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Washington, D.C., Futures Group, Options for Population Policy, 1993 Feb. , 24 p. (Policy Paper Series No. 2)While in 1960, 9% of 415 million married women of reproductive age in less developed countries were using some form of fertility control, by 1990, the proportion had increased to 51% of 716 million women. Contraceptive use has expanded most in East and Southeast Asia and in Latin America. There has been also progress in South Asia, the Middle East, and North Africa. China accounts for over 40% of current users in the developing world. An approach to strategic planning at the sector level is outlined. OPTIONS for Population Policy II is a 5-year project funded by the Office of Population of the USAID. The goal of the project is to help USAID-assisted countries formulate and implement policies that address the need to mobilize and effectively allocate resources for expanding family planning (FP) services. The titles of the working papers published as part of an ongoing Policy Paper Series focusing on various aspects of operational policy in FP include: 1) Assessing Legal and Regulatory Reform in FP; 2) Strategic Planning for the Expansion of FP; 3) Policy Issues in Expanding Private Sector FP; 4) Communicating Population and FP Information: Targeting Policy Makers; and 5) Cost Recovery and User Fees in FP. Sector-level strategic planning is a 5-step process: 1) assessment of the current situation in the population/FP sector and examination of future prospects in the sector; 2) identification of the alternative program approaches that could be employed to achieve stated goals and objectives; 3) review and ranking of these programs for the selection of the one which best suits the needs and conditions of the country; 4) commitment by the decision makers to an action plan to implement the chosen program expansion strategy; and 5) agreement on arrangements for monitoring and periodic evaluations of programs.
PEOPLE. 1992; 19(1):11-3.This article profiles Avabai Wadia, a life-long activist who was a founder of both the Family Planning Association of India (FPAI) and the International Planned Parenthood Federation (IPPF). Before the age of 20, Wadia had already become the first woman in India to pass her Bar exams, and was living in London working on women's issues and promoting Indian independence. Her motivation came largely from her parents, who held a liberal attitude towards women's position in the world and professed the view that "right must be done." Having returned to India, Wadia worked briefly for the Supreme Court but abandoned her legal career in favor of volunteer work. She did, however, put her legal education to good use, working in favor of equal rights to inheritance, divorce, education, etc. Her activism exposed her to the plight of poor women, and she became aware of the importance of birth control. In 1949, she and a few other men and women formed a small family planning committee, which soon became the FPAI. This new organization lobbied the government to make family planning part of the 1st 5-year development plan and succeeded: India became the first country to include family planning in a national plan. Wadia then joined Margaret Sanger and others in organizing an international conference on family planning in Bombay, a conference that spawned the IPPF. for 29 years she led the FPAI, and from 1983-89, she served as IPPF president. She says that during the past 4 decades, India has made remarkable achievements on family planning, but that great challenges still lie ahead. She describes some of the new directions that FPAI has begun to take and discusses some of the future directions of IPPF.
Report of the Seminar on Programme Sustainability through Cost Recovery, Kuala Lumpur, Malaysia, 21-25 October, 1991.
London, England, IPPF, 1991. 15,  p.In the face of widespread user acceptance, rapidly growing demand, and developing country financial constraints, family planning associations must learn how to operate more efficiently and mobilize new resources with a view to ensuring greater long-term sustainability. Cost recovery was therefore identified as a means of maximizing the use of limited resources, improving program quality, strengthening management, and making service providers more accountable to clients. This document reports results from seminar participants organized to share the benefits of cost recovery with the international community, and to review policy and management issues. Reviewed in the seminar were country experiences with cost recovery, working group discussions on the definition of sustainability, the cost framework of family planning, determining user fees and clients' willingness to pay, preconditions for setting user fees, prerequisites for social marketing, models for cost sharing with the government and private sector, and country case studies from the Gambia, India, and Kenya. Those programs attaining highest self-sufficiency were aided by strong government commitment to either support family planning or to not impede program progress. Also helpful were a businesslike approach to service provision, a strong promotional campaign, organizational structure conductive to effective resource management, and resolve to try diverse approaches. In concluding, the importance of placing the customer first, cost-effectiveness, cost analysis, strategic planning, inter-FPA cooperation, and business plans are mentioned.
Management information systems in maternal and child health / family planning programs: a multi-country analysis.
STUDIES IN FAMILY PLANNING. 1991 Jan-Feb; 22(1):19-30.Management and information systems (MIS) in maternal and child health were surveyed in 40 developing countries by trained consultants using a diagnostic instrument developed by UNFPA and the Pan American Health Organization (PAHO). The instrument covered indicators of input (physical infrastructure, personnel, training, finances, equipment, logistics), output (recipients of services, coverage, efficiency), quality, and impact, as well as frequency, timeliness and reliability of information. The consultants visited national and 2 provincial level administrative and service points of public and private agencies. Information on input was often lacking on numbers and locations of populations with access to services. In 15 countries data were lacking on personnel posts filled and training status. Logistics systems for equipment and supplies were inadequate in most areas except Asia, resulting in shortfalls of all types of materials and vehicles coinciding with idle supplies in warehouses. Financial reporting systems were present in only 13 countries. Service outputs were reported in terms of current users in 13 countries, but the proportion of couples covered was unknown in 25 countries. 2 countries had cost-effectiveness figures. Redundant forms duplicated efforts in half of the countries, while data were not broken down at the usable level of analysis for decision-making in most. Few African countries had either manual or computer capacity to handle all needed data. Family planning data especially was not available to draw the total picture. Often information was available too late to be useful, except in Portuguese speaking countries. Even when quality data existed, managers were frequently unaware of it. It is recommended that training and consultancies be provided for managers and that these types of surveys be repeated periodically.
Population Reports. Series J: Family Planning Programs. 1987 Sept-Oct; (34):921-51.Family planning services through the workplace is an idea that is attracting more attention, benefit's workers, employers, and nations. Large manufacturers and plantations in India first offered family planning to workers in the 1950s. Now also in Indonesia, the Philippines, Thailand, South Korea, Turkey, Egypt, Kenya, and elsewhere, many large companies have added family planning to other health services. In some Latin American countries social security systems have added family planning for many workers. Many different groups, including compaines, labor unions, government-sponsored social marketing programs, and the military, run employment-based programs. Services are offered in workplace clinics, through referrals, in free-standing facilities, in social security hospitals, and in community clinics. Funding comes from employers, governments, unions, family planning associations, and USAID. The most effective programs offer supplies and services as well as information, offer them directly at the workplace, and use worker-volunteers to distribute pills and condoms. Successful programs require the full support of company management. Favorable cost-benefit projections can show managers that offering family planning makes financial sense and contributes to employee health.
Populi. 1985; 12(3):34-9.The US Agency for International Development (USAID) in consultation with the government of Kenya agreed in 1983 to prepare a demonstration family planning project, which would assist the private sector as well as other major nongovernment providers of health services to upgrade their health services, train and augment their nursing and other medical staff, provide family planning equipment and free contraceptives, and establish these health facilities as full-time family planning service delivery points. The Family Planning Private Sector Program (FPPS) will assist 30 private sector firms, "parastatal" organizations, and other private and nongovernment organizations that already provide health services to their workers, their dependents, and in many cases the surrounding communities to upgrade their services and add a full-time family planning facility. As some of the firms or organizations have multiple outlets, the program will create 50 or more new family planning delivery points throughout Kenya, thereby also relieving some of the pressure on government facilities. The FPPS sub-projects are to recruit at least 30,000 new acceptors. FPPS has added a guideline that at least 60% of these new acceptors be retained in the program for at least a period of 2 years. The FPPS program has received an enthusiastic reception from employers, the unions, and nongovernment organizations such as the Protestant Church Medical Association and the Seventh Day Adventists. The FPPS team can provide projects with a variety of services and funds for family planning related equipment, supplies, and activities. These include assistance with project design, training existing medical staff in family planning service delivery, the collection of baseline information, and the provision of funds for equipping family planning clinics. The government has encouraged FPPS to be innovative and to introduce family planning services into as wide a variety of health services as possible. As presently designed, the FPPS program is primarily a service delivery program but is beginning to play an increasingly dynamic role in information and education activities about family planning. From the start, the participating projects demanded assistance in spreading the family planning message to the workers, their families, and the community. It is evident that the program has stimulated management, clinic staff, and workers and has generated competition between projects to reach and exceed their targets of both new acceptors and high continuation rates.