FAMILY PLANNING SERVICES - EVALUATION REPORT

EVALUATION COVERS THE PERIOD 1/77 TO 1/78 AND IS BASED ON A STUDY CONDUCTED BY CONTRACTORS (CENTER FOR COMMUNICABLE DISEASES AND AMERICAN PUBLIC HEALTH ASSOCIATION) USING DATA FROM INTERVIEWS, FIELD WORK, AND REPORTS. WHILE THE BIRTH RATE HAS NOT BEEN NOTABLY REDUCED AND OUTPUTS HAVE BEEN LOWER THAN PLANNED, SUBSTANTIAL PROGRESS HAS BEEN MADE. A TOTAL OF 105 CLINICS NOW OFFER FP SERVICES. FP TRAINING WAS PROVIDED TO 70 PHYSICIANS, 75 NURSES, 100 NURSE AUXILIARIES, AND 50 MEDICAL SCHOOL GRADUATES. A TOTAL OF 105,000 FP PAMPHLETS WERE PUBLISHED. BECAUSE MIDWIFE RECRUITMENT WAS SLOWER THAN EXPECTED, ONLY 63,000 FERTILE AGE WOMEN ARE USING CONTRACEPTIVES, 12,000 SHORT OF THE REVISED TARGET. NEW RECRUITMENT PLANS HAVE BEEN MADE AND MORE RESOURCES IN THIS AREA ARE RECOMMENDED. BY THE END OF 1977, OVER 600 MIDWIVES COMPLETED A NEWLY-DEVELOPED TRAINING COURSE IN FP AND MCH. TRAINING EFFORTS WERE HAMPERED, HOWEVER, BY ADVERSE ROAD AND WEATHER CONDITIONS. FIELD SUPERVISION OF MIDWIVES WAS INADEQUATE. SUPERVISION TRAINING IS PLANNED, BUT WILL TEMPORARILY DIVERT MIDWIFE TRAINING. EFFORTS TO INCREASE REFERRALS BY MIDWIVES TO CLINICS HAVE FALLEN SHORT OF EXPECTATIONS. WHILE THE MINISTRY OF HEALTH (MOH) IS ABLE TO CONDUCT LIMITED FP STUDIES, SURVEYS, AND RESEARCH, DATA ON BIRTH AND MORTALITY RATES, CONTRACEPTIVE USE AND DISTRIBUTION AND REFERRAL SYSTEM USE ARE INADEQUATE OR UNAVAILABLE. FUNDS TO IMPROVE MOH CAPABILITY IN THIS AREA ARE RECOMMENDED. LESSONS LEARNED INCLUDE THE NEED FOR TRAINING OF MIDWIVES IN MARKETING OF SUPPLIES AND FOR MORE THAN ONE TEAM OF MIDWIFE INSTRUCTORS; AND THE NEED FOR A STAFF WITH CONSIDERABLE TIME AND EDUCATION TO SUPPLY THE MIDWIFE KIT. PRO-AG OF 3/9/78 INCORPORATED THE RESULTS OF THE PRESENT EVALUATION. FUTURE ACTIONS INCLUDE THE WRITING OF A MORE REALISTIC LOGFRAME FOR THE REMAINDER OF THE PROJECT; A REVIEW OF THE CLINICAL SERVICES COMPONENT; AND A DISCUSSION OF THE PRESENT EVALUATION WITH THE DIRECTOR OF MCH/FP SERVICES.