POPULATION AND FAMILY PLANNING

USAID assisted the Government of El Salvador (GES) to establish its institutional capacity and capability for providing contraceptives to both rural and urban populations. Acceptor data from individual service agencies was analyzed. In most respects, project performance has been better than anticipated. GES resources devoted to family planning (FP) have been progressively higher during the past 3 years which has resulted in the continued expansion of the public health infrastructure, the percentage of women using contraceptives rising from 14.2% in 1975 to 18.1% in 12/77, and the number of health posts increasing from 114 in 1975 to 132 in 1977. The socio-political environment for FP has improved due to GES support, continuing silence of the Catholic Church concerning population control, and effective media coverage. Utilization of paramedics has increased, contraceptives are readily available, and donor groups have expanded. The Sterilization program has been very successful due to the quality of training given to physicians, and favorable mass-media coverage. Project implementation has also benefited from the reorganization of staff and resulting revitalization of the Salvadoran Demographic Association, and the IPPF affiliate. Major problems encountered have included slow acceptance of the pill and IUD contraceptive methods, lack of official authority for nurses to give initial pill prescriptions, inefficient patient flow at FP clinics, equipment and maintenance problems in sterilization clinics, and the lack of responsiveness of ISSS Clinic in implementing its part of the overall program. Important lessons learned from project are that: 1. AID must encourage the maximization of contraceptive technologies available within any national FP program, 2. financial commitments of the host country should be written into the agreement, and 3. political leaders should be convinced of the importance of FP. Last year of project will place more emphasis on the mass media communications program.