Family planning programs in industrial establishments: an operations research study

An operations research study in the Philippines sought to uncover determinants of the sustainability of employment-based family planning (FP) programs offered in industrial settings where the Philippine Center for Population and Development (PCPD) had provided assistance in implementing Responsible Parenthood/FP-Maternal Health (RP/FP-MH) Programs. Qualitative data were gathered through observations and interviews with the target population and with company management and program implementers. Based on this study, the following recommendations were made: 1) training outputs should be echoed to employees immediately; 2) RP/FP-MCH team members should be recruited from each level of the work force; 3) an appropriate IEC (information, education, and communication) strategy should be devised to respond to the short time-frame in which employees can participate; 4) team-building training should be incorporated as a regular activity early in the contract period; 5) sectoral targeting should be used within a given company; 6) training programs should be designed for each of the three types of team members and should overlap the basic topics; 7) teamwork and mutual assistance should be encouraged; 8) the work of the teams should be rewarded; 9) commendable initiative of liaison officers should be sustained; 10) representatives of the PCPD should maintain a close relationship with the teams through PCPD staff visits to the companies; 11) management requires more intensive orientation on the RP/FP-MH program; 12) PCPD support should be withdrawn gradually until the companies are able to sustain the program themselves; 13) it may be helpful to require a company to meet rigid criteria in order to take part in the PCPD project; 14) OR should be continued; and 15) the concept and practice of quality of care should be introduced to service delivery and training of staff and motivators.     

Perceived factors of family planning clinic performance and service quality

As part of a larger operations research project, this 1990 study analyzed the performance of the Philippine Department of Health's (DOH) family planning (FP) clinics. Specific study objectives were 1) to measure acceptor targets, servicing capacity utilization, outreach, and costs; 2) to determine what providers believed affected performance; 3) to record which quality indicator providers use; and 4) to determine the perceptions of acceptors about clinic personnel, the clinic as a FP outlet, FP service processing, and FP service quality. Data were gathered from clinic records and from sample surveys in 25 clinics in four specified locations. Eight clients were sampled from each of the 100 clinics. It was found that clinic staff accepted low attainment of FP acceptor targets and that clinic capacity utilization levels were at 25% of capacity. Providers were unaware of the number of potential FP acceptors in their areas and had no information about the costs of running their clinics. The FP clinic managers identified 34 major determinants of clinic performance, but more than half reported that they had very little control over these determinants. The providers described quality service from the point of view of the acceptors and described the quality of a clinic in terms of the minimal physical characteristics required. The acceptor survey revealed that acceptor satisfaction depends upon 1) clinic accessibility and lay-out, 2) intensive personal contact, and 3) clinic infrastructure. The study uncovered a need for the DOH to institute management training programs for clinic managers and to provide managers with the resources and personnel to shift priorities in favor of FP coverage and prevalence. Managers, who are resource allocators, must also receive information about the costs of FP services in their clinics. In addition, the DOH's determination that its FP program would be facility- rather than community-based should be modified to incorporate community outreach elements. The DOH can also make a big impact on perceptions of quality (of both providers and acceptors) by improving clinic conditions to meet basic standards. Once these basic needs are met, additional needs of acceptors can and must be addressed.     

A fresh look at family planning communication

As a step toward development of a national information, education, and communication (IEC) plan, a reassessment of such efforts practiced by the agencies involved was undertaken. A paper published in 1978 by the Research Utilization Unit of the Population Information Division, Population Center Foundation, reviewed materials used and accounts of experience in conceptualizing and communicating family planning messages by 12 private and public sector agencies. The most common concepts employed by the agencies were small family size, responsible parenthood, family welfare, community and national development, birth spacing, delayed marriage, contraceptive use-effectiveness, "manliness," delayed 1st pregnancy, value and rights of children, human behavior and social environment, and population dynamics. Most of the messages were conceptualized and developed through formal and informal consultation with field staff. The need to consider the specific needs of target audiences was considered crucial, and thus decentralization of IEC production was recommended. Such decentralization has been a goal of the Philippine program since 1976, but the effort has been hampered by lack of local training and resources, and of studies to support successful implementation. Mass and mixed media approaches were found to be used by most of the agencies, although a reliance on interpersonal approaches was found to be most prevalent in rural areas. Among recommendations for policy makers were development of a systematized data base for IEC materials, regional capabilities in research and development, and studies of funding and existing resources.     

A new terminal judgment method for family planning: indistinct comprehensive judgment]

The purpose of family planning (FP) program evaluation is to make comparisons between different work units and between the past and the present. The evaluation covers the impact of programs in economic, social, and demographic terms. If the impact is not quantified, it is difficult to distinguish differences in program performance. It is also hard to determine the relative standing of different organizations if each one has different merits and deficiencies. A mathematical model is used to quantify the performance of each unit in a FP program. 4 variables are used as the program indicators in the model: 1) percentage of child births following planning, 2) percentage of deferred marriages, 3) birth control prevalence, and 4) percentage of one child pledges. Indicators of social impact include 3 variables: 1) the attitude of FP workers, 2) the efforts of FP workers put in FP and 3) the results of program implementation. The indicator of economic impact is the investment for evasion of the birth of a child. Grades are assigned to indicators of social impact for each organization. The values of each variable is put in a matrix. Weights are given to each variable based on the emphasis of the program or a specific evaluation. The weights are determined through discussion with people involved in the program. A weighted average of all the above factors is the final grade of an organization's FP program performance.     

The Population Program's Medium-Term Plan: a blueprint for welfare

The Population Program in the Philippines initially was preoccupied with the problem of fertility reduction. From 1981-85, the program will be carrying out a 5-year population plan which aims at the reduction of fertility as well as the broader goal of enhancing the well-being of the family and of society. Called the Medium Term Plan, this population plan began to evolve in January 1978 when President Marcos called for a comprehensive review of the population program in the context of the country's overall development plans. The Special Committee to Review the Philippine Population Program, worked from February to June 1978 and focused attention on the policy, program, and research components of the population program. They assessed the achievements of the program, analyzed its limitations, and recommended future policy and program thrusts. In performing its task, the committee observed the following guidelines: 1) the program must be evaluated by taking into account the overall development goals that are directly related to the population problem, 2) the program must be evaluated in its totality, 3) the concept of family planning must be redefined as family planning and welfare, 4) research must be recognized as a vital instrument for program formulation, and 5) the population program must be evaluated with an awareness of the role of financial and institutional support in its implementation. The committee's findings stressed the need to link family planning efforts with the rest of socioeconomic issues outlined in the government's 5-year development plan for 1978-82. The broad objective of the National Population Program is to reduce the population growth rate to levels that promote national welfare and individual well-being. Under the Medium Term Plan the population growth rate should be reduced from an estimated 2.3% to an estimated 2.0% in 1985. To achieve this objective, the program aims to raise the number and quality of protected couples, promote delayed marriage, promote internalization of the small family size norm, and study other development factors. 14 strategies and their objectives are outlined along with action steps.     

An analysis of the determinants of family planning volunteer workers' performance in Iloilo City

This report analyzes data from a survey of 106 Barangay (village) Service Point Officers (BSPOs) associated with the City Population Office and 106 Barangay Health Workers (BHWs) associated with the City Health Office to compare the family planning (FP) service delivery performance of these voluntary workers in Iloilo City in the Philippines and to quantify the effects of the factors which influence their performance. Both the BSPOs and the BHWs assist in the delivery of health and FP services at the grassroots level. The survey data were supplemented with interviews with key informants, focus group discussions with married couples of reproductive age, clinic records, and observations of the BSPOs and BHWs at work. The analysis compared the sociodemographic characteristics of the two groups; the recruitment procedures followed (if any); FP training; actual FP-related work; involvement in community organizing; incentives received; supervision of the volunteers; attitude towards their work; FP knowledge, attitude, and practice; time allocated to FP activities; number of clients served; and number of clients counseled. Correlation analysis of factors influencing volunteer performance indicated that FP training had the largest positive influence on FP activities. The output of the workers was also positively affected by the amount of time spend in FP activities and by their involvement in community organizing. The commitment of the workers had a significant impact on the number of clients they resupplied with contraceptives. Variation in the FP performances of the two groups was caused by the fact that delivery of FP services is a major role of the BSPOs and only one of many responsibilities of the BHWs. These findings reinforce the planned restructuring of Iloilo City's FP program which would once again designate the Population Office as the lead agency. Increasing the knowledge of these volunteers about the side effects and contraindications of various methods should have a positive effect on continuation rates. Recruitment of volunteers should be based on the individual's level of interest and commitment.     

Social Demography and Eugenics in the Interwar United States

This article explores the relationship between eugenics and demography in the United States in the interwar era. In focusing on the founding of the International Union for the Scientific Investigation of Population Problems and the Population Association of America, it shows how early population scientists contested and negotiated the boundaries of the population field. The article maps the shifting focus away from biological interpretations of population dynamics toward the social, in part as a reaction to the rise of Fascist population research and policy. However, it also shows how social demography was closely intertwined with a “social eugenics” that attempted to ensure human betterment through methods more consistent with New Deal policymaking. This, the article argues, contributed critical intellectual and material resources to the development of social surveys of fertility behavior and contraceptive use, surveys that are more commonly perceived as having undermined eugenics through challenging the biologically deterministic assumptions upon which it was based.     

Teachers are students in ZPG program called 'Pop Ed.'

Zero Population Growth's Population Education (Pop Ed) program began in 1975 as an ongoing effort to bring the "real world" into the classroom by demonstrating the relationships among population trends, food and energy resources, and environmental and economic problems. The training workshops which last for a day or 2 have the following goals: 1) to offer a brief demographic overview for teachers, 2) to provide lesson plans and techniques readily usable in the classroom, 3) to alert teachers to the best written and audiovisual materials available, 4) to identify local resources for teaching Pop Ed, and 5) to provide sample materials. In the 1st year of program operation 10 workshops were held. These workshops are credited, at least partly, with the subsequent population instruction that reached over 10,400 students and 1600 teachers. Another 15 workshops were held in the 2nd year of operation. Obstacles to the program are the assumption on the part of some teachers that Pop Ed belongs in disciplines other than their own and the belief on the part of many teachers that they will require extensive training.     

The nature of family planning management in China]

Family planning (FP) program management in China uses the power of the state to manage population reproduction. the characteristics of program management are as follows. 1) The FP program is for the benefit of the state, community and individual, 2) the FP program is a process of birth planning under social planning rather than an individual family's planning, 3) FP include both restriction on the number of people and the improvement of the quality of the population. 4) FP is a public affair. Government organizations at all levels of coordination and mobilize the FP program so that people of all walks of life can participate. 5) People participate in the FP program management by expressing their views in the people's congress, through communication with administration leadership, and through self-education. The special features of FP program management in China are also reflected in its concerns with a variety of target populations, its need for cooperation from people and its need for involvement of all institutions and enterprises. As the human reproductive cycle is long, making a long- term strategic policy for FP is no less important than long-term economic planning. The management of the program should emphasize direction and persuasion, the provision of services and help to people, and the efforts to involve government or public organizations in promoting planning programs.     

The Philippine population program: a stocktaking

Summarizes findings of the Special Committee to Review the Philippine Population Program, created by the Commission on Population to evaluate population related programs and recommend program directions for the future. The Committee conducted a 2 part study: an indepth review and analysis of existing policies and programs, evaluation of their effectiveness, and identification of organizational, statistical and policy or program related gaps and bottlenecks; and recommendations on policy and program thrusts for the next 5 years. Along with specific recommendations on program operations, service delivery, and research, the Committee made a number of important policy recommendations. Chief among these were a call for the development of a broader popultion policy, not focused only on growth but encompassing demographic, manpower, and welfare components; recognition of the need for the program to advocate an ideal family size and a desirable age for marriage; and redesign of the program on a broad scale to integrate it fully with national development plans.     

Pop-ed programs for the out-of-school youth

39% of the Philippines youth are not in school and these youths receive no training for responsible parenthood and community life. A number of agencies try to reach these members of society, including the Bureau of Youth Welfare (BYW), the Family Planning Organization of the Philippines (FPOP), the Foundation for Youth Development in the Philippines (FYDP), the Rizal Youth Development Foundation (RYDF), the Philippine Rural Reconstruction Movement (PRRM), and the Philippine Youth Welfare Coordinating Committee. BYW conducts informal group sessions including discussions among 13-24 year old members who have started self-employment projects. FPOP's youth program, SIGLA, aims at developing out-of-school youths social y and having them disseminate information to other out of school youths. This information includes family development, family planning, and population-related information, and is disseminated through activities and workshops. FYDP aims at functional literacy but also disseminates family planning information to out-of-school youths. RYDF conducts week-long seminars in topics such as birth processes, family relations, and care of babies. PRRM integrates population and family planning into its nonformal education program for out-of-school youth and adults in Nueva Ecija Province. Problems encountered in these programs are 1) suspicion of parents, and 2) feelings of inadequacy on the part of teachers. While emphasis has been on unemployed youth, efforts should be made to reach those youth who are employed.     

The Philippine population program under the Aquino administration

3 views of the Philippine Population Program under the Aquino government are presented: the first states the government's position on population programs and the next 2 criticize that position. Issued by the Commission on Population (POPCOM) in early 1987, the first statement establishes the government's stance on population programs. It explains that the 1987 Philippine Constitution reaffirms the government's commitment to the ultimate goal of the Population Program: the improvement of the quality of life in a just and humane society. The statement explains the constitutional guarantees, policy principles, and policy strategies concerning population. The next view presented is an excerpt from Alejandro N. Herrin's paper entitled "Population, Health and Education: Policy Initiatives Under the Aquino Administration." In it, Herrin explains that after 1 year of silence, POPCOM finally issued a policy statement. The statement, however, is marked by ambiguity, avoiding an explicit mention of a policy to moderate fertility. Furthermore, the statement fails to clarify the government's position on 2 basic issues: whether or not an acceptable economic and social development can be achieved within a reasonable time without a moderation of the current high fertility and population growth, and whether or not the government is justified in sponsoring a program to moderate fertility and population growth. The 3rd view presented in the document is that of Virginia A. Miralao. In her essay "Population Policies, Family Planning Programs, and Women's Reproductive Rights," Miralao explains that the current population program -- which directly affects the lives of women -- has virtually excluded women in its planning. Moreover, since Aquino came into power, the Catholic church has gained great influence and has opposed family planning programs.     

Psychology's role in the conserving society

Because the earth's natural resources are finite and are growing increasingly more difficult to exploit, energy and resource conservation will soon become essential to our way of life. Psychologists and other social scientists can help in that transition, and recently they have begun to do relevant research in several areas: environmental pollution, recycling and solid wastes, reducing litter, and energy usage and conservation. Research approaches that have been used include studies of environmental and energy attitudes, behavioral research, social interaction studies, community conservation programs, and large-scale consumer research. More work is especially needed on the topics of transportation energy use, industrial and commercial energy conservation, and community action campaigns. Research efforts should increasingly utilize measures of actual behavior and actual energy usage, long-term longitudinal approaches, realistic field settings, and costeffective procedures. In addition to doing research, psychologists can contribute to the advent of the conserving society through program evaluation studies, proposals for innovation, dissemination of validated scientific knowledge, and offering policy advice.     

Introduction: Population Perspectives on Sexual Minorities

Population scientists investigate a multitude of important issues surrounding demographic trends and change. Yet, sexual minorities—including gay, lesbian, bisexual, and transgender persons—continue to represent an understudied group in population-based research. This has both social and political implications, as it hampers our ability to identify and locate where sexual minorities fall along the spectrum of issues typically investigated by demographers. This special issue includes important population-level studies aimed at understanding the demographic landscape for sexual minorities. Though not an exhaustive list, these include family organization, health disparities, educational attainment, and important implications for measurement and estimation. Perhaps more important, these studies also provide a roadmap that population scientists can use to help develop areas ripe for inquiry.     

World Population Day '93 observed

President Abdur Rahman Biswas inaugurated the World Population Day '93 at the Osmani Memorial Hall in Dhaka, Bangladesh, on July 11. He stressed the importance of reducing the national population growth rate from 2.03% in 1923 to 1.82% by the 1995. The event was organized jointly by the Ministry of Health and Family Welfare, the Directorate of Family Planning, and the United Nations Population fund (UNFPA). The president expressed his deep concern over the population growth rates in developing countries, which are much higher than resources. He noted with satisfaction that 40% of the eligible couples in the country practice family planning (FP) and expressed hope that this could be raised to 50% by 1995. If the program becomes successful, ideal families would consist of two children by 2005. He later presented prizes and certificates to field workers, ulemas, traditional birth attendants, FP depot holders, and the workers of nongovernmental organizations for their commendable services in Fp and maternal-child health services. The Health and Family Welfare minister in his speech warned that if the current population growth is not checked, the consequences would be disastrous, which could be averted by adopting new strategies. The deputy minister for Health and Family Welfare illustrated the threat of population escalation and recounted some of the recent government control measures. The secretary, Ministry of Health Family Welfare, said that at the present rate of growth the Bangladeshi population would double in 34 years. The director general, Directorate of Family Planning, said that the FP program has become accountable with a system of incentives and disincentives. Earlier, the UNFPA country director in his speech remarked that it was crucial for the entire world to solve the population problem. In the morning, in the main cities, hundreds of people involved in national FP activities paraded to demonstrate the social legitimacy of the Bangladeshi Fp program.     

Male prostitution: pathology, paradigms and progress in research

The body of research on male sex workers (MSWs) in the social science literature has evolved concurrently with the research that de-pathologized homosexuality. Unfortunately, the majority of studies focusing on MSWs have been dominated by paradigms that dehumanize the researched. Psychopathology, social deviance and, with the advent of HIV, MSWs as "vectors of disease," framed research questions. Further, many researchers have focused on typologies of MSWs, reporting respective associated characteristics. However, the knowledge gained by past research was often a product of the places MSWs were sampled; social scientists relied heavily on street MSWs. although other places and venues for sex work existed. What has been learned through this narrow focus has often been generalized to all men engaged in sex work resulting in stigmatization, stereotyping, and demonization. In the past decade, two important developments related to the field of sex work have been introduced. First, researchers have embraced a new paradigm that respects MSWs' personal motivations for sex work. Dominant among these motivations is the view of sex work as a job and, hence, a valid source of income. Second, the Internet has emerged as a new venue for sex work; a venue to which researchers are just beginning to turn their gaze.     

Meeting health and family planning needs in Latin America and the Caribbean

The operations research and technical assistance (OR/TA) project in The Population Council has concentrated on fertility and infant mortality issues in Latin American and the Caribbean for more than a decade through INOPAL. INOPAL is an acronym for Investigacion Operacional en Planificacion Familiar y Atencion Materno-Infantil para America Latina y el Caribe (Operations Research in Family Planning and Maternal-Child Health in Latin America and the Caribbean). In March 1995, the project entered its third phase, INOPAL III, with the renewal of its contract from the United States Agency for International Development (USAID). To facilitate communication between INOPAL, collaborating agencies, and USAID, INOPAL Director James Foreit moved from Peru to a Council office in Washington, D.C. INOPAL has six objectives: 1) to test the integration of family planning and reproductive health services; 2) to increase access to family planning; 3) to develop strategies to reach special populations; 4) to improve the sustainability of family planning programs; 5) to improve service quality; and 6) to institutionalize operations research capability in the region. INOPAL II conducted 61 subprojects in 12 countries in collaboration with 24 USAID cooperating agencies and other international organizations. The project established new services for postpartum women, adolescents, and rural women; improved program quality and financial sustainability; increased vasectomy promotion and the range of available contraceptives; and developed new modes of service delivery. A key finding of INOPAL II operations research was the importance of increasing cost-effectiveness to ensure program sustainability. INOPAL III will work toward all six objectives, with an emphasis on integrating reproductive health and family planning services. Operations research and technical assistance (OR/TA) subprojects will focus on the prevention and treatment of sexually transmitted diseases, perinatal and postpartum care, and postabortion care.     

Oil Spill Disruption and Problem Drinking: Assessing the Impact of Religious Context among Gulf Coast Residents

Population Research and Policy Review - While a wide body of research has indicated that social resources may be enhanced through religious practice, few studies have explored how social resources...     

Redefining family planning programs

The Population Council's issue paper entitled Reconsidering the Rationale, Scope, and Quality of Family Planning Programs calls on family planning programs to focus only on reducing unwanted fertility by helping people meet their own reproductive goals safely and ethically. Many family planning programs have been wrongly handed the extra responsibility of reducing wanted fertility. They have therefore used inappropriate means (e.g., incentives, quotas, and coercion) to boost contraceptive prevalence. If programs do focus on reducing unwanted fertility, they will foster reductions in overall fertility and population growth as well as improvements in clients' health and well-being. A new framework has emerged from this shift in rationale. It sets the stage for expanding the scope, improving the quality, and assessing the impact of family planning programs in terms of client choice, health, and well-being. A program needs to determine the range and quality of family planning services it provides at the local level. Local program managers, policymakers, and consumer interest groups should establish minimum or achievable standards of service based on the local health care capacity. Program items that should be assessed include choice of methods, information for clients, technical competence, interpersonal relations, mechanisms to encourage continuity of care, and appropriate constellation of services. The Population Council has conducted rapid appraisals of the quality of care of family planning services to help local program managers to evaluate the strengths and weaknesses of their programs. The HARI (Helping Individuals Achieve their Reproductive Intentions) Index measures a program's success in helping clients safely prevent unwanted or unplanned pregnancy. Program managers can conduct a self-assessment that revolves around answering four questions. Family planning services are an important social investment and are essential to development.     

Improving quality of care: a status report. Family planning

A recent report on progress in providing good quality care in family planning (FP) programs, prepared by Valerie Hull, the head of a Working Group on Quality of Care in Indonesia, contains findings that are relevant worldwide. While concern about the quality of health care is not new, the concept was only formalized in 1989 when Judith Bruce published a framework of the essential elements of quality of care. Attention to quality of care highlights the shift in focus of FP programs from demographic goals to client-oriented services that was promoted by the 1994 International Conference on Population and Development. While efforts to improve quality have burgeoned in the 1990s, Hull reports that these projects are only rarely carried out as comprehensive, mainstreamed national efforts. The obstacles Hull found to improving quality of care include resource constraints, weaknesses in training and management, and a lack of program standards and guidelines to counteract deeply entrenched attitudes and practices. However, Hull notes that committed individuals at all levels are working to change the system in all countries.