MATERNAL AND CHILD HEALTH/CHILD SPACING EXTENSION PROJECT (NIGER), FINAL REPORT

FIELD OPERATIONS BEGAN IN DECEMBER 1972 AND TERMINATED IN JANUARY 1975. THIS REPORT REVIEWS THE MCH PROJECT IN NIGER, SUMMARIZES THE PROJECT ACTIVITIES, AND INDICATES PROJECT ACHIEVEMENTS. DIFFICULTIES AND CONSTRAINTS ARE NOTED AS WELL AS THE MEASURES TAKEN DURING THE COURSE OF THE PROJECT WHICH MODIFIED THE WORK PLAN BUT WERE ESSENTIAL TO ACHIEVE ITS OBJECTIVES. THE ARRONDISSEMENT OF SAY, WITH A POPULATION OF 50,000, WAS SELECTED AS THE PILOT ZONE. IN THIS AREA, THE PROJECT ATTEMPTED TO: (1) IMPROVE THE HEALTH INFRASTRUCTURE BY PROVIDING ESSENTIAL EQUIPMENT AND SUPPLIES; (2) PROVIDE REFRESHER TRAINING TO MCH PERSONNEL; (3) INTEGRATE MCH ACTIVITIES IN ALL THE EXISTENT HEALTH FACILITIES; (4) EMPHASIZE HEALTH EDUCATION; (5) TRAIN VILLAGE HEALTH WORKERS; (6) EVALUATE THE HEALTH NEEDS OF THE POPULATION THROUGH SURVEYS AND SPECIAL STUDIES; AND (7) INTRODUCE CHILD SPACING ACTIVITIES. PREVALENT ATTITUDES IN NIGER, A PRONATALIST COUNTRY, WERE NEGATIVE TO FAMILY PLANNING. THERE WAS GENERAL POLITICAL SUSPICION OF THE MOTIVATION FOR ASSISTANCE IN FAMILY PLANNING, LACK OF KNOWLEDGE OF WHAT IT MEANT AND CONFUSION BETWEEN SUCH MEASURES AS STERILIZATION AND CONTRACEPTION. MAJOR EDUCATION ACTIVITIES AND SPECIAL STUDIES WERE UNDERTAKEN TO DEMONSTRATE TO LEADERSHIP THAT THE HEALTH OF MOTHERS AND CHILDREN WOULD BENEFIT FROM THE TIMING, SPACING AND LIMITATION OF PREGNANCIES. STUDIES INCLUDED: (1) SURVEY OF WOMEN TO DETERMINE RISK FACTORS; (2) HEALTH DEMOGRAPHIC SURVEY; (3) SURVEY OF PHYSICIANS -- PRESCRIPTION OF CONTRACEPTIVES -- DEFINITION OF "MEDICAL-SOCIAL" INDICATIONS; (4) MALNUTRITION SURVEY. THESE STUDIES ARE DISCUSSED IN DETAIL.