Expansion of family planning services

PES covers the period 3/83-8/84 and summarizes (an unattached) special evaluation based on document review, site visits, and interviews with key personnel. The major provider of FP services in Guatemala, APROFAM, is expanding its overall program and extending clinical services into rural areas. APROFAM has a talented staff, devoted to its programs and increasingly more effective as inservice and external training opportunities have been made available. However, APROFAM has serious problems in long-range planning and has been weak in the area of income generation. Several organizational changes are suggested to assist the managerial staff and strengthen planning and financial systems. APROFAM training has generally been of high quality, but upgrading and reorganization are indicated; the possibility of establishing a separate training unit should be explored. Also, training personnel should participate with clinical services personnel in reviewing FP technologies to determine the most appropriate informational content for each level of trainers. The Information, Education, and Communication (IEC) function should also be reorganized and improved, with additional training provided for staff in designing mass media campaigns and educational materials. As the variety and quantity of IEC materials being produced by APROFAM are not keeping pace with projected needs, some of the materials preparation could be assigned to outside agencies, allowing IEC staff to concentrate on evaluating the materials. Major program activities would be severely curtailed without continued A.I.D. support during APROFAM"s current period of growth in service delivery. The evaluation recommends that A.I.D. take the initiative in coordinating assistance from international donors, until APROFAM is better able to do this itself. However, USAID/G does not agree - part of the Mission"s country development strategy calls for encouraging the Guatemalan government to establish a National Population Council which would coordinate inputs, assign program areas, and set population policy. Dialogue on this issue will be initiated with the new democratic government during CY1986.