POPULATION AND FAMILY PLANNING

THIS PES IS BASED UPON AN EVALUATION CONDUCTED BY A TEAM OF EXPERTS ASSEMBLED BY THE AMERICAN PUBLIC HEALTH ASSOCIATION, AND WHICH INCLUDED SITE VISITS, INTERVIEWS WITH PROJECT PERSONNEL, AND EXAMINATION OF PROJECT REPORTS AND STUDIES. OVERALL, APROFAM (GUATEMALAN FAMILY PLANNING ASSOCIATION), THE PROJECT GRANTEE, HAS BEEN SUCCESSFUL IN MEETING ITS OBJECTIVES. PROJECT ACTIVITIES INCLUDED INFORMATION, EDUCATION, AND COMMUNICATION (IEC) USING BOTH PERSON-TO-PERSON COMMUNICATIONS AND THE MEDIA, AND DIRECT DISTRIBUTION OF CONTRACEPTIVES AS WELL AS TECHNICAL-MEDICAL INFORMATION TO LOCAL HEALTH FACILITIES. A RECENT SUSPENSION OF FP ACTIVITIES IN RURAL HEALTH POSTS STEMMED FROM CONCERN BY THE MINISTER OF HEALTH THAT ORAL CONTRACEPTIVES BE ADMINISTERED ONLY UNDER MEDICAL SUPERVISION. (SMALL RURAL HEALTH POSTS ARE NOT ASSIGNED PHYSICIANS.) HOWEVER, THE MINISTER RECENTLY EXPRESSED HIS WILLINGNESS TO IMPLEMENT A FP PROGRAM WITH AID AND APROFAM ASSISTANCE. THE FOLLOW-ON PROJECT WILL INCORPORATE MEDICAL SUPERVISION. CONTRACEPTIVES WERE SUPPLIED ON A REGULAR BASIS TO 580 MOH CLINICS, PRIOR TO SUSPENSION OF THE HEALTH POST FP ACTIVITIES. A RURAL COMMUNITY-BASED DISTRIBUTION SYSTEM WAS PUT IN PLACE, SERVING 35,000 USERS. SIX URBAN AND 37 RURAL RADIO STATIONS DELIVERED FP MESAGES 3 TIMES DAILY. IN 1978, 190,000 PAMPHLETS WERE DISTRIBUTED. THE TARGET OF PROVIDING FP SERVICES TO 7% OF THE WOMEN-IN-FERTILE AGE BY THE END OF 1978 WAS EXCEEDED BY 2%. CONTRACEPTIVE USE AMONG THE RURAL LADINOS REACHED 21.1%, WHILE REACHING ONLY 4% AMONG THE INDIANS. PROJECT INVOLVED WOMEN IN THE ACTUAL DELIVERY OF FP SERVICES -- BOTH AS HEALTH AUXILIARIES AND CONTRACEPTIVE DISTRIBUTORS. PROJECT EXPERIENCE DEMONSTRATED THAT THE POPULATION GROWTH RATE CANNOT BE REDUCED IN GUATEMALA WITHOUT SPECIAL ATTENTION TO THE INDIAN POPULATION AND THEIR CULTURAL DIFFERENCES. A FULL EVALUATION REPORT IS ATTACHED (PD-AAF-780-C1).