Performance of the Association for Voluntary Sterilization in developing countries, 1982-1985

External final evaluation covers the period 1982-1985 and is based on document review, interviews with project personnel, and site visits to 7 countries. AVS has surpassed project targets (in, e.g., training, support of clinic-based services, maintenance of sterilization equipment), and has made considerable progress in voluntarism, medical surveillance, and management as well. Program direction is consistent, staff are well qualified, financial and administrative practices are sound, and morale is high. AVS has initiated a movement to post a medical advisor in each project region to provide TA to subproject staff, an action which A.I.D. should encourage. Such a system has already been approved in Bangladesh and would, if introduced in other areas, facilitate communications and improve medical reporting. AVS has taken great precautions to ensure strict voluntarism in all projects it supports; no evidence of coercion has been observed or reported in any AVS-supported activities. Increased emphasis has been put on counseling, to ensure that prospective acceptors are fully informed of alternative FP measures and of the irreversibility of sterilization before undergoing sterilization. Follow-up surveys of acceptor satisfaction have been conducted in five countries and initial results have been favorable. Tangentially, the closely allied World Federation of Health Agencies for the Advancement of Voluntary Surgical Contraception has played a positive role in advancing professional education, medical quality assurance, leadership, and policy development as well as information dissemination. A.I.D. and the Federation need to work more closely together, however. Because AVS has successfully assisted private and public institutions in providing safe and affordable sterilization services, it is recommended that funding be continued for the next five years. Other recommendations are also included.