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  1. 1
    099406

    Country report: Bangladesh. International Conference on Population and Development, Cairo, 5-13 September 1994.

    Bangladesh

    [Unpublished] 1994. iv, 45 p.

    The country report prepared by Bangladesh for the 1994 International Conference on Population and Development begins by highlighting the achievements of the family planning (FP)/maternal-child health (MCH) program. Political commitment, international support, the involvement of women, and integrated efforts have led to a decline in the population growth rate from 3 to 2.07% (1971-91), a decline in total fertility rate from 7.5 to 4.0% (1974-91), a reduction in desired family size from 4.1 to 2.9 (1975-89), a decline in infant mortality from 150 to 88/1000 (1975-92), and a decline in the under age 5 years mortality from 24 to 19/1000 (1982-90). In addition, the contraceptive prevalence rate has increased from 7 to 40% (1974-91). The government is now addressing the following concerns: 1) the dependence of the FP and health programs on external resources; 2) improving access to and quality of FP and health services; 3) promoting a demand for FP and involving men in FP and MCH; and 4) achieving social and economic development through economic overhaul and by improving education and the status of women and children. The country report presents the demographic context by giving a profile of the population and by discussing mortality, migration, and future growth and population size. The population policy, planning, and program framework is described through information on national perceptions of population issues, the evolution and current status of the population policy (which is presented), the role of population in development planning, and a profile of the national population program (reproductive health issues; MCH and FP services; information, education, and communication; research methodology; the environment, aging, adolescents and youth, multi-sectoral activities, women's status; the health of women and girls; women's education and role in industry and agriculture, and public interventions for women). The description of the operational aspects of population and family planning (FP) program implementation includes political and national support, the national implementation strategy, evaluation, finances and resources, and the role of the World Population Plan of Action. The discussion of the national plan for the future involves emerging and priority concerns, the policy framework, programmatic activities, resource mobilization, and regional and global cooperation.
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  2. 2
    034685

    Brazil.

    Population Crisis Committee [PCC]

    Washington, D.C., Population Crisis Committee, 1985 Dec. 8 p. (Status Report on Population Problems and Programs)

    In 1985 Brazil's new civilian government took a potentially significant step towards political commitment to a national population program by appointing a national Commission for the Study of Human Reproductive Rights and by accepting large-scale external assistance to implement a nationwide maternal and child health program intended to include family planning services. Brazil's traditional pronatalist policy has been undergoing a change since 1974 and family planning is now viewed as an indispensable element of Brazil's development policy. Several laws which had long impeded the growth of family planning services have been revised or repealed. It is no longer illegal to advertise contraceptives, but abortion is only allowed in restricted circumstances. Approval for voluntary sterilization is easier to obtain. Brazilians who practice family planning obtain services primarily through commercial channels or the private sector. The government and private family planners are faced with a major problem of organizing family planning services for rural areas and the vast city slums. The estimated cost of a national family planning program for Brazil is between US$221 million for 1990 and US$182 to US$324 million for the year 2000. The various aspects of the government program are discussed. The private sector was instrumental in introducing family planning to Brazil. A private non-profit organization was established by a group of physicians to encourage the government to develop a national family planning program and to inform the public about responsible parenthood. This organization (BEMFAM) was given official recognition by the federal government and a number of states and declared a public convenience. Another organization (CPAIMC) was established to provide maternal and child health care in poor urban areas. The sources of external aid, accomplishments to date and remaining obstacles are discussed. Sources of external aid include: UNFPA, USAID, IPPF, the Pathfinder Fund and Columbia University's Center for Population and Family Health (CPFH). A change in popular and official pronatalist attitudes has been effected.
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  3. 3
    033841

    General lessons learned from evaluations of MCH/FP projects in Botswana, Malawi, Swaziland and Zambia.

    United Nations Fund for Population Activities [UNFPA]

    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.
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  4. 4
    118854

    Report on the evaluation of UNFPA assistance to the Swaziland family planning programme.

    Ryder B; Burton J; Frieiro L

    New York, New York, United Nations Fund for Population Activities [UNFPA], 1982 Dec. xi, 44, [10] p. (Project SWA/75/P01)

    The long range objective of this project (1976-1981) was to improve and enhance the health and welfare of mothers and children, especially in rural areas. In assessing Project achievements and the degree to which progress toward the long term objective has been accomplished, the Evaluation Mission found that the immediate objectives had, to a large degree, been met within the general framework of the Ministry of Health's (MOH) development program. Service delivery points in governmental, mission private and industrial/plantation health facilities are now widely distributed throughout Swaziland. The integration of preventive and curative is clearly in place in the rural health clinics and health centers. Analysis of service statistics data indicates that a large % of pregnant women attend antenatal clinics. Family planning services are now offered in 86 clinics with 27,094 clinic attendances recorded for 1981. The pill is the most popular method, followed by condoms, injectables and IUDs. An adequate though incipient health education program is functioning. The MOH strengthened the health infrastructure for, and has in place a program of, maternal child health (MCH) and family planning (FP). The strong points of the program are the government's commitment to MCH/FP, the general strategy, the training component, the number and quality of staff involved in service delivery, the number of service delivery points and the system of recruitment and the employment of Rural Health Motivators (RHM). Weak points, which appear to have hindered a more effective program performance, are planning and management, the lack of solid socio-anthropological knowledge to base, the lack of a focal point for FP, supervision at all levels and the lack of monitoring and evaluation which, if properly undertaken, could have led to changes and adjustments in the program. Future activities supported by the United Nations Fund for Population in the organization and management of family planning activities within the MCH program and within other government and voluntary organizations. UNFPA should help the government prepare a new proposal for UNFPA assistance to family planning activities in the country and should consider supporting supervision and training activities.
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