APHA EVALUATION TEAM REPORT, INTERNATIONAL FERTILITY RESEARCH PROGRAM

This special contracted evaluation, conducted by a team from the American Public Health Association (APHA), covers the period 9/77-9/80 and is based on document review, a site visit to IFRP, and interviews with IFRP and AID/W staff. IFRP is making progress in dealing with the recommendations made by AID/W at the time the grant was provided, especially with regard to research. For example, IFRP has reduced the number of clinical centers reporting data, as well as the amount of data reported, and has upgraded both the quality of the data and its own statistical evaluation methods. Increased emphasis has been placed on social science research. The APHA team recommends that IFRP de-emphasize programmatic activities such as maternity care records and prevalence studies and give greater attention to the long-term effects of fertility regulation methods used in LDC's, particularly vasectomy and the relation of hormonal contraceptives to cancer. Further refinement of IFRP's reproductive age mortality survey (RAMOS) is particularly recommended. Also recommended is early clinical evaluation of IFRP's commendable new osmotic cervical dilator, further testing of IUD's, and studies on female sterilization. The APHA team commends IFRP's plans to develop new data processing systems and appropriate software for use in LDC's and encourages greater in-country, short-term training in system design and use. IFRP improvements in organization and staffing since the A.I.D. grant have been less impressive. Of particular concern to the APHA team is the recent high turnover rate (25% from 9/79 to 7/80), with many departures being from high-level positions. Major recommendations in these areas include making a clear administrative division between the biomedical and social sciences and developing an autonomous international coordinating unit; establishing a permanent scientist leader; and contracting local universities and institutions to alleviate personnel shortages.