Belize family life education project

External mid-term evaluation covered the period through 6/87 and was based on document review, site visits, and interviews with BFLA"s Board of Directors, staff, and clients, and Government of Belize (GOB) officials. The project is generally on track. Considerable progress has been made in establishing two BFLA Centers (the one in Dangriga has been in operation for a year), and clinical and support staff have participated in several learning/training experiences both overseas and locally. The information, education, and communications (IEC) program is well established; there is increased awareness of BFLA among Belizean professionals, and BFLA workshops and training seminars have helped spread knowledge about family life and human sexuality among youth, health and education professionals, and community members, although there remains scope for increasing the utilization of radio in future efforts. Project inputs have generally been timely, but delays have occurred in procuring certain items. Also, while the attention to quality care is commendable, the present screening and counseling process can result in increased waiting time (and therefore anxiety), especially for new patients. Finally, the present system of collecting service statistics, though complete, should be modified to account for increased users and service outlets. Key constraints seem to be: negative perceptions of FP among influential members of society; the overambitious short-term objectives developed for BFLA; and the failure - due in part to low levels of TA - to achieve proposed staffing levels. Further, TA was not always beneficial because of the length of the consultancy, the consultant selected, or the BFLA"s inability to incorporate the type of suggested systems, the latter being the case with the financial management TA. Another problem has been the GOB"s failure to enunciate a population or child-spacing policy, although senior-level managers as well as lower-level providers with the Ministry of Health support BFLA"s work. The project has taught: there is an unmet demand for FP services in Belize, despite religious and political opposition; use of the national radio station for IEC has been extremely effective; 72% of BFLA clients had used a modern contraceptive method prior to visiting the BFLA center; and establishment of a PVO like BFLA requires more sophisticated administrative support and better communication with the parent-support organization than was the case in the first 2 years of operation.