GOT/USAID mid-term evaluation of the Tunisian family planning program report of the phase II mission

Phase II of the midterm evaluation covers the period 1978-3/80 and is based on a review of the findings of Phase I of the evaluation (PD-AAJ-061) regarding project strengths and weaknesses; discussions with the staff of the GOT implementing agency, the National Family Planning and Population Office (ONPFP), officials of other GOT agencies, and medical faculty; and site visits. While quantitative and qualitative indicators demonstrate that the project has had a high level of success, new use of contraceptives has declined slightly since 1977 and large urban-rural and regional disparities in access to FP services persist. Among the recommendations for ONPFP"s 1980-86 program are: (1) prepare background papers on population trends and policy options; (2) consider making one person responsible for analyzing the FP-related needs of all GOT agencies; (3) establish a plan for national integration of FP and other health services; (4) increase the availability and quality of FP services; (5) strengthen special FP programs and FP support components; (6) develop the physical infrastructure to stimulate and service demand for FP; (7) introduce new programs, methods, and applications of the existing infrastructure; (8) strengthen and decentralize ONPFP management of FP services; (9) develop detailed plans for each major program activity and thoroughly analyze personnel and supply needs; (10) plan and implement a comprehensive strategy for penetrating underserved rural areas; (11) strengthen the information and education program, particularly in rural areas; (12) stimulate the participation of the Ministry of Health and of the private and commercial sectors in providing FP services; (13) strengthen data collection and analysis capabilities for research and evaluation; (14) improve biomedical research; (15) hire and train an adequate number of competent FP personnel; (16) develop national, regional, and governorate-level training policies, priorities, and plans; and (17) improve the FP training of physicians, paramedics, and GOT personnel. Numerous specific recommendations for achieving these ends are presented.