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In: Zatuchni GI, Labbok MH, Sciarra JJ, eds. Research frontiers in fertility regulation. Hagerstown, Maryland, Harper and Row, 1980. 58-63. (PARFR Series on Fertility Regulation)The important characteristics of a contraceptive are as follows: 1) sex of the user; 2) duration of effectiveness; 3) probability and ease of reversibility; 4) timing of use; 5) ability to be used after the suspicion or recognition of conception; 6) mode of applciation; 7) frequency of use; 8) safety and side-effects; 9) contraceptive effectiveness; 10) need for continuing volition or motivation to use the method; and, 11) peer approval. Scientists often underestimate the potential for misuse of even the simplest means of fertility control. One-time methods such as the IUD or sterilization have been found effective in developing countries unable to provide a continuous supply of contraceptives to their population. For the IUD, adequate follow-up care msut be available. Many methods require a sophisticated health care system. To expect physician-dependent delivery of anything but a 1-time only method as a practical approach to family planning is unrealistic. Community workers, auxiliary, and paramedical personnel have been able to reach many couples with Western style methods, e.g. pill distribution. Contraceptives like the condom can be distributed through commercial systems. By procuring contraceptive commodities competitively and in bulk, USAID has negotiated extremely low costs. From 1968-79, over $233 million was spent for these commodities.
Studies in Family Planning. September 1978; 9(9):235-237.The National Family Planning Coordinating Board (BKKBN) of Indonesia began a program of expansion of services in mid-1977. On Java and Bali there are 25,000 contraceptive resupply posts. In the 10 outer-island provinces where program services began in 1973-74 village family planning volunteers work in 4000 communities. The BKKBN has been conducting intensive training programs for community leaders to manage local fertility programs since 1977. The major responsibility for maintaining family planning acceptors will be transferred from government agencies to local organizations. The total family planning budget for fiscal year 1975-76 was U.S. $25.5 million, 50% of which came from the Indonesian government and 50% from donor agencies, including USAID. USAID provided 34 million monthly cycles of oral contraceptives in 1976. Indonesia will be able to supply most of its own contraceptives by 1983-84. The number of family planning service points for all of Indonesia have increased to 1.8/1000 married women in 1976 to 3.8/1000 in 1978. These should increase to 5.4/1000 by 1982.
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.
Washington, D.C., USAID, September 16, 1975. 85 pThe USAID Population/Family Planning Project for Tunisia was evaluated by a 4-man team from July 21-August 1, 1975. The team was to determine the project's status, outline a strategy for phasing out USAID support by mid-1977 and set up criteria for further USAID assistance. Tunisian family planning programs historically lacked management/implementation skills. The creation of the Office National du Planning Familial et de la Population (ONPFP) and appointment of President Director General Chekir alleviated many problems, mainly by recruiting highly qualified, youthful management teams. Program effectiveness depends on the will of the Regional Administrator and varies with individual personalities. Recommendations by the evaluation team include greater use of existing facilities; better dissemination of family planning information; national policy on the role of the nurse/midwide; addition of 2 full-time physicians to ONPFP; update national program goals; adopt community-based distribution system; resolve authority diffusion at local levels; training physicians in mini-laparoscopy technique; evaluations at regular intervals. The success of the Tunisian program is indicated by a marked decrease in birth rate in 1974. Since Tunisia is a model program in the Muslim world it was recommended that USAID continue support until FY 1978.
People. 1975; 2(4):5-11.A survey of selected countries to illustrate the variety of approaches used in supplying contraceptives through the community is presented; and the agencies involved are listed. The various types of community-based distribution schemes in 33 countries of Latin America, Africa and Asia are identified and briefly described. The personnel and methods utilized in individual countries include rural community leaders, fieldworkers, satisfied contraceptive users, paramedical and lay distributors, women's organizations, commercial marketing, education programs, market day strategies, and government saturation programs. The community-based program for distributing oral contraceptives with technical assistance from BEMFAM, an IPPF affiliate, in northeastern Brazil is described in detail, with emphasis onsocial marketing techniques and the mobilization of resources. In addition to IPPF, other agencies working in community-based distribution include Family Planning International Assistance, International Development Research Centre, Population Services International, The Population Council, UNFPA, USAID, and Westinghouse Health Systems Population Centre.