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In: The global family planning revolution: three decades of population policies and programs, edited by Warren C. Robinson and John A. Ross. Washington, D.C., World Bank, 2007. 155-174.In Jamaica, as in many countries, the pioneers of family planning were men and women who sought to improve the well-being of their impoverished women compatriots, and who perhaps were also conscious of the social threats of rapid population growth. When, eventually, population control became national policy, the relationship between the initial private programs and the national effort did not always evolve smoothly, as the Jamaican experience shows (see box 10.1 for a timeline of the main events in relation to family planning in Jamaica). A related question was whether the family planning program should be a vertical one, that is, with a staff directed toward a sole objective, or whether it should be integrated within the public health service. These issues were not unique to Jamaica, but in one respect Jamaica was distinctive: it was the setting for the World Bank's first loan for family planning activities. Family planning programs entailed public expenditures that were quite different from the infrastructure investments for which almost all Bank loans had been made, and the design and appraisal of a loan for family planning that did not violate the principles that governed Bank lending at the time required a series of decisions at the highest levels of the Bank. These decisions shaped World Bank population lending for several years and subjected the Bank to a good deal of external criticism. For that reason, this chapter focuses on the process of making this loan. (excerpt)
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.
Give the people what they want and spread their satisfaction for others to follow. The Indonesia FP experiences.
Jakarta, Indonesia, National Family Planning Coordinating Board, 1989. 12 p. (HMA.78/KA/89)In 1970 when the family planning (FP) program was launched in Indonesia the population numbered 120 million with an annual growth rate of 2.3%. As of the early 1980's the growth rate started to decline, but the population still reached 178 million by 1989. The strategy called for institutionalizing and popularizing the concept of the small, happy, and prosperous family. The program went through several phases: institution-building, maintenance and implementation, and graduation with community participation. Rural successes in contraceptive prevalence has to be counterbalanced by an urban campaign during 1984-85 when rapid expansion of FP courses in 31 cities were initiated. The private sector supply was set up for private clinics taking care of acceptors. The Blue Circle IEC Campaign was instituted with the support of USAID and the Johns Hopkins PCS project. This entailed using private advertising to develop mass media promotion for FP providers of high quality, low cost contraceptives. In 1986 the condom called Dua Lima was introduced by cooperating with the Somarc project of The Futures Group. A 40-60% discount was effected for products under the Blue Circle label. The idea of self-reliant FP has taken hold.
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.
Assignment Children. 1985; 69/72:397-414.The recent immunization campaign in El Salvador has been a success despite the civil war. Both the government and the guerrillas agreed that the goal of immunizing children was an ideal transcending all differences, and that immunization should be taken to all parts of the country and all Salvadorian children. The campaign had the personal support of the head of state, the church, UNICEF, PAHO/WHO, ICRC and other organizations who worked with the parties to implement the campaign. The 3 national immunization days, held on February 3, March 3, and April 21, 1985 were transformed into days of tranquillity. This article describes how the campaign was organized and presents an assessment of its achievements. An executive committee was created and both UNICEF and PAHO/WHO took part in its meetings. Specific commissions handled channeling, training, supplies, the cold chain, information and evaluation, and promotion and education. The plan of action proposed that all branches of government and the private sector support the immunization campaign and a national support council was establish for this purpose. The original goal was to immunize 400,000 children under 3 years of age against diphtheria, pertussis, tetanus, polio, and measles. The goal was extended to cover children under 5 years of age. Funding was provided from both public and private organizations. Reasons the campaign was a success despite war conditions include: the campaign was backed by political commitment; the mechanisms created to implement the campaign functioned smoothly; mobilizing the media generated a change in opinion and attitude. The campaign rested on solid technical and political foundations. It reached 87% of children under 5 in the area.
General lessons learned from evaluations of MCH/FP projects in Botswana, Malawi, Swaziland and Zambia.
New York, New York, UNFPA, 1984 Dec. iv, 41 p.4 maternal-child health/family planning (MCH/FP) projects were evaluated by the United Nations Fund for Population Activities (UNFPA) in the Southern Africa Region between 1981-1984. The projects were in Botswana, Malawi, Swaziland and Zambia. An overriding finding at the time of the Evaluation Missions was the acceptance of family planning (child spacing) by all 4 governments, when at the onset of the projects, family planning was either not included in the project documents or was included only as a minor contributant to the MCH programs. The intervention by UNFPA was very important for the acceptance and promotion of family planning activities by the governments. The Evaluation Missions concluded that there were 3 primary reasons for the successful intervention: UNFPA has a broad mandate to provide assistance in MCH and FP, a commitment to development projects in line with the governments' priorities, and the ability to fund projects very quickly, facilitating project implementation. Each of the 4 projects is assessed in terms of population policy changes, MCH/FP program strategy and serive delivery, organization of the MCH/Fp unit, health education, training, evaluation and research systems, and administration and management. Essential factors affecting the project are outlined and recommendations made. The last section discusses general lessons derived from the MCH/FP projects evaluated. 5 areas are identified where similar problems exist to varying degrees in all the projects evaluated. These are: training of medical personnel in FP (the main MCH/FP service provider in these projects was the nurse/midwife); supervision of personnel and the supply and distribution of contraceptives; research and evaluation, especially regarding the sociocultural setting of target populations and the inadequacy of existing service statistics and other sources of data; project monitoring (technical and financial) and finally project execution by the World Health Organization (WHO). Specifically in regard to the recruitment of experts, the provision of supplies and equipment, and the provision of funds for local costs, WHO execution has been deficient.
Sex education and family planning services for adolescents in Latin America: the example of El Camino in Guatemala.
[Unpublished] 1984. ix, 54,  p.This report examines the organizational development of Centro del Adolescente "El Camino," an adolescent multipurpose center which offers sex education and family planning services in Guatemala City. The project is funded by the Pathfinder Fund through a US Agency for International Development (USAID) population grant from 1979 through 1984. Information about the need for adolescent services in Guatemala is summarized, as is the organizational history of El Camino and the characteristics of youngg people who came there, as well as other program models and philosophies of sex education in Guatemala City. Centro del Adolescente "El Camino" represents the efforts of a private family planning organization to develop a balanced approach to serving adolescents: providing effective education and contraceptives but also recognizing that Guatemalan teenagers have other equally pressing needs, including counseling, health care, recreation and vocational training. The major administrative issue faced by El Camino was the concern of its external funding sources that an adolescent multipurpose center was too expensive a mechanism for contraceptive distribution purposes. A series of institutional relationships was negotiated. Professionals, university students, and younger secondary students were involved. Issues of fiscal accountability, or the cost-effectiveness of such multipurpose adolescent centers, require consideration of the goals of international funding agencies in relation to those of the society in question. Recommendations depend on whether the goal is that of a short-term contraception distribution program with specific measurable objectives, or that of a long-range investment in changing a society's attitudes about sex education for children and youth and the and the provision of appropriate contraceptive services to sexually active adolescents. Appendixes are attached. (author's modified)
In: Tokyo International Symposium, April 1977: Action Now Toward More Responsible Parenthood Worldwide. Tokyo, Japan Science Society, 1977, pp. 291-310Add to my documents.
Proceedings of the Royal Society of London, B. 1976 Dec 10; 195(1118):187-198.In the past 15-20 years there have been advances in fertility regulation. These advances are modest gains that frequently involve a bioengineering input, include collaboration between public agencies and industry, and are closely related to the needs of developing nations. They are the result of the existence of specialized programs whose major goal is the development of new technology. However, a similar specialized public mechanism to undertake the wide range of activities related to product development and introduction of the new technology into family planning does not exist. The 3 major phases of the contraceptive development process are biomedical development, product development, and product introduction-market development. There are 4 areas that require more attention. The 1st of these is a product development laboratory that would accept responsibility for dosage form development, stability testing, quality control procedures, product and packaging modifications, and the production of supplies for biomedical research. Such a laboratory would increase the acceptability of existing methods and promote new developments. Also needed is a contraceptive information service, offering ''full disclosure'' product-related information to managers of family planning programs. A 3rd need is for a patent and licensing administration for the public sector; this would assure that new contraceptives developed with public funds would be made widely available to family planning programs at a reasonable cost. Finally, there is a need to establish a contraceptive introduction planning unit that would consider the program implications of new methods of fertility control and aid countries in planning for their introduction. The availabiltiy of a specialized capacity to take responsibility for public leadership in these 4 areas would contribute greatly to the development of new contraceptive methods that are appropriate to the needs of developing countries and to the success of present international contraceptive research and development efforts.(Authors', modified)
Bangkok, Thailand, March 1968. 28pThe government of Malaysia has initiated a highly visible, high prio rity family planning program to supplement private family planning efforts in accelerating the decline in birthrates and in promoting the health of families. Because increases in economic production were barely able to meet increase in population, the need for reducing the birthrates in East and West Malaysia became apparent. In 1953, private Family Planning Associations were established and eventually there was one such association in each state. By 1966, these private efforts were providing contraceptive services and supplies through 166 clinics. These associations also sponsor a variety of public information and education activities. In 1966 the government launched a family planning program by passing the Family Planning Act and creating the National Family Planning Board (NFPB). The ultimate aim of the government is to incorporate family planning into an overall health service program. The NFPB is presently a semi-autonomous organization with its own professional staff and clinics and manned by its personnel within the Ministry of Health. The responsibilities of the Board are to establish and administer clinics and distribute funding, conduct social and biological research concerning birth control acceptance and methods, and evaluate the effectiveness of family planning programs. The four divisions of the board include: 1) Administrative Division; 2) Service and Supply Division, whose duties include training new personnel; 3) Research Evaluation and Planning Division; 4) Information Division. The government clinics will be attached to existing government health facilities with priority going to establishing facilities in urban areas. International agencies are supporting the program with contraceptive supplies, technical assistance and training. With the acc eptance of the major ethnic groups and no political or religious opposition and enthusiastic government support, the program is a model for other developing countries.