informed on key points, the full evaluation approach proved too labor-intensive to be practical as a tool for continuously monitoring distributor performance. Based on experience with the full model, a supervisory form was developed which included some of the same elements but was more practical for routine use in the field.
The impact of strengthening clinic services and community education programs on family planning acceptance in rural Madagascar.
In: Operations research family planning database project summaries, [compiled by] Population Council. New York, New York, Population Council, 1993 Mar.  p. (MAD-01)The government of Madagascar and donors are planning substantial increases in family planning (FP) services; at present the Ministry of Health (MOH), with UN Population Fund support and local Planned Parenthood collaboration, offers FP services in only 5-10% of the country's 2000 clinics. Initial efforts by JIRAMA (the Water and Power Company) to use a mobile clinic to offer FP services in the rural areas of the central province demonstrated some demand for FP services and achieved an estimated prevalence rate of 5-6% in the first 2 years, compared to an estimated 1-2% nationally (in 1989). The mobile approach has several weaknesses, however, and its implementation has entailed problems. For example, JIRAMA added no new staff to already busy government MCH clinics when it began to offer FP services, and contraceptives and equipment were in short supply during the first 2 years. Training for collaborating MOH staff was minimal, and educational efforts were sporadic. Also, costs were relatively high. This study, which cost US $35,259, investigated the impact of a new approach by comparing 2 different levels of program intensity with a control group. In 3 rural clinics, a more intense and higher quality program, consisting of new, locally-based, nurse-midwife staff, as well as increased training, supplies, and equipment and increased clinic and community educational efforts, was compared to the mobile-based program. Data were collected over 2 years, after which a sample survey will measure results. The study will determine the relative cost and effectiveness of recruiting new FP clients and maintaining them on a contraceptive method for a period of at least 3 months in an intensive clinic program compared to a less-intensive program of 24 mobile clinic sites in the same general area. The high-intensity program enrolled 17.4 new acceptors per month, compared to 12.8 in the medium-intensity program and 3.2 in the mobile program, about the same as all the mobile clinics prior to the intervention. Service delivery costs/new acceptor were $4.33 in the medium-intensity, $5.14 in the high-intensity, and $15.75 in the mobile program. Continuation rates improved in both the high- and medium-intensity program clinics, but deteriorated in the mobile program, perhaps partly due to the disturbed social and political climate in the latter half of 1991, which interfered with all program activities. While uncontrolled factors in the study deserve additional consideration and analysis, researchers recommended that the mobile clinics be converted to the medium- or high-intensity program and drew possible lessons for the forthcoming expansion of the national FP program. The final data analysis and report remain to be completed. A dissemination seminar will be held as soon as possible.
In: Operations research family planning database project summaries, [compiled by] Population Council. New York, New York, Population Council, 1993 Mar.  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.
In: Operations research family planning database project summaries, [compiled by] Population Council. New York, New York, Population Council, 1993 Mar.  p. (BKF-05)The family planning (FP) program in Burkina Faso has grown steadily since its introduction in 1985, but information and service provision still occur primarily at the clinic level. One way of decentralizing the provision of FP information is to train traditional birth attendants (TBAs) in FP and encourage them to promote FP during their maternal and child health (MCH) care activities. Therefore, a TBA training project was implemented by the Ministere de la Sante de l'Action Sociale et de la Famille (MSASF), with support from the American College of Nurse-Midwives (ACN-M). This operations research study, which cost US $28,608 and was conducted by the MSASF's Family Health Division (DSF) with support from the Population Council's Africa operations research/technical assistance (OR/TA) project, assessed the training project's effect on the training and supervisory capabilities of clinical staff with responsibilities for the TBAs, on the ability of TBAs to promote FP, and on the FP knowledge, attitude, and practice (KAP) of women of reproductive age (WRA) in the target villages. The goal was to assist MSASF in improving the capacity of TBAs to provide high quality FP/MCH care at the community level. The 20-month evaluation used a quasiexperimental design to test the effects of the intervention. The clinical staff was assessed for its ability to train and supervise the TBAs, and 45 TBAs were followed before and after training to assess their ability to promote FP within their communities. A random sample of 20 WRA with children under the age of 5 years was interviewed in the village of each TBA to evaluate the effect on the communities' FP/KAP. The results will be presented in a written report and at a seminar for those responsible for the national FP program. Project activities began in March 1991. The baseline study for the evaluation showed that most of the supervisors have been FP providers and were generally knowledgeable about modern contraceptive methods. At the village level, the baseline study indicated that, while modern FP methods were largely unknown, WRA were interested in birth spacing and generally disapprove of an immediate resumption of sexual relations after delivery (64% would wait at least a year). When asked about their first source of information on birth spacing, 37% of the women mentioned the health clinics and only 2% TBAs. However, 17% of the women had discussed birth spacing with a TBA. Following the training, 2 supervision strategies evolved. In one province, an "integrated" approach combined supervision of the TBAs' MCH/FP activities with periodic immunization campaigns to avoid some of the problems relating to lack of supervisory resources. The second province relied on a traditional, project-specific supervisory approach. Preliminary results indicate that TBAs could play a vital role in sensitizing the population to FP activities.
Contraception. 2002 Jul; 66(1):1-5.The use of consensus recommendations and clinical guidelines is now widespread in industrialized countries and is becoming more common in developing countries. As guidance documents have become more influential, their methodological rigor has come under closer scrutiny. Using two independently developed scales, the authors assessed the methodological quality of an important set of guidelines developed by the WHO. The consensus recommendation document called Improving Access to Quality Care in Family Planning: Medical Eligibility Criteria for Contraceptive Use has become the basis for national guidelines in dozens of countries. The authors compared the quality of the WHO guidelines to that of over 300 previously assessed published guidelines. In most categories of quality, the WHO exceeded the mean scores for other published guidelines. The authors discuss these comparisons, as well as the strengths and weaknesses of the WHO guidelines. (author's)
New WHO medical eligibility criteria for contraceptives: adaptation for use in a local service in UK.
Journal of Family Planning and Reproductive Health Care. 2001 Jul; 27(3):149-52.The WHO has published an updated edition of the document entitled "Improving Access to Quality Care in Family Planning: Medical Eligibility Criteria for Contraceptives." The aim of the WHO initiative is to establish international norms for the medical eligibility criteria for contraceptive methods in the context of emerging evidence. The data are presented in a user-friendly format for local application and are based on the work of a group of international experts who reviewed all the clinical evidence on methods of contraception. The guidance consists of a series of tables, one for each method type, with a list of conditions and diseases, the advice given, which is based on a balance of benefits and risks, and the reason for the advice. It aims to provide guidance to family planning and reproductive health programs, and the scientific community, in the preparation of guidelines for service delivery of contraceptives. The publication of the evidence supporting the recommendations and formal linking of advice to the evidence is necessary, and would make their adaptation for local use an easier task. This edition has been used to revise the contraceptive policies and prescribing practices in West London, in order to help improve access to, and quality of, family planning services for all clients.
Quality of care in family planning service delivery. A survey of cooperating agencies of the Family Planning Services Division, Office of Population, U.S. Agency for International Development.
[Unpublished] 1992 Apr. v, 39,  p.The purpose of this report was to provide information to the Family Planning Services Division of the Office of Population, Agency for International Development on approaches to the quality of care of eight of its cooperating agencies (CAs); namely, Association for Voluntary Surgical Contraception, Cooperative Assistance Relief Everywhere, Center for Development and Population Activities, Enterprise, International Planned Parenthood Federation/Western Hemisphere Region, Pathfinder, Family Planning Services Expansion and Technical Support project, and Social Marketing for Change project. The report addresses questions on the following areas: CA definition of quality of care, approaches to assessing quality, success stories, constraints to quality of care, future activities, and their recommendations regarding quality of care. The overall approaches of quality assurance fall into four categories: grass roots, medical/management monitoring, information and training, and method/stage of program approach. The approaches to assessing quality of care that are developed by each CA are often complementary. Some of the major constraints to quality of care include lack of understanding of client-oriented services, provider bias, and restrictive government policies. Estimated resources devoted for quality of care was between 5 and 30%. In terms of the future of the quality of care, all CAs would like to increase levels and approaches, and try new approaches and activities in the area of quality of care.
[Unpublished] .  p.This paper presents a summary of the key points of a statement on quality of care that was developed jointly by the International Planned Parenthood Federation (IPPF) technical expert panels. Quality of care is an essential element of the IPPF Strategic Plan, called Vision 2000, which places the following challenge before the IPPF: successfully addressing the need for quality of care is the key to the future viability and continued credibility of IPPF and family planning associations (FPAs) as the conscience of the family planning movement. In order to provide quality of care, the clients' rights and the providers' needs have to be addressed. Following this framework recognizes the rights of clients to information, access, choice, safety, privacy, confidentiality, dignity, comfort, continuity, and self-expression. Providers, for their part, should have the following needs met: training, up-to-date information, adequate physical infrastructure and family planning supplies. Quality of care at the strategic level should involve aspects of advocacy, access to education and services, as well as monitoring. The role of IPPF and FPAs in demonstrating quality of care is discussed. In brief, it is the responsibility of FPAs to ensure that quality of care is provided within whatever is available, and to devise an effective, permeating and sustained environment and system for improved quality of care.
VIETNAM POPULATION NEWS. 1998 Apr-Jun; (7):1-2.Minister Tran Thi Trung Chien, Chairperson of Vietnam's National Committee for Population and Family Planning (NCPFP), led a delegation to the US during May 16-28, 1998. During the visit, the delegation visited a number of US-based international donor organizations and US population institutions to introduce Vietnam's population and family planning program, its problems and challenges, and to exchange issues of common concern in a bid to secure support for the country's population program. In-depth discussions were held with institutions such as the US Agency for International Development, UN Population Fund, World Bank, Population Reference Bureau, Population Action International, Planned Parenthood Federation of America, The Population Council, The Futures Group International, Carolina Population Center, and Family Health International. Focus was given to improving the quality of reproductive health and other program sectors which are in need of international support and cooperation. Vietnam's current emphasis upon reproductive health is an important policy shift.
Washington, D.C., Futures Group International, POLICY Project, 1998 Sep. vii, 69 p.This report presents case studies of reproductive health (RH) and family planning programs and policies in Bangladesh, India, Nepal, Ghana, Jordan, Senegal, Jamaica, and Peru. Data were obtained from in-depth interviews among 20-44 individuals in each country who were key representatives of population and RH government ministries, parliaments, academia, nongovernmental organizations, women's groups, donor agencies, and health care staff. Findings focus on the following topics: RH context; the policy process; participation, support, and opposition; policy implementation; financial resources; and general implementation. Progress is gauged based on improving knowledge of stakeholders; planning for integrated and decentralized services; developing human resources; improving quality of care; addressing legal, social, and regulatory issues; clarifying donors' role; and maintaining long-term aims. All countries made considerable, though limited, progress according to the mandates of the 1994 Cairo Plan of Action. Population size ranges from 2.6 million in Jamaica to nearly 1 billion in India. The countries vary in level of urbanization, literacy, fertility, contraceptive prevalence, infant mortality, maternal mortality, and prenatal care and delivery. Although the social, cultural, and economic contexts vary, all countries have a subordinate role for women. All countries struggled with setting priorities, financing, and implementation. Bangladesh made the greatest progress. Jordan still emphasizes mostly family planning. India, Nepal, Jordan, Senegal, and Peru will need donor funding to advance a broad constellation of services.
London, England, International Planned Parenthood Federation [IPPF], 1997. viii, 379 p. (IPPF Medical Publications)The "Family Planning Handbook for Health Professionals" is based on the concepts of sexual and reproductive health. It replaces the "Family Planning Handbook for Doctors" (1988) by emphasizing the role of a team of professionals, including medical doctors, nurses, midwives, and counselors. In addition to covering available contraceptive methods, the handbook includes chapters on infertility, sexually transmitted diseases, routine reproductive health screening, and cervical cytology. It is intended for use by health care professionals in association with IPPF's "Medical and Service Delivery Guidelines," but offers more in-depth explanations of the background, techniques, and methods.
London, England, International Planned Parenthood Federation [IPPF], 1997. xxii, 298 p. (IPPF Medical Publications)Consistent with the framework adopted at the 1994 International Conference on Population and Development, this second edition of "Medical and Service Delivery Guidelines for Family Planning" emphasizes the reproductive health needs of couples rather than family planning (FP) program targets. The focus of the guidelines is on providing services that reach essential standards of quality and are scientifically, socially, and operationally sound. They can be utilized as a guide for the delivery of FP services, a reference document for assessing quality of care, an outline for pre-service and in-service training, and as a tool for supervisors. In addition to updating information on specific contraceptive methods, this second edition includes new chapters on emergency contraception, pregnancy diagnosis, reproductive tract infections and STDs, and infection prevention and control. Intended users include program planners and users, as well as clinical and community-based services providers, trainers, and supervisors.
INTEGRATION. 1998 Spring; (55):2-5.The current unsatisfactory status of reproductive health (RH) in the Philippines needs to be improved. Inadequate access to treatment for reproductive morbidity, unmet need for family planning, violence against women, inadequate access to and delivery of prenatal care, and inadequate care during delivery are some reasons why reproductive health care urgently needs to be promoted. The UN Population Fund (UNFPA) has been supporting the Philippines' population program since 1972. The current Fourth Country Program of Assistance to the Philippines for 1994-98 aims to help the government of the Philippines achieve population growth and distribution which are consistent with sustainable development. The current UNFPA-assisted program has the following sub-programs: reproductive health (RH) and family planning (FP); population and development strategies; gender, population, and development; and adolescent health and youth development. Total program budget is US$35 million. The RH/FP program is discussed, followed by consideration of the difficulties which must be overcome and the Sustainable Community-based RH/FP Project Emphasizing Quality of Care.
Addis Ababa, Ethiopia, Pathfinder International, .  p.This booklet describes how Pathfinder International is collaborating with the Ethiopian government and nongovernmental organizations (NGOs) to expand the availability of high-quality family planning (FP) and reproductive health services. The introduction notes that Ethiopia is struggling to overcome poverty and that the government has instituted a progressive population policy to overcome the country's high rate of maternal, infant, and child mortality and high population rate. Next, various aspects of the services and leadership offered by Pathfinder since it began work in Ethiopia in 1964 are reviewed, especially the first community-based reproductive health services program in the country and specific integrated reproductive health and FP projects carried out in partnership with several local nongovernmental organizations. The introduction of community-based service delivery methods as a way to improve access to services is then discussed as is Pathfinder's commitment to quality and program sustainability. The booklet also relays Pathfinder's response to the fact that the reproductive health needs of adolescents require a different approach, which once again relies on collaboration with NGOs through the creation of three new youth centers that offer recreational activities as well as reproductive health services and information. Throughout the booklet, case histories are presented of individuals helped by activities supported by Pathfinder. The booklet closes with a look at an effort to train former prostitutes to generate income as hairdressers and tailors and to become community-based reproductive health agents.
[Unpublished] 1987 Jan.  p.After decades of conflict, the potential for dialogue between the international population establishment and the US women's health movement exists. Collaboration with the population establishment would provide feminists an opportunity to have a real impact on the quality of care and reproductive choices for women in developing countries. The major obstacle to such cooperation in the past has been the emphasis of population programs on lowering fertility rates rather than on meeting women's needs or protecting their health. This paper outlines steps that must be taken to make international family planning programs more responsive to women's needs. These include: 1) involvement of local women's groups in program planning, implementation, and evaluation; 2) increased emphasis on comprehensive programs that seek to empower women in culturally viable ways; 3) increased funding for maternal-child health/reproductive health services, including infertility care; 4) higher standards of care in the areas of contraceptive screening, the range of methods available, over-the-counter and community-based distribution, and counseling clients about their right to change methods; 5) stipulations that funding continuation depends on an evaluation of the quality of care provided; 6) revision of health provider training programs to include quality of care issues as a fundamental principle; 7) dialogue on quality of care issues among a wider circle of international family planning agencies; 8) redefinition of the concept of contraception continuation to include user satisfaction; and 9) replacement of lowered fertility rates and high contraceptive prevalence with user satisfaction and control over reproductive capacity as indicators of the success of family planning efforts.
FORUM. 1996 Dec; 12(2):9-10.The Salvadoran Demographic Association (ADS), the Salvadoran affiliate of the International Planned Parenthood Federation (IPPF), has always worked to deliver high-quality family planning services to its clients, especially to those without access to general health services. As such, ADS's family planning clinic at the Profamilia Hospital provides a clean, serious environment in which high-quality family planning services are provided. Counselors explain to clients all methods of family planning and how they work. Clients do not have to wait long to be seen. Maintaining the high-quality level of service is a priority for ADS. A recent review of the instruments used by medical supervisors and regional directors was therefore conducted and led to improvements in internal clinic control, commodities management, resource use, and client care. The institutionalization of a medical audit reinforced these improvements. Moreover, a computerized IPPF/Western Hemisphere Region-designed Clinic Management System was installed to enhance the processing of client records, the maintenance of product and sales data, and the follow-up of outpatients. Two studies to assess client satisfaction with services in each of ADS's clinics found the overwhelming majority of respondents to be satisfied with services received. Survey participants also generally believed the ADS services to be better than those provided at other health centers. ADS will keep working to expand the quality and coverage of family planning and reproductive health services to rural areas of El Salvador.
POPULATION - FAMILY PLANNING NEWS. 1996 Jan-Jun; (2):8.A project funded by the United Nations Population Fund (UNFPA) and entitled "Improving Quality of Care in Family Planning and Reproductive Health Programmes," identified modest cost approaches to improving quality of care (QOC). After official clearances were received in April, a rapid assessment study began in May / June at the Shamirpet primary health center in Andhra Pradesh, India; in the Eheliyagoda and Kuruwita divisions in Ratnapura, Sri Lanka; and in the Duytien district in Namha province, Viet Nam. ICOMP collaborated with two government agencies, the Family Health Bureau (FHB) in Sri Lanka and the Center for Population Studies and Information (CPSI) in Viet Nam; the collaborating agency in India was the Administrative Staff College of India (ASCI). The study covered prenatal care, immunizations, reproductive health, and family planning. Assessment tools, developed and provided by ICOMP, included guidelines for interviews and group discussions involving contraceptive users and nonusers, men, various kinds of providers and managers, and checklists for observation of services and facilities. A five-day workshop was organized in Kuala Lumpur in July for the three country teams. Based on the results of the rapid assessment study, an action plan was developed by each team, and the baseline research tools were discussed and modified. The Indian team began interventions in October 1995; the Sri Lankan and Vietnamese teams concentrated on completing the action plans and planning for the various interventions during the last quarter.
International Planned Parenthood Federation medical and service delivery guidelines for family planning.
London, England, International Planned Parenthood Federation [IPPF], 1992. xviii, 169 p.The International Planned Parenthood Federation has developed these guidelines to help persons working in family planning services and education ensure adequate levels of quality of care. The guidelines conform to the three dimensions of technology assessment needed for any project: it must be scientifically, socially, and operationally sound. Providers should adapt the service delivery guidelines to local realities. They should consider the needs and resources of the various sites in which the guidelines will be applied. The guidelines can also be developed into educational and training materials. They serve as a guide to the delivery of family planning services, a reference document for assessing quality of care, a training instrument, and a tool for supervision. The first chapter addresses the rights of the client, ranging from the right to information to the right of opinion. The second chapter is dedicated to contraceptive counseling, while chapter 3 is dedicated to family planning training. Chapter 4 discusses hormonal contraception (combined oral contraceptives, progestagen-only pills, service management, progestagen-only injectables, and the subdermal implants, Norplant). IUDs are covered in detail in chapter 5. The barrier methods addressed in chapter 6 include condoms, diaphragms, cervical caps, and spermicides. Chapter 7 covers both male and female voluntary surgical contraception. Natural family planning methods are addressed in chapter 8 entitled Periodic Abstinence. These methods include the basal body temperature method, the cervical mucus method (Billings method), the calendar or rhythm method, and the sympto-thermal method. The guidelines conclude with a detailed statement on diagnosis of pregnancy and a list of suggested reading material.