Improved family planning services

PES covers the period 1/84-3/86. The project is making satisfactory progress - accounting for 79% of couple-years of protection through SDA and 6.4% nationwide - although its community-based contraceptive distribution component was terminated in 3/85. IEC staff are competent and dedicated, like SDA staff overall, but limited by size, and also in knowledge and interest in mass media. Still, community education, teenage sex education, and documentation components are meeting targets, and, with the emphasis on broadcasting, mass media is ahead, although materials are slow-paced relative to those developed for the social marketing (S/M) department and commercial entities. Heavy work loads have precluded follow-up S/M research. Unvarying instructional approaches and an emphasis on cognitive learning over skills have limited otherwise acceptable FP training, showing the need to train SDA staff in curriculum design and instruction. The training staff will need to expand to meet the needs of upcoming project 5190210. Little advantage would be gained by incorporating IEC into training. Medical staff are well trained and adequate for current needs; clinic outreach is limited in rural areas by the political situation and the limited facilities available. Standard consent and surgical procedures have been followed for sterilizations; efficiency could be increased if each clinic had another set of laparoscopic equipment. While clinics have the facilities and staff support to initiate income-producing services, costs of equipping a full laboratory may make it infeasible. Clinics must increase their activity and can, once the referral network is functioning. Logistics and maintenance are adequate, but would benefit from warehousing security, well-equipped maintenance facilites, a computerized inventory system, and better allocation of vehicles among clinics. Spare parts stock, especially for biomedical equipment, is inadequate due to communications problems between donors - the Internatinal Planned Parenthood Federation and A.I.D. - and maintenance staff. SDA has grown dependent on external assistance and must prepare to increase income generation and decrease operating costs. USAID/ES did not accept, inter alia, recommendations to continue the condom vending machine program and to move S/M from the SDA to the private sector; S/M will be included among further studies. USAID/ES will require that SDA implement changes in project management - e.g., communications and information systems - and outputs before approving an extension.