Development of population and family planning programs in Somalia : an assessment of initiatives and assistance

Negative factors include lack of a national FP policy, tradition, a low population density, and a pronatalist mentality stemming from a high infant mortality rate (150/1000) and the needs of the military. On the other hand, most women interviewed expressed a desire for childspacing, a measure which Parliament has approved for maternal/child health (MCH) purposes; the 10 doctors trained by The Johns Hopkins Program for International Education in Gynecology and Obstetrics (JHPIEGO) are eager to increase the currently meager supply of contraceptives; and the politically powerful Somali Women's Democratic Organization (SWDO) is a potential force for spreading FP. General recommendations are that A.I.D.: support the provision of primary health care, including FP, in an extended health delivery system in Somalia; procure, through an intermediary donor, an adequate supply of contraceptives; assess JHPIEGO's effects on the availability of FP services; expedite implementation of the delayed Primary Health Care Project to extend MCH and FP services to rural areas and define the roles of project participants; contract a U.S. institution to provide technical assistance for the proposed Knowledge, Attitude, and Practice studies; explore the possibility of establishing a Contraceptive Retail Sales Program in Somalia; help the Ministry of Health (MOH) develop an FP information management system; and coordinate FP activities with those of the International Planned Parenthood Foundation. Use of the SWDO health component to communicate FP information and a series of MOH family health and childspacing broadcasts are also recommended. More specific recommendations focus on integrating demographic factors in economic planning; collecting and analyzing health data; and establishing regional statistical offices. Included are reviews of the social and cultural factors affecting development of a national FP program and of in-country demographic data collection and population research, FP program management, and programs for women; and nine study-related appendices.