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London, FPA, 1972. 48 p.Currently, public authorities pay for almost 2/3 of the family planning consultations conducted by the Family Planning Association, and this is the most significant development since the publication of the last Family Planning Association Report. Additionally, more local health authorities are operating direct clinic and domiciliary services. The Family Planning Association handed over the management of 39 clinics to public authorities in the 1971-1972 year. However, despite this progress, family planning service provision by public authorities throughout England continues to be uneven in quality and extent. Spending by local health authorities for each woman at risk varies from 1 penny per woman at risk in Burnley (excluding the city of London) to 179 pence at Islington. In addition to the problem of inconsistency in spending, there appears to be no immediate prospect of a comprehensive family planning service - one that is available to all, is free of charge, and is backed by an adequate education campaign. Although government help for the extension of domiciliary family planning service is impressive, it should not obscure the false economies in spending on other contraceptive delivery services such as general practitioners, specialist clinics, and specialized advisory centers. Until the government announces the details of its plans for family planning services within the National Health Service beginning April 1974, the Family Planning Association's own detailed planning cannot be exact. The Association's basic policy continues to be to turn over the responsibility for the management of clinic and domiciliary contraceptive services as quickly and as smoothly as possible to the public authorities. Already there is concern that some clinic services managed by public authorities may become less attractive, particularly to young people, and that differences in the quality of service will increase under local public management as well as that backup services will be neglected. Also existing is the realization that the public authorities do not do enough to attract people to the use of contraception.
New York, UNFPA, June 1979. (Report No. 13) 151 pThis report is intended to serve, and has already to some extent so served, as part of the background material used by the United Nations Fund for Population Activities to evaluate project proposals as they relate to basic country needs for population assistance to Thailand, and in broader terms to define priorities of need in working towards eventual self-reliance in implementing the country's population activities. The function of the study is to determine the extent to which activities in the field of population provide Thailand with the fundamental capacity to deal with major population problems in accordance with its development policies. The assessment of population activities in Thailand involves a 3-fold approach. The main body of the report examines 7 categories of population activities rather broadly in the context of 10 elements considered to reflect effect ve government action. The 7 categories of population activities are: 1) basic data collection; 2) population dynamics; 3) formulation and evaluation of population policies and programs; 4) implementation of policies; 5) family planning programs; 6) communication a and education; and 7) special programs. The 10 elements comprise: 1) decennial census of population, housing, and agriculture; 2) an effective registration system; 3) assessment of the implications of population trends; 4) formulation of a comprehensive national population policy; 5) implementation of action programs integrated with related programs of economic and social development; 6) continued reduction in the population growth rate; 7) effective utilization of the services of private and voluntary organizations in action programs; 8) a central administrative unit to coordinate action programs; 9) evaluation of the national capacity in technical training, research, and production of equipment and supplies; and 10) maintenance of continuing liason and cooperation with other countries and with regional and international organizations.
Egypt, USAID. 1978 March; 82.A review of Egypt's population/family planning policy and assessment of the current population problem is included in a multi-year population strategy for USAID in Egypt, which also comprises: 1) consideration of the major contraints to expanded practice of family size limitation; 2) assessment of the Egyptian government's commitment to fertility control; 3) suggestions for strengthening the Egyptian program and comment on possible donor roles; and 4) a recommended U.S. strategy and comment on the implications of the recommendations. The text of the review includes: 1) demographic goals and factors; 2) assessment of current population efforts; 2) proposed approaches and action for fertility reduction in Egypt; and 4) implication for U.S. population assistance. Based on analysis of Egyptian population program efforts, the following approaches are considered essential to a successful program of fertility reduction: 1) effective management and delivery of family planning services; 4) an Egyptian population educated, motivated and participating in reducing family size; 5) close donor coordination; and 6) emphasis on the role of women.
CBFPS (Community-based Family Planning Services) in Thailand: a community-based approach to family planning.
Essex, Connecticut, International Council for Educational Development, 1978. (A project to help practitioners help the rural poor, case study no. 6) 91 pThis report and case study of the Community-Based Family Planning Service (CBFPS) in Thailand describes and evaluates the program in order to provide useful operational lessons for concerned national and international agencies. CBFPS has demonstrated the special role a private organization can play not only in providing family planning services, but in helping to pioneer a more integrated approach to rural development. The significant achievement of CBFPS is that it has overcome the familiar barriers of geographical access to family planning information and contraceptive supplies by making these available in the village community itself. The report gives detailed information on the history and development of the CBFPS, its current operation and organization, financial resources, and overall impact. Several important lessons were learned from the project: 1) the successful development of a project depends on a strong and dynamic leader; 2) cooperation between the public and private sectors is essential; 3) the success of a project depends primarily on the effectiveness of community-based activities; 4) planning and monitoring activities represent significant ingredients of project effectiveness; 5) a successful project needs a sense of commitment among its staff; 6) it is imperative that a project maintain good public relations; 7) the use of family planning strategy in introducing self-supporting development programs can be very effective; 8) manning of volunteer workers is crucial to project success; and 9) aside from acceptor recruitment in the short run, the primary purpose of education in more profound matterns such as childbearing, womens'roles in the family, and family life should also be kept in mind. The key to success lies in continuity of communication and education.
In: Watson, W.B., ed. Family planning in the developing world: a review of programs. New York, Population Council, 1977. p. 54-55The government of Honduras included a population policy in its National Development Plan for the period 1974-1979. This policy will be implemented by providing information regarding responsible parenthood, by using natural and technical resources to produce a well-nourished and creative population, and by applying the principles of voluntary participation in family planning programs. The 2 family planning programs in Honduras are the government maternal and child health program and the Family Planning Association of Honduras program. The government program, initiated in 1968, operates 34 clinics which offer family planning along with prenatal and postnatal care, child care, and nutrition education services. The Family Planning Association, established in 1961, operates 2 clinics and served 42,000 people during 1975. 9000 of this group were 1st acceptors. Oral contraceptives were chosen by 80% of the new acceptors; 13% chose IUDs and 5% chose injectables. The Association's information and education activities included conferences, talks, courses, seminars, and home visits. Additionally, the Association is operating a demonstration community-based distribution program with financial assistance from the International Planned Parenthood Federation. 40 workers in each of 2 cities provide contraceptives in their own neighborhoods.
In: Stamper, B.M. Population and planning in developing nations: a review of sixty development plans for the 1970's. New York, Population Council, 1977. p. 87-90In Kenya's Development Plan 1966-1970 it is stated that the population problem seriously impacts on the future development of the country and noted that the government has decided to emphasize measures to promote family planning education. The 1970-1974 Kenya plan estimates the size of its population as 10.7 million in 1969 and assumes a rate of growth of 3.1%/year throughout the duration of the plan. The crude birthrate is estimated to be 50/1000 population and the crude death rate to be 19/1000 population. The 1974 population is estimated as 12.4 million. Included in the plan is a current estimate and a future projection of the size of the working-age population but neither a current estimate or a future projection of the school-age population is provided. Rapid population growth is recognized as a contributing cause of the country's unemployment problem, and population pressures on health services and on housing are discussed. The government plans to double the existing 130 family planning clinics outside of Nairobi and increase the part-time family planning workers from 300 to 700. The program proposed in the plan has not been fully implemented. Contraceptives were being offered by only about 1/3 of the government's clinics by 1974, and they are not available to a large proportion of the population. Some private family planning activities have been in operation in Kenya since as early as 1952, and the Family Planning Association of Kenya was created in 1962. The 1974-1978 development plan proposes a comprehensive program for achieving specific demographic targets. The new 5-year family planning program, financed by the government of Kenya and 8 international donors, hopes to have some 400 full-time service points and another 17 mobile units to serve another 190 places on a part-time basis.
Draper World Population Fund Report. 1977 Summer; 4:23-25.Sri Lanka has undergone a classic demographic transition over the last 30 years. In 1971, the country was 1 of the most densely populated agricultural countries in the world. By 1975, Sri Lanka's birthrate had declined to 27.2, the lowest rate in South Asia. This decline in fertility is attributed to increased contraceptive use, due to a greater awareness of modern family planning methods and easier access to contraceptive facilities. A brief history of the family planning movement in the country is presented. The Sri Lanka family planning program today illustrates a cooperative venture between private organizations and government programming. High levels of celibacy and late marriage in Sri Lanka, caused by demographic, economic, and educational factors, have also resulted in a declining percentage of married women in the under-30 age group.
In: Inter Governmental Coordinating Committee. Southeast Asia Regional Cooperation in Family and Population Planning. A Report on the IGCC Regional Expert Meeting between Family Planning Administrators and Commercial Marketing Executives held in Penang, Malaysia, 22-24 September 1974. Kuala Lumpur, Malaysia, IGCC Secretariat, 1975. 53-4.The IPPF Central Medicine Committee has concluded that non-medical distribution of oral contraceptives is appropriate, and that such methods of distribution can and should be devised. Accordingly, the Committee recommends Member Associations to 1) devise and introduce new schemes for distribution of oral contraceptives, along with other contraceptives; 2) persuade governments and the medical profession of the health benefits to mothers and children of non-medical distribution of oral contraceptives; 3) establish educational and informative programs which describe the use of oral contraceptives, relative contraindications, and possible side effects; and 4) reorganize clinic facilities to ensure easy access to trained personnel in the event that a woman is uncertain about the use of oral contraceptives, needs reassurance, or has a complicated medical condition. The Committee deems these measures appropriate because the limitation of oral contraceptives to doctors' prescription is geographically, economically, and culturally discriminatory and results in more deaths and sickness to women and children than would be the case if fertility were voluntairly controlled.
IPPF Situation Report, March 1969. 12 p.The total population of Nigeria as of 1967 is 61,450,000. For 1957 the birthrate is recorded as 49.2/1000, and the growth rate is given as 2.7/100 for the 1963-1967 period. The Family Planning Council of Nigeria was established in 1964 and has been an associate member of the International Planned Parenthood Federation since 1967. The government officially recognizes the Council but provides no financial support. However, there have been indications that family planning will have a major part in the development plans of the government when the present war is over. There is no anticontraceptive legislation, and supplies are duty free as part of technical assistance. Of the 10,000 women who have received contraceptive services to date, about 75% reside in Lagos. Currently, 300 women receive contraceptive advice each month in Lagos. The intention is to increase this figure to 1500 a month. The Family Planning Council, the Lagos Medical School, and the Lagos Island Maternity Hospital cooperate in the effort to train family planning staff. To date educational efforts have been concentrated in Lagos. The Family Planning Council is now involved in the effort to form branches in all states and attempts have been made to bring already existing family planning clinics into membership with the Council.
Costa Rican Demographic Association (Asociacion Demografica Costarricense (ADC): the coupon system controversy.
Managua, Nicaragua, Instituto Centroamericano de Administracion de Empresas, 1973. 43 p. (INCAE Management Case No. 9-575-601)This case study was developed as a teaching tool for administrative family planning personnel. The Costa Rican Demographic Association (ADC) assumed responsibility for the distribution of oral contraceptives (OCs) through commerical outlets in a program started by Alberto Gonzalez. Gonzalez had organized a rural distribution system of OCs by recruiting local women to sell OCs to friends and relatives at reduced prices. The number of women involved grew so rapidly, Gonzalez, who was a founder of ADC and its first Executive Director, expanded the distribution system to urban areas. In 1964, however, stiff opposition to the distribution system was made by the College of Pharmacists, for OCs were being sold at greatly reduced prices through noncommerical outlets. After difficult negotiation, the College agreed, in 1967, to allow the ADC to import and distribute contraceptives providing a pharmacist supervised the distribution, a doctor's prescription was obtained, and the ADC disburse OCs in pharmacies. The latter provision forced ADC to abandon its highly successful system of individual distributors. Instead, a woman had to go to a clinic, obtain a doctor's prescription as well as a blue (minimal charge) or green (no charge) coupon and then find an authorized outlet to purchase the OCs at a reduced price. The pharmacist had to keep special inventories and maintain a coupon system in order to obtain credit from ADC. ADC had to make sure inventories were maintained and that proper controls were placed on the distribution process. By 1971, 233,309 cycles of OCs were distributed through the coupon system. Nonetheless, questions were raised by USAID and other organizations about control procedures and pricing. It was suggested that it might be more convenient for the patient if the clinics themselves could assume the responsibility of supplying OCs to patients.
Country Profiles. 1972 Oct; 19.The estimated population of Iran in 1972 was 31,000,000, with an estimated rate of natural increase of 3.2% per year. In 1966 61% of the population lived in rural areas, male literacy was 41% and female literacy 18%. Coitus interruptus is the most common form of contraception used in Iran, followed by condoms. Because of the rapid rate of population growth, the government has taken a strong stand in support of family planning. The Ministry of Health coordinates family planning activities through the Family Planning Division. Contraceptive supplies are delivered free of charge through clinics. The national family planning program also is involved in postpartum programs, training of auxiliary personnel, communication and motivation for family planning population education, evaluation and research. The overall goal of the program is to reduce the growth rate of 2.4% by 1978, and to 1% by 1990.