Program for voluntary surgical contraception

The Association for Voluntary Surgical Contraception (AVSC) will implement the project, which will expand access to VSC while ensuring the safety, quality, and voluntarism of the programs. AVSC will introduce VSC services to 18 new countries (mostly African) and continue 30 existing public sector country programs. Stress will also be put on vasectomies (25 programs), postpartum VSC (38), and private, for profit programs (22). Other AVSC efforts will include: (1) testing and introducing new sterilization techniques (e.g., the Filshie clip and the Li no-scalpel vasectomy technique); (2) adding long-acting contraceptives such as NORPLANT and the Copper T-380A IUD to AVSC programs, where appropriate; (3) establishing reversal services, where appropriate; (4) institutionalizing regional training programs (15 in counseling and 21 in surgery) for medical and nonmedical staff; and (5) increasing collaboration in operations research and other types of analysis. Priority will be given to supporting organizations with cost sharing ability and programs with the potential to have a broad impact. Diverse cost-recovery opportunities will be explored. Careful attention to voluntarism and informed choice will continue to be a major emphasis. AVSC will: (1) develop tools (e.g., guidelines, survey instruments, counseling manuals, and auditing techniques) for assessing voluntarism; (2) develop educational materials for informing potential clients about VSC; (3) expand efforts to train VSC counselors; and (4) ensure that temporary contraception methods are effectively available in all AVSC programs. AVSC will enhance the safety and quality of VSC services by providing medical training, updating/introducing safety guidelines through regional and local workshops (covering such topics as surgical techniques, asepsis, and anesthesia), supporting medical supervision systems, and participating in international, regional, and national medical conferences. To ensure institutionalization, AVSC will conduct 44 operations research and cost studies, along with supplying 145 TA visits. Information dissemination activities will include periodic publications, journal articles, and presentations. The World Federation for Voluntary Surgical Contraception will work with AVSC in various aspects of the project, including efforts in advocacy and information sharing.