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Report. Seminar on Maternal and Child Health / Family Planning Programme Management, convened by the Regional Office for the Western Pacific of the World Health Organization, Nadi, Fiji, 29 April - 10 May 1991.
Manila, Philippines, WHO, Regional Office for the Western Pacific, 1991 Jul. , 67 p. (Report Series No. RS/91/GE/08(FIJ); (WP)MCH/ICP/MCH/001-E)12 national coordinators of UNFPA funded maternal and child health/family planning projects attended the Seminar on Maternal and Child Health/Family Planning Programme Management in Nadi, Fiji between April 19-May 10, 1991. The Regional Office for the Western Pacific of Who organized the seminar. Participants came from Cook Islands, Federated States of Micronesia, Fiji, Kiribati, Papua New Guinea, Republic or Marshall Islands, Republic of Palua, Samoa, Solomon Islands, Tonga, Tuvalu, and Vanuatu. Seminar leaders concentrated on having participants use the UNFPA project formulation guidelines and evaluation procedures. Participants learned about project formulation, target setting, project management (personnel, time, and logistics), management information systems (MIS), and project strategies especially community participation. At the end of the seminar, they applied their new knowledge and skills in developing workable country plans of action. Resource personnel helped each participant with preparing the country plans. Overall the participants considered the seminar to have been a success. Yet, even though UNFPA laid out the guidelines logically, participants found them to be complex and difficult to understand. They also expressed the need for training after the seminar to make it more effective. Participants acknowledged the importance of MIS and that MIS must be developed further in participating countries. Further they mentioned the value of community based data in effectively managing projects. A sample country plan of the Federated States of Micronesia and the Kingdom of Tonga follows the report.
In: Korean experience with population control policy and family planning program management and operation, edited by Nam-Hoon Cho, Hyun-Oak Kim. [Seoul], Korea, Republic of, Korea Institute for Health and Social Affairs, 1991 Sep. 311-27.The Korean experience with collaboration in family planning (FP) is explored in this chapter. Attention is paid to the nature of the decision, external resources (International Planned Parenthood Federation (IPPF) in detail and the following in brief: the UN Economic and Social Commission (UNECOSOC) and the UN Fund for Population Activities (UNFPA), the Population Council of New York (PC), the Swedish International Development Authority (SIDA), the US Agency for International Development (USAID), and the Japanese Organization for International Cooperation (JOICFP)). Suggested criteria for FP projects include, community concern, prevalence, seriousness of unmet need, and manageability, but with external collaboration, consideration should be given to whether domestic resources are insufficient, the priorities of potential donors, expected problems with compliance with the grant, and government commitment to the project. External collaboration can take the form of moral support, technical cooperation, or financial support. The nature of the project as well as the expected achievements of the project need to be identified. Resources may be manpower, facilities, commodities, money, and/or time. The Korean experience with IPPF began with a visit by IPPF in 1960. In 1961, the Planned Parenthood Federation of Korea (PPFK) was accepted as a member of IPPF. Support which began in 1961 has reached over 16 million dollars cumulatively. At present about 25% of support for FP comes form IPPF. The author's experience as a representative of PPFK to IPPF and other groups is described. Tables provide information on commodities supplied by year and dollar amount, and allotment of UNFPA Assistance to Ministries and Institutions between 1973-86 by the number of projects and the dollar amount; types of program activity and dollar amount from UNFPA is also provided.
PEOPLE. 1991; 18(2):24-5.The effect of the Gulf War on family planning services in the Arab Region is discussed. The war may also underscore the problems of inequities in the distribution of wealth, misuse of natural resources, displacement of people (refugees and human rights), and precariousness of economies based on disorganized imported/exported labor. It is hoped that this will lead to a coordinated population policy on migration and population movements in the Arab Region. The Arab world has also exposed it's high fertility rates, mortality rates, poverty, and conditions of women. The IPPF family planning associates have functioned in 14 Arab countries with hesitant support. The scarce family planning resources may be diverted to investments in national security and emergency care and curative services. Health, education, nutrition, and joblessness are critical for Iraqis, Jordanians, and those fleeing or being expelled from Iraq, Kuwait, and Saudi Arabia. Their status may be no better than the refugees stranded in Jordan. Attitudes from the war may lead to pressure on mothers to replace the dead, or retreat into thinking about safety in numbers. Public opinion against the West's imperialist plots about family planning, as evidenced in Israel's pronatalist policies, may equate family planning with being anti-Islamic and antinationalist. These fears are further exacerbated by the fundamentalist concerns about anti-Islamic family planning. Religious fanaticism also threatens the newly acquired rights of women to choose the desired number of children, to education, and to hold public office. A further complication is the political nature of international assistance which may punish poorer Arab nations for their rebellion, or be distributed based on political aims. No Arab nation is neutral and IPPF will suffer resulting in fewer exchanges and regional-based activities.
[Unpublished] 1991. Presented at the Demographic and Health Surveys World Conference, Washington, D.C., August 5-7, 1991. 32 p.Brazil's National Survey of Maternal-Child Health and Family Planning, conducted in 1986 as part of the international program of Demographic and Health Surveys, consolidated and extended the findings of 9 previous state-level surveys. This work outlines the impact of survey data on Brazil's private sector family planning organizations, donor agencies, the press and opinion leaders, and the federal government and legislators. The finding of the survey that the rate of contraceptive usage among women aged 15-44 married or in union was much higher than expected at 65.4%, initially suggested that the family planning organizations and donors had completed their tasks, but more careful scrutiny pointed up serious problems. Family planning problems identified in the survey included low levels of knowledge and use of contraception in the impoverished northeast and among groups with low levels of income and education; a very high proportion of users (80%) of just 2 methods, oral contraceptives (OCs) and female sterilization; low rates of use of other effective and reversible methods; a large number of unnecessary caesareans performed only to give the woman access to sterilization services, with fully 72% of sterilized women undergoing the procedure during a cesarean delivery; low average age (31.4 years) of sterilization acceptors and low parity of a substantial proportion; use of pharmacies to obtain supplies by over 93% of OC users and OC use at inappropriate ages; low male participation in family planning; and lack of family planning services for adolescents. The survey demonstrated the reality of family planning in Brazil and prompted a rethinking of the aims and goals of family planning programs. Many aspects of maternal-child health and sexual and reproductive health in addition to provision of contraceptives should be included in a high quality family planning program. The survey findings did not completely resolve all the polemics and controversies that have beset the family planning program in Brazil, but they helped dispel some charges against the program. For the most part, only the most strongly ideological opponents have remained unmoved.
Arlington, Virginia, DUAL and Associates, Population Technical Assistance Project [POPTECH], 1991 Dec 5. vii, 41,  p. (Report No. 91-127-127; USAID Contract No. DPE-3024-Z-00-8078-00; PIO/T No. 623-0004-00-3-10002)In 1975, International Planned Parenthood Federation (IPPF) founded the Centre for African Family Studies (CAFS) in nairobi, Kenya to train family planning program personnel in service delivery management skills and technologies. A USAID funded 4 year CAFS Project Grant, scheduled to end in June 1993, consisted of training courses with incountry follow up to make sure courses were applicable to the changing situation of family planning programs in Africa. CAFS was to become totally self sufficient by June 1993. It planned to recover direct training costs from participants. CAFS experienced considerable difficulties in organization and management (a new director and loss of IPPF funding), during the project. The evaluation team found the training courses to be of high quality. Further former participants wished to continue receiving CAFS services and would recommended CAFS courses to colleagues. New financial procedures and addition of experienced financial staff had set CAFS on its way to financial self sufficiency, but these changes would not bring about self sufficiency by June 1993. Further CAFS restructured management and its organizational structure thereby moving it towards decentralization of authority and decision making. Even though CAFS was the only African regional institution providing training services for family planning personnel, it could lose its competitive edge since it had problems in providing francophone courses, inadequate incountry follow up visits, and insufficient research and evaluation skills in developing training programs. CAFS needed to address these obstacles. The team highlighted the need for CAFS to no longer depend on individual staff to maintain high quality courses so courses would not suffer from staff turnover. In conclusion, the team recommended that USAID continue to support CAFS.
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.
Evaluation of Matching Grant II to International Planned Parenthood Federation / Western Hemisphere Region (IPPF/WHR) (1987-1992).
Arlington, Virginia, DUAL and Associates, Population Technical Assistance Project [POPTECH], 1991 Jul 26. xii, 48,  p. (Report No. 90-078-116; USAID Contract No. DPE-3043-G-SS-7062-00)This is a mid-term review of a matching grant given to the International Planned Parenthood Federation/Western Hemisphere Region (IPPF/WHR) by USAID's Office of Population for 1987-1991. The grant covers projects in Brazil, Colombia, Mexico and 9 smaller countries, and 4 regional activities, commodities, technical assistance, management information systems (MIS), and evaluation support. The goal of the grant was to reach new acceptors with quality services, to exert leadership of public sector providers, and to improve internal management. The goals in the 3 large nations are to focus on pockets of need or inadequate service or method mix. The goals of attracting 2.8 million new acceptors, improving services, making detailed plans and keeping strict financial reports have been met. The most serious problem was the lack of a regional evaluation of goal evaluation, the real cost of contraception, and impediments to contraceptive use. There were also difficulties in forwarding funds at the beginning of the FPA's year, and in sending in agency workplans on time. Better communication structures could probably remedy this. It is recommended that the matching grant be renewed in 1992.
IN TOUCH 1991 Jun; 10(99):21-2.Despite obstacles to expanding immunization coverage (EPI) in developing countries, progress has been made in Bangladesh and is described. A February, 1991, World Health Organization cluster evaluation survey indicates that government efforts during the 1980s, with the cooperation and assistance of non-governmental organizations (NGO), have increased the degree of immunization coverage in Bangladesh. 80% coverage for BCG, measles, and DPT-3 antigens is realized in the Rajshahi division, 1 of 4 divisions sampled in the survey. Use of existing FWAs and HA as vaccinators; DC, UNO, and upazila chairmen involvement; partner recruitment for mobilization efforts; steam sterilization of needles; maintenance of an effective cold chain; and monthly vaccination sessions at more than 108,000 sites throughout the country worked together to successfully yield greater immunization coverage. Sustained efforts are, however, required to ensure vaccine protection of the 4 million children born into the population each year. 80% or greater universal coverage in Bangladesh is the focus of continued efforts. Eradication of polio, measles, and neonatal tetanus is possible in the 1990s, while Vitamin A distribution and more effective promotion of family planning services are also objectives. Government and NGO workers must promote awareness of EPI, monitor EPI service delivery, and encourage HAs, FWAs, UHFO Civil Surgeons, UNOs, DCs, and upazila chairmen to provide regular EPI services.
[Unpublished] 1991.  p.Jose G. Rimon, II, Project Director for the Johns Hopkins University Population Communication Services (JHU/PCS) Center for Communication Programs, visited Finland to attend a NORPLANT planning meeting. Meeting discussion focused upon issues involved in expanding NORPLANT programs from pre-introductory trials to broader national programs. Financing and maintaining quality of care were issues of central importance for the meeting. Participants included representative from NORPLANT development organizations, the U.S. Agency for International Development, the World Bank, and other donor agencies. Mr. Rimon was specifically invited to make a presentation on the role of information, education, and communication (IEC) on NORPLANT with a focus upon future IEC activities. The presentation included discussion of the need to develop a strategic position for NORPLANT among potential customers and within the service provide community, the feasibility of global strategies positioning in the context of country-specific variations, the need to identify market niches, the need for managing the image of NORPLANT, and the need to study IEC implications in terms of supply-side IEC, content/style harmonization, materials volume, and language and quality control. Participants collectively agreed to develop an informal group to address these issues, concentrating upon universal issues potentially addressed on a global scale. A meeting on strategic positioning is scheduled for August 19-20, 1991.
London, England, IPPF, 1991.  p.This publication describes the accomplishments of the International Planned Parenthood Federation (IPPF), the world's largest voluntary family planning organization, during 1990-91. IPPF's works to promote family planning services internationally and to educate people and government on the benefits of family planning. The publication begins with a message from the organization's president, Dr. Fred Sai of Ghana, who tells of the dedication present among the members of IPPF. Sai also identifies some of the critical issues being faced by IPPF: the need to ensure quality care and increase the participation level of women in the organization's administration. Following the president's message, Secretary General Halfdan Mahler reviews some of the concerns faced by IPPF. As he explains, while the world now recognizes the need for family planning, financial contributions to population programs continues to lag. Other concerns include the need for strategic thinking and planning and the need to empower women. The publication also includes an overview of the following: awards presented by or received by IPPF; new publications begun by the organization; international events in which IPPF took part (the World Summit for Children and the International Union for the Conservation of Nature and Natural Resources); and list of IPPF volunteer meetings. Additionally, the report contains an overview of the accomplishments in the 6 IPPF regions: Africa, the Arab World, East and South-East Asia and Oceania, Europe, South Asia, and the Western Hemisphere. The report provides figures concerning the amount IPPF grants, the contraceptive prevalence rate, and the fertility rate of each member nation. Finally, the report contains IPPF income and expenditure figures.
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.
Kuala Lumpur, Malaysia, ICOMP, 1991 Mar. v, 26 p.The International Council on Management of Population Programmes (ICOMP) in Kuala Lumpur, Malaysia exists to strengthen the effectiveness of population programs by improving management practices in member countries. Specifically, it promotes population program management at management schools and other institutes. Further, it aims to institutionalize management oriented research and training within the national program system. Another means to strengthen the effectiveness of population programs includes an effective network among population program managers and management organization. Moreover the successful management techniques used in the corporate sector must be applied in the population sector. In 1983, ICOMP expanded to include health projects and women/s development. In 1990, ICOMP sponsored at least 19 projects ranging from conferences and regional workshops to publications. ICOMP and 3 other development agencies supported institutional development assistance projects in 9 African countries. ICOMP, as the executing agency, provided resources for administrative and research support services; staff development and training; computers; software; and books, journals, and documentation for population and family planning research and case writing purposes. ICOMP also supported 2 women development activities in Bangladesh. In Dhaka, trainers taught leadership and management skills to rural school principals, women staff of nongovernmental organizations, sales clerks, and women doing income generating activities. In Chittagong, they trained poor women in improve household skills so they can earn an income. Some of the other projects consisted of regional workshops in logistics and supply in family planning programs, a financial management study, and family living education.