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In: Operations research family planning database project summaries, [compiled by] Population Council. New York, New York, Population Council, 1993 Mar.  p. (PHI-01)In 1975, a USAID-Commission on Population (POPCOM) planning team reported that the key problem facing the National Family Planning (FP) Program in the Philippines was extending the program beyond its existing network of municipal-based clinics to the surrounding barrios. At that time, the number of new FP acceptors was declining, and there was a shift to less effective methods among current users. Because most clinics were urban-based, rural acceptors could not easily access FP services. The report recommended that supply depots be established in barrios and that motivators be used to distribute contraceptives and hygiene information and materials. An operations research project, which cost US $77,313, was developed to test the feasibility and cost-effectiveness of delivering FP/hygiene materials directly to households in rural areas. The Barrio Supply Point (BSP) operators were to visit and make available to every household free FP and hygiene materials. After the initial visit, BSP operators were to continue to serve as resupply agents. Although contraceptives were resupplied free, a nominal charge was required for hygiene materials. A quasi-experimental study design was employed. Pilot tests were conducted to determine what materials might be effectively distributed in addition to contraceptives. Project support was terminated in December 1978, before the project was fully implemented, because of the evolution of a national outreach program. Results of the pilot test showed that over 90% of households offered free condoms and oral contraceptives, or free contraceptives and bars of soap, accepted them. No data on use of these items were collected.
In: Operations research family planning database project summaries, [compiled by] Population Council. New York, New York, Population Council, 1993 Mar.  p. (EGY-01)Egypt's family planning (FP) program, active since 1966, has been facilitated by the country's population density, flat terrain, and extensive health infrastructure. Nevertheless, by the early 1970s, a substantial proportion of couples were still not using contraception because of minimal clinic outreach; high dropout rates for oral contraceptive (OC) users; lack of knowledge about side effects among clinic staff and clients; disruptions in clinical supplies; and unavailability of other methods, such as the IUD, especially in rural areas. In 1971, USAID supported the American University in Cairo's (AUC) FP research activities in rural Egypt, in which household fertility survey data, a follow-up of women attending FP clinics, the cultural context of FP, communication and education, and the implementation of services were studied. In 1974, AUC initiated a demonstration project (which cost US $224,000) of a low-cost way to provide FP services to all married women in a treatment population through a household contraceptive distribution system. The interventions were implemented in the Shanawan (rural) and Sayeda Zeinab (city of Cairo) communities of Menoufia Governorate. During an initial canvas in November 1974, married women 15-49 years of age, who were living with their husbands and were not pregnant or less than 3 months postpartum and breast feeding, were offered 4 cycles of OCs or a supply of condoms. During a second canvas in February 1975, acceptors were provided with an additional 4 cycles of OCs and referred to a local depot for resupply. Each distribution area was mapped, and each housing unit numbered. Data collected through canvassing consisted primarily of eligibility screening items and provided numbers of acceptors, refusals, ineligibles, not at homes, etc. To increase coverage, 2 attempts were made to reach women not at home. Of the 2,493 women canvassed in Sayeda Zeinab, 1713 (69%) were eligible to receive contraceptives. Of these, 58% accepted 4 to 6 cycles of OCs. At the time of initial household distribution, 45% of eligible women were already using OCs. As a result of the canvass, an additional 5% of the women became acceptors. The AUC did not expand the household distribution of contraceptives to other urban areas of Cairo, because women there evidently already had adequate access to FP information and supplies. In the 6,915 households canvassed in Shanawan, 1156 of the 1820 women (64%) were eligible to receive contraceptives. Of these, 45% accepted 4 to 6 cycles of OCs. 21% of eligible women were already using OCs at the time of initial household distribution. Although condoms were offered, few were accepted, apparently because it was not culturally acceptable for women to either distribute or accept condoms. One year after the initial household distribution, contraceptive use among married women of reproductive age had increased 69% from 18.4 to 31% among all age and parity groups and at all educational and occupational levels, and the incidence of pregnancy declined from 19.3 to 14.9%.
In: Research Triangle Institute and South East Consortium for International Development. Rural development programs and their impacts on fertility: state-of-the-art. Summary report [Research Triangle Park, North Carolina, RTI, 1980]. 91-100. (AID Project 931-1170: Rural Development and Fertility)6 categories of rural development activities (RDAs) have been assigned high priority by USAID as policy instruments and/or program interventions: 1) participation of the rural poor in the design, financing and implementation of rural development projects; 2) extension of the health care, education, and welfare services in rural areas; 3) rural marketing systems that extend the infrastructure, including agricultural coops, roads, and storage facilities; 4) rural financial markets extending credit to farmers, coops, small scale industry; and, 6) off-farm employment opportunities generated by small scale industry, craft cooperatives, or other activities, especially for women. This paper provides examples of how to apply assessments of the potential impact of RDAs which represent the 6 priorities. The ultimate impact on fertility behavior depends upon the objective of self-help activity. 2 examples offered are construction of an elementary school and construction of an all-weather road to that same community. The ultimate objective is to be able to suggest not only the direction of fertility influence but also something about the strength of that influence. More precision will be achieved through various case studies.
GLIMPSE. 1994 Sep-Oct; 16(5):4.A workshop was held on 28 September 1994 at the International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDR,B) to share the lessons learned on door step delivery of injectable contraceptives in eight rural thanas in Bangladesh. The workshop was organized jointly by the Directorate of Family Planning, Government of Bangladesh (GOB) and the maternal-child health-family planning (MCH-FP) Extension Project (Rural) of ICDDR,B. A total of 150 participants from the Centre, the national family planning program, different NGOs, and donor agencies attended the workshop. The Minister for Health and Family Welfare, GOB, inaugurated the function as the chief guest. The director of the MCH-FP Extension Project (Rural) welcomed the guests. The Secretary of the Ministry thanked the Centre for its role in the national family planning program, and reiterated that the extension project is a collaborative project of the GOB and the Centre. The Minister emphasized that the population boom is a major problem of the nation. He thanked the Centre for helping the government in seeking solutions to this problem. The UNFPA Country Director expressed his happiness about the implementation and progress of the injectable contraceptive project. David Piet of USAID recommended that equal attention be given to all family planning methods, and not just to injectables. Also, he emphasized the quality of care and the sustainability of the method. The Director General of the Directorate of Family Planning thanked the implementors of this program at different levels for their contribution, and expressed his satisfaction over the activities of the project. The director of the Centre said that the Centre was proud to be involved in this project with the Bangladesh government. He thanked the donor agencies for supporting the Centre in providing family planning services to the nation.
[Unpublished] 1979 Jul 16. 23, , 5 p. (EGY-02)Building on previous AID-supported research by the American University in Cairo, specifically a study of household contraceptive delivery, the Social Research Center (SRC) expanded a household distribution system tested in Shanawan to 38 rural villages in the Menoufia Governorate. The project, which cost US $919,440, was designed to test the effectiveness of the household-based approach to delivery of family planning (FP) services. Like the earlier project, this study was based on the assumptions that there was an unmet demand for contraceptives and that this demand could be systematically identified and met in a culturally acceptable way, using lay women as distributors. Once a community is systematically exposed to FP information and services, a community-based resupply system can effectively meet the ongoing demand for services. The project tests 4 different FP systems, where a first round of free household distribution is followed by: 1) free resupply at the clinic; 2) free resupply in the village; 3) resupply sold at the clinic; and 4) resupply sold at a village depot. Distribution and resupply agents were local women. The study employed a quasi-experimental design. Villages were matched as far as possible on sociodemographic characteristics and contraceptive usage and were randomly assigned to one of the 4 types of delivery systems. Data were collected through a baseline survey conducted at the same time as the household distribution of contraceptives to assess contraceptive behavior. A follow-up survey conducted 9 months later with eligible women only (married, fecund, and age 15-44) was designed to evaluate the household delivery system and focused on contraceptive and fertility behavior. Prevalence increased from 19.1% at the baseline to 27.7% 8 months after the distribution (relative increase of 45%). The delivery system proved to be culturally, logistically, and administratively feasible. There was no significant difference in prevalence between those groups who were charged for a resupply of contraceptives and those who were not. Prevalence increased from 19.5 to 28.5% in the former group and from 18.7 to 26.9% in the latter. Based on this study, a modified version of the tested delivery system was implemented in collaboration with the Governorate of Menoufia among the entire rural population of 1.4 million. The modified system included a wider range of contraceptive methods as well as health and community development components.
Lancet. 1992 May 9; 339(8802):1178.Your note about river blindness (Mar 28, p803) provides an excellent summary of the outstanding achievements of the Onchocerciasis Control Program in West Africa (OCP). Unfortunately, the title you have chosen is distinctly misleading. The OCP is starting its final attack on river blindness in most parts of the 11 West African countries covered by its remit. Nevertheless, there are still more than 16 million persons infected with Onchocerca volvulus in the remaining 23 endemic countries outside the OCP area, most of which are in Africa. At least 250,000 of these dwellers in remote rural areas are blind as a result: and a similar number have severe visual impairment. For them, the attack on river blindness has scarcely begun. Their only hope lies in regular annual dosing with ivermectin. The WHO, several nongovernmental organizations (especially the recently founded River Blindness Foundation), UN agencies, USAID, and the Mectizan (ivermectin) Expert Committee are now just beginning to assist the Ministries of Health in other affected countries that are untouched by OCP. The task of delivering ivermectin in a cost-effective manner is even greater than that which faced the OCP at its outset; and the struggle will take just as long. Success may well depend on the world bank and OCP donors being prepared to help finance the scheme. The OCP's final attack may signal the end of 1 campaign, but it is far from being the end of the war against river blindness. (full text)
[Unpublished] 1977. 99 p.This report was prepared in response to a request from the Asian Bureau of the US Agency for International Development (USAID) that all USAID missions in Asia develop national profiles on the status of women in their countries. The 1st section of the report, "Women's Legal and Social Status," is based on the 1974 Bangladesh Population Census and presents information on the laws and customs related to women's property and inheritance rights, marriage, and divorce. The 2nd section, "The Rural Woman," provides information on the role of women in rural society. Although 90% of the 76.2 women in Bangladesh are rural, data in this area are limited. Statistics on Bangladeshi women are presented in an Appendix. These data reveal the subordinate position of women in Bangladesh society. Females account for only 0.9 million of the 20.5 million population in the labor force. Of the 7.8 million primary school graduates, 2.7 million are female; of the 4.0 million secondary school graduates, 0.7 million are female. Women constitute 0.07 million of the 0.7 million college graduates. An average number of 6 children/family is reported, and 0.8 million (4.7% of eligible couples) females practice family planning. Recognition of the contributions being made by women to Bangladesh society and development of these activities through additional training and support is urged. Greater participation of women in agriculture and other development activities should be encouraged. Recent indicators of the changing status of women in Bangladesh include the creation of a Women's Affairs Division within the President's Secretariat. In addition, 10% of public sector jobs are being reserved for women.
Grass roots, herbs, promoters and preventions: a reevaluation of contemporary international health care planning. The Bolivian case.
Social Science and Medicine. 1983; 17(17):1281-9.In evaluating a United States Agency for International Development (USAID) project in Bolivia, the author argues that the program unwittingly contributed to the situation that created Bolivia's political problems. A 5-year pilot project which covered 39 villages and colonies in the Montero district in the state of Santa Cruz began in 1975 and was completed in 1980. In 1980 the project was "deobligated" when all but essential economic aid to Bolivia was halted following a political coup. The pilot project was based on 1) community participation through health care; 2) a referral system from health post of the promotor to the center with an auxiliary nurse midwife, to secondary and tertiary care in hospitals by physicians; 3) an emphasis on preventive medicine; and 4) the use of traditional medicine along with other therapy by the promotor. Although these concepts sound appropriate, they are in fact derived from contemporary thought in advanced industrial societies. The assumptions about social reality that are inherent in these plans actually misconstrue Bolivian society. The unintended consequences of the project actually diminish rural health care. A difference between the Western health planner's conception and the Bolivian conception--of community, of effective referral systems, of preventive and indigenous medicines--can have the effect of producing a health care program that has little resemblance to what was originally intended. The Bolivian elite actually manipulated the USAID health care programs through hegemony in the villages. The Jeffersonian concept of community is not applicable in Bolivia where resources are only exchanged through personal contacts. In villages of multiple class or ethnic groups or both or in villages with close ties or histories of ties with larger, more cosmopolitan groups, multiple different interests exist. These work against each other to prevent the very cooperation envisioned by the health care programs. The author suggests that developed countries should consider native ideologies, native social relations, and indigenous medicine more sensitively in design.
Washington, D.C., U.S. Dept. of Health, Education, and Welfare, Office of International Health, 1978 Aug. 288 p. (Contract No. TAB/Nutrition/OIH RSSA 782-77-0138-KS)The most rapidly growing category of health assistance is the development of low cost health delivery systems which integrate health services, family planning, and nutrition interventions. It has been shown that the perception of improved child survival due to better health and nutrition is a precondition to the acceptance of family planning on the part of the rural poor in developing countries. In 1977, 27% of AID health funds went to integrated low cost health delivery systems and in 1979 the figure was 43% with Africa receiving the largest proportion (1/3) of the funds. This volume summarizes 39 AID projects based on information contained in AID Project Identification Documents and Project Papers. 2/3 of the projects summarized target the population of a region or subregion in the country rather than the population as a whole; the assumption here is that if the value of low cost rural health delivery can be demonstrated in a part of a country it will be extended to other regions.
Washington, D.C., U.S. International Development Cooperation Agency, 1981 Jan. 59 p.This strategy statement prepared by the USAID field mission includes a brief description of the political background of aid to Honduras and an analysis of the country's economic situation including an examination of the extent and causes of poverty among different population subgroups, an overview of the economy and assessment of its ability to absorb aid, a discussion of development planning as reflected in the 5-year plan and "Immediate Action Plan" drafted in late 1980; an assessment of progress to date in development efforts and of the Honduran govenment's commitment to development objectives; and a discussion of other donors. Favorable and unfavorable factors influencing achievement of development efforts are then identified, program strategy prior to and during the current planning period are discussed, and specific issues such as the role of the private sector, human rights, the role of women, and public sector management are examined. AID's sectoral objectives and courses of action in agriculture and rural development, population, health and nutrition, education, urban and regional development, and energy are outlined, with problems, current activities, and strategy for 1983-87 identified for each sector. Efforts to improve regional cooperation and AID program efficiency are described. Proposed assistance levels and staff levels are discussed. A series of tables containing data on public sector operations, central government budget expenditures, balance of payments, and key economic indicators are included as appendices.
Summary report of the FAO Regional Population Workshop for Latin America, Santiago, Chile, 26 October-1 November 1974.
Rome, Italy, FAO, 1975. 40 p. (Mr/H5397/E12.75/1/800)Objectives of this FAO workshop for Latin America were to develop a common understanding of FAO's policies, to update FAO staff on the current demographic situation, to provide an opportunity to exchange ideas, and to acquaint FAO staff with program activities supported by FAO, with FAO and UNFPA (United Nations Fund for Population Activities) guidelines and procedures. The workshop reviewed problems related to food supply and agricultural development with particular reference to the demographic situation and to food production, trade, and nutrition problems in Latin America. FAO's population programs include research advisory services, training, fellowships and publications in population aspects of agricultural development planning, promotion of the collection of population-related statistics, projections of agricultural labor force, activities in agricultural education and training, and other rural development programs. The workshop reviewed programs and activities with population components in different Latin American countries. The operation principles of UNFPA, its policies, major areas of activity, and the related regional activities of other UN agencies, such as the United Nations Economic Commission for Latin America, the Organization of American States, and the Pan American Health Organization were addressed. Activities undertaken by UNFPA and by specialized agencies of the UN include seminars of employers on population and family planning, production of educational films, workshops for trade union education officers, curricula and teaching aids development, the assignment of family education experts to regional centers for functional literacy education, training courses in population education, and seminars on occupational health and welfare. Assistance to FAO programs comes from several governmental sources, such as USAID and the Canadian International Development Research Center, and from private organizations, such as the Church World Service, the Ford Foundation, and IPPF, the National Academy of Science, the Population Council, the Rockefeller Foundation, and the Tinker Foundation. This report contains a list of workshop participants, an organizational chart showing FAO's units concerned with population activities, and a list of Latin American organizations which include studies of population in their programs.
Impact of population assistance to an African country: Department of State, Agency for International Development. Report to the Congress by the Comptroller General of the United States
U.S. General Accounting Office. Comptroller General, Washington, D.C., United States, 1977. (ID-77-3) v, 65 p.Add to my documents.
Washington, D.C., U.S. Office of International Health, Division of Planning and Evaluation, 1976. 144 p. (Syncrisis: the dynamics of health, XIX)This report uses available statistics to examine health conditions in Senegal and their interaction with socioeconomic development. Background data are presented, after which population, health status, nutrition, environmental health, health infrastructure, facilities, services and manpower, national health policy and planning, international organizations, and the Sahel are discussed. Diseases such as malaria, measles, tuberculosis, trachoma and venereal diseases are endemic in Senegal, and high levels of infant and childhood mortality exist throughout the country but especially in rural areas. Diarrhea, respiratory infections, and neonatal tetanus contribute to this mortality and are evidence of the poor health environment, and lack of basic services including nutrition assistance, health education, and potable water. Nutrition in Senegal appears to be good in general, but seasonal and local variations sometimes produce malnutrition. Lowered fertility rates would reduce infant and maternal mortality and morbidity and might slow the present decline in per capita food intake. At present the government of Senegal has no population policy and almost no provisions for family planning services. Health services are inadequate and inefficient, with shortages of all levels of health manpower, poor planning, and overemphasis on curative services.
Washington, D.C., U.S. Office of International Health, Division of Planning and Evaluation, 1976. 92 p. (Syncrisis: the dynamics of health, XVII)This article uses available statistics to analyze health conditions in Bangladesh and their impact on the country's socioeconomic development. Background information on the country is first given, after which population characteristics, health status, nutrition, national health policy and adminstration, health services and programs, population programs, environmental sanitation, health sector resources, financing of health care and donor assistance are examined. Bangladesh's 3% annual population increase is expected to increase already great population pressure and to have a negative impact on the health status of the population. Although reliable health statistics are lacking, infant mortality is estimated at 140 per 1000, 40% of all deaths occur in the 0-4 age group, and maternal mortality is high. Infectious diseases exacerbated by malnutrition are the main causes of death. 4 key factors are responsible for the general malnutrition: 1) rapidly growing population, 2) low per capita income, 3) high incidence of diarrheal diseases, and 4) dietary practices that restrict nutrient intake. Most of the population has access only to traditional health services, and medical education is hospital oriental and curative, with minimal emphasis on public health. The level of environmental sanitation is extremely low.
Washington, D.C., USAID, 1979. 26 p.Senegal is a poor country with limited economic resources in the Sudan-Sahelian climatic zone. The population of 5.1 million is largely rural, with 70% working in agriculture. The mean per capita income is about $300 per year with many farmers making $75 per year. The AID development strategy emphasizes assisting the rural poor in agricultural development, particularly the groundnut basin, the Fleuve, and the Casamance, which have the greater concentrations of rural poor and the most potential for increased production. Small-scale farms consisting of 360,000 units account for 70% of the population and produce over 95% of Senegal's agricultural production. With the exception of lands held by religious leaders, there are no tenant-landlord relationships or landless poor classes. Health programs are also needed to increase agricultural productivity. Human resource development is needed because people must be sensitized to the need for change and trained to play an active role in their development. The key limitations to implementation of projects are lack of trained Senegalese, administrative delays, and local costs. Basic infrastructure development is necessary for Senegal's long-term development, particularly large-scale irrigation projects.
Paris, Organisation for Economic Cooperation and Development, Development Centre, 1978. 193 p. (Development Centre Studies)The World Population Conference which took place in Bucharest in 1974 witnessed many debates and rhetorical controversies over the role of family planning programs in Third World countries and their relation to development. This report is the result of a collaborative study realized by the Development Centre and the World Bank which investigates how developing countries, as well as aid agencies, are thinking about population problems and, as a consequence, about population assistance in the "post-Bucharest era." The report includes detailed surveys of 12 developing countries, representing Asia, Africa, Latin America and the Middle East. It also interviews and reports on the activities of a large number of population assistance agencies. The roles of international organizations such as the UNFPA, the UN population division and the World Bank itself are assessed in terms of their impact on national development through population control efforts. Reviews of assistance provided to developing nations by nongovernmental agencies, private foundations and developed nations are also presented. Each country paper presented provides an overview of the country's demographic characteristics; a summary of history of population policies, pre- and post-Bucharest era; an overview of population strategies past and present, their integration with other-sector activities; family planning program administration; and a survey of all forms of population assistance available and utilized by the country. Macro-level analyses of changes in family planning assistance by organizations since Bucharest, as well as micro-level, country-specific studies of how each nation has assimilated these changes and has developed a specific population policy are provided.
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.
[Unpublished] 1977 Jun. 169 p.Population and development policy decisions must be based on accurate demographic data in order to correctly formulate priorities in budgets and expenditures. Family planning as a public policy cannot be imposed upon private citizens; it must be freely chosen. The question remains: what determines fertility in the private sector and what can government do to align policy with performance? Research and analysis is needed to develop policy in keeping with local customs, standards, and individual sensibilities. Should more money be spent on education, health care, or development? Research from poor countries is spotty and disorganized. More money is spent on reduction of infant mortality than on family planning. Fertility control is still a controversial subject. Funds supplied for population and health are barely matched by many developing countries whose priorities lean toward agriculture and nutrition. In Haiti the 5-year development plan ignores the interactions between population growth and economic development. If the current level of fertility continues, it will act as a deterrent to development. A population impact analysis of El Salvador examines the effect AID policies and programs have on fertility control. Implementation of a policy in its first stages is described for Guatemala. Family models and global models show touchpoints where public policy might interface with private practice. Rural development implies increased production, equal opportunities, and a low fertility rate. All 3 are interrelated and affected by demographic events. Rising incomes, below a threshold level, has increased the fertility rate among the very poor.
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: Inter-governmental Coordinating Committee (IGCC) and The Population Commission of the Philippines. Financial management of population/family planning programmes. (A Report of the IGCC Regional Workshop/Seminar on the Financial Management of Population/Family Planning Programmes, Manila, Philippines, March 15-17, 1976). Kuala Lumpur, Malaysia, IGCC, . 132-8.The population of Nepal has nearly doubled in the years 1941-1971, from more than 6 million to almost 12 million. This equals a growth rate of 2.07% annually. The population density per square kilometer is 81 and the average family size is 5.5. Based on past growth rate trends, population is estimated to be 16 million by 1986. The seriousness of the population problem is heightened by the prevailing early marriage system among the rural population and the very low level of literacy in the country. Family planning services have been provided by the private sector, in the form of Family Planning Association of Nepal, and by the government since 1968. The organizational set-up of the Family Planning and Maternal and Child Health Project of the government is diagrammed. This program provides free services at 265 clinics throughout the country. Special attention is given to prenatal, postnatal, immunization, and nutrition education care to combat the extremely high infant mortality rate in Nepal. Charts present family planning and maternal and child health achievements in the last several years. Funding and financial management are discussed. Foreign assistance is badly needed by the program.
Country Profiles. 1970 Oct; 1-12.The report gives population trends and the status of family planning projects in Ghana. A general background account of Ghana's demographics (size and growth patterns, redistribution trends, urban/rural distribution, religious and ethnic composition, economic status, literacy, future trends, and social/economic groups and attitudes) is discussed. The relationships of national income, size and quality of the labor force, agricultural labor and productivity, public education, and health to the population's growth is summarized. Development of a population policy is described along with major recommendations for a national policy. The organization and structure of the national family planning program is set forth along with a table of "planning targets for increasing the use of contraceptives". Current practices of birth control are reviewed; supportive state and international agencies' roles are discussed; a prognosis of population planning efforts concludes the report.
World Health Forum. 1983; 4(2):157-61.In developing countries, the delivery of basic health care services is often hampered by communications problems. A pilot project in Guyana, involving 2-way radio in 9 medex (medical extension) locations, was funded by USAID (United States Aid for International Development). A training manual was prepared, and a training workshop provided the medex workers with practical experience in using the radios. The 2-way radios have facilitated arrangements for the transport of goods, hastened arrangements for leave, and shortened delays in correspondence and other administrative matters. Communication links enable rural health workers to treat patients with the advice of a doctor and allow doctors to monitor patient progress. Remote medex workers report that regular radio contacts with their colleagues have lessened their sense of isolation, boosted their morale, and helped build their confidence. 1 important element of the project was the training given to the field workers in proper use of the radio and in basic maintenance. Another key to the success of the system appears to be the strength and professionalism of the medex organization itself. Satellite systems may eventually prove to be the most cost effective means of providing rural telephone and broadcasting services and may also be designed to include dedicated medical communications networks at very little additional cost.