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Leiden, Netherlands, Rijks Universiteit, Leiden, Wetenschapswinkel, 1995 Feb. 67 p.After initiating public debate in the Netherlands about how and to what extent UN Population Fund (UNFPA) policies respect women's autonomy and reproductive rights, the cooperating research groups investigated the UNFPA policy dealing with incentives and disincentives to accept family planning (FP) and goals for FP providers. Interviews were held in 1994 in Bangladesh with 125 women and men in rural Bogra and in suburban Dhaka to determine 1) the extent to which incentives influence contraceptive choice, 2) decision-making roles within families, 3) the extent to which health workers are rewarded and the amount of influence they exert over contraceptive choices, and 4) the extent to which service provider disincentives affect attempts to reach service goals. This report of that study provides background information on the research and on the development of population control policies in Bangladesh, the organization of the FP program, and contraceptive methods available. Part 2 traces the incentive program from its probable introduction in India in 1956 through the Bangladeshi Financial Incentive System starting in 1976. Arguments in favor of the use of incentives are summarized. The third part of the report provides an analysis of the data gained from focus group discussions and from interviews with potential users, with women who had undergone a tubectomy more than two years earlier, with vasectomized men, with IUD users, with longterm IUD users, with Norplant users, with women who rely on menstrual regulation, and with service providers. The final section compares findings from Bogra and Dhaka and provides a discussion of the findings in light of other reports in the literature in terms of such issues as quality of care, voluntary and informed choice, and women's status. Recommendations from the study include protecting the human and reproductive rights of women by prohibiting the use of incentives in favor of improving health care, contraceptive availability, and women's status.
A diagnostic study to evaluate the prevalence of clinical and non-clinical delivery of Norplant in the Indonesian family planning program.
In: Operations research family planning database project summaries, [compiled by] Population Council. New York, New York, Population Council, 1993 Mar.  p. (INS-14)Indonesia's national family planning (FP) program constituted the largest introduction of Norplant in the world; the first 5-year removals were scheduled for late 1991. The ANE operations research/technical assistance (OR/TA) project is conducting a use dynamics study to examine Norplant's use in the field. To prepare for that study and to get early information on program functioning, the National Family Planning Coordinating Board (BKKBN) and the Population Council, in conjunction with Andalas University in West Sumatra and BKS-PENFIN in West Java, undertook a diagnostic study in the fall of 1991 at a cost of US $6,250. Field teams investigated 6 clinics in each of the 2 provinces, interviewing service providers and examining records. 10 acceptors from each clinic (total 120) were visited in their homes to determine the feasibility of locating them and whether they were still using implants. About 70% of acceptors in each province had been served by nonclinical sources, either "safaris" or mobile teams. The 4-year life-table continuation rate was 78%. No written information specifically devoted to Norplant was available to providers or to clients. All physicians and nurse-midwives, as well as many nurses, had some training in Norplant insertion and removal. Contrary to expectation, clinical staff, records, and logistics all seemed generally adequate for 5-year removal. Results were used to address issues raised, and a final report has been completed. The feasibility of the use-dynamics study was confirmed. Available records generally matched official records, although significant gaps were found. The study allowed questionnaires and field procedures to be refined.