AFGHAN FAMILY GUIDANCE ASSOCIATION CLINIC EXPANSION

The project will be executed by the Ministry of Public Health (MPH) with U.S. long- and short-term technical assistance. New AFGA clinics will be established in the central cities of 16 presently unserved provinces, bringing the total number of AFGA clinics to 35. In Kabul, the major population center, seven of nine existing clinics will be re-located to serve areas of greater population density. All clinics will be staffed with at least one physician or nurse and a family guide (FG). A total of 126 new FG"s (for a total of 140) will be trained and their functions expanded to include prescribing and supplying contraceptives (except IUD"s); and providing basic maternal child health services such as nutrition and hygiene education to mothers of small children. FG"s will also continue to serve as information resources to potential acceptors. AFGA will also recruit at least one male FG per clinic, and will increase the area covered by the FG"s by requiring them to have definite schedules along planned routes. Existing FG"s will be retrained to allow them to perform the above functions. AFGA headquarters will be reorganized and upgraded to allow it to manage the expanded clinic system. Two new administrative positions will be established to handle setting up clinics, as well as assist the medical, information, and education directors. A training center for FG"s will also be created. Finally, a clinic information analysis unit will be formed to manage and automate the existing client information system which provides a statistical base for program evaluation in such areas as type of client; side effects commonly encountered from contraceptives; and the amount of supplies dispensed from each clinic. The revised information system will publish monthly, quarterly, and annual reports of each clinic"s progress. Some 76,000 men and women are expected to benefit from the project. Amendment of 3/17/78 extends project 2 years, increases funding, and proposes a plan to enable AFGA to manage its operations more efficiently. Elements of the plan include: (1) improving AFGA"s statistical reporting system and client record/retrieval system; (2) training personnel to deliver a wider range of maternal child health/FP services while coordinating its programs with other government FP/health activities; (3) improving clinic training programs, field supervision, and program evaluation capabilities; (4) and using knowledge derived from the "Village Health Survey" funded by A.I.D. in 1977 to augment the training of clinical personnel and outreach agents. (PD-AAS-205)