Satisfied users clubs: family planning acceptors as model agents of the program

The National Population Program in the Philippines has encouraged family planning acceptors to shift from their passive role as recipients of family planning services into an active role as program participants. In the mid 1970s the Commission on Population (Popcom) began setting up satisfied users clubs in various regions of the country with the aid of the Ministry of Social Services and Development (MSSD). Other government institutions like the Ministry of Labor and Employment (MOLE) formed similar family planning groups. So did private agencies participating in the Program. There were indications at that time that community based family planning clubs could help the Program in informing couples about family planning and in motivating them to practice contraception. In 1977 a study conducted by the University of the Philippines Institute of Maternal Clinic found that family planning acceptors in Dumaguete City received social and psychological support from local barrio women's clubs. A 1978 Community Outreach Survey indicated that full time outreach workers (FTOWs) found statisfied users clubs helpful in increasing the number of new acceptors in their areas and in bringing down the number of family planning dropouts. Once a decision to create a club is made, club organizers meet with the barangay captain and his council to get their approval and seek their cooperation in inviting people to join the proposed club. Once the approval is given known family planning users in the community or mothers of reproductive age are invited to attend a community assembly. Of 59 clubs surveyed, only 10 had a formal constitution and bylaws. All clubs elected their officers and conducted monthly meetings which lasted from 2-4 hours. The main selling proposition of the clubs is the involvement of members in nonfamily planning activities like income generating schemes, skills training, nutrition seminars, and immunization of children. 81% of the officers of all 59 clubs were family planning acceptors. The majority of officers had undergone voluntary sterilization. Only 8 of the 59 clubs considered themselves single purpose clubs committed to the promotion of family planning. The other 51 were multipurpose organizations, with both family planning and nonfamily planning activities. In the area of family planning, the club's objectives were to increase family planning acceptors, disseminate family planning information, and maintain current users.     

Family planning as preventive health measure

The link between health and family planning efforts in the Philippines goes back to the beginnings of the National Population Program. In this interview, Dr. Dumindin of the Ministry of Health (MOh) discusses the impact of family planning on health. The family planning program of the MOH, since its inception in 1970, has undergone expansion and taken new initiatives and directions to meet the changing needs of the target clientele. Family planning information, education, and motivation is provided and maintained during routine prenatal, natal, and postnatal clinic and field activities. As of January 1986, the MOH had a total of 2100 clinics--rural health units, medical centers, hospitals, mobile clinics, and special clinics--all over the country. It is estimated that the Ministry's family planning activities have averted around a million births. It is hoped to extend the coverage of the programs to areas that have not been reached before, through further community involvement, by enlisting the participation of more workers in the community, training them on integrated health and family planning services, setting up more service facilities and clinic extensions, and by improving contraceptive use-effectiveness. Hopefully, the Philippine people will become less program-dependent and more self-motivated, and they will recognize the need for birth spacing, birth limiting, and total health care--not as suggested from the outside, but coming from within themselves.     

Sarikaya: toward community self-reliance in health and family planning

The Sarikaya Project of the Philippine Ministry of Health's National Family Planning Office was conceived as an innovative approach to providing information, education, and communication on health, nutrition, and family planning using the services of neighborhood leaders who can gain the cooperation and participation of community members in health and family planning programs. The Sarikaya worker (SW) serves as the link between the community and the Ministry of Health. Selection of SWs is a collaborative effort of the Barangay Health Service midwife, the community, and the barangay council. SWs are trained by the BHS midwife in a 5-day seminar which includes an orientation to the role and function of the Sarikaya Project, health and family planning IEC, and 1st aid. SWs undertake activities in family planning, maternal and child health, nutrition, environmental sanitation, communicable disease control, and emergency treatment. As volunteers, the SWs receive no compensation except for a nominal training allowance. The SW relies on the BHS midwife for technical and logistical support, on the health committee of the barangay council for coordination and administrative support, and on informal community leaders for guidance and advice. Pilot testing of the sarikaya project was undertaken in 1979, when 241 workers were trained. Results of early evaluations were encouraging, and plans were made to expand the project in 1980.     

Strengthening family planning management]

Prior to 1984, enforcement of family planning policies in an undisclosed PLA military settlement in China's Jinan Military Region was totally inadequate. After notification from the central government, this military settlement immediately began enforcing family planning policies, resulting in sudden and full compliance with the central government's family planning policies. The system of scientific management of promoting and enforcing family planning, established by local administrators, is described. Management by objectives, clearly defined individual tasks and responsibilities, an full cooperation and support on the part of the authorities are some of the factors responsible for the effectiveness and success of the family planning efforts in this military settlement. A number of potential problem areas are identified scientific management techniques in dealing with uncooperative parties are emphasized.     

On family planning and socialist cultural civilization]

Family planning is a very important part of the Socialist cultural civilization, and it has a great impact on the ideology, ethics, and change of moral concepts. The old concept of having a large family and favoring boys over girls has been changed because of the popularization of family planning, and the overall quality of China's population can thus be improved. In the practical work of family planning, construction of the Socialist cultural civilization should be handled well. Science should be developed and taught to the general public, and the traditional ideology concerning birth and population should be gradually changed and eliminated. In this way, people will become more conscious of the need for family planning. In the meantime, efforts should be made to promote social welfare, such as the establishment of more and better daycare centers and nursing homes so that the common worries about family planning can be removed. The people should gradually learn about their rights and responsibilities as citizens and understand that family planning is in the best interest of the whole country as well as for the good fortune of later generations. With close cooperation between the people and the government and with reasonable management of family planning, China will be built into a strong nation with an adavnced Socialist cultural civilization.     

Seven measures for population control announced in Guangzhou

On 7 October 1988, the Municipal Government of Guangzhou, China, announced the following Decision: "First, great efforts should be made to strengthen education on the situation and tasks of the family planning programme. Second, family planning work is included in the target responsibility system of leaders at all levels during their terms of office and whether it is good or bad for the fulfillment of their family planning tasks will be considered as one of the criteria for the assessment of cadres in their work to link up with rewards and punishments. Third, the current family planning policies must be resolutely and unswervingly carried out. For those units where family planning policies have not been well carried out and where family planning work has long been stagnant, competent authorities should send capable cadres to help them improve their work within a definite period of time. Fourth, the principle of 'three priorities' (i.e., priority of publicity and education to economic restriction, priority of contraceptive measures to induced abortions, and priority of day-to-day work to shock work) must be adhered to while technical service and work of transforming the backward situation in some places should be done. Fifth, the family planning organizations at all levels must be perfected and ranks of family planning workers be strengthened with the stress on those at the township, town, and street neighbourhood levels. Moreover, the family planning offices should be set up or full-time family planning workers be staffed for enterprises and undertakings in the cities. Sixth, funds for the family planning work must be guaranteed. Seventh, the management of family planning for [the] floating population must be strengthened and a management group for [the] floating population, which consists of representatives from the Municipal Government and departments concerned, must be established."     

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 participation of non-governmental organizations in the Philippine population program

In 1957 the National Council of Churches in the Philippines (NCCP) established the Family Welfare Center, offering an educational program in family planning; it was subsequently expanded and reorganized into the Planned Parenthood Movement of the Philippines. Since its creation in 1970 the Philippine Population Program has brought together government, private, and religious activities. Under the 1987-92 development plan nongovernmental organizations (NGOs) will be taking a more active role in the implementation of the population program by contributing to the maternal and child health/family planning and the information, education, and communication (IEC) components. There are more than 50 private organizations engaged in such population activities. These include national women's organizations and development NGOs with a mass base. The Family Planning Organization of the Philippines is carrying out a 3-year comparative study of the effectiveness of community volunteers in the acceptance of natural family planning. The Reproductive Health Philippines has completed a follow-up of Depo Provera defaulters in a previous clinical study of Depo Provera acceptors conducted in 1985-87. IEC support from various medical and social organizations also helped advance family planning and population awareness of the program. The Mary Johnston Hospital and Iglesia ni Kristo have been front-runners in sterilization through their mobile teams and regular clinics. On the negative side, funding constraints are threatening the very existence of some NGOs. Even those that do not face such constraints face problems related to cost effectiveness, priority setting, capability building, and staff development. A survey of the Population Center Foundation identified some urgent concerns: sharing experience in self-reliance, enhancement of the managerial skills of staff, and funding problems. NGOs complement the family planning services of the government as well as focus on the smooth flow of IEC activities.     

Comics: a medium for today's development messages

Filipino illustrated magazines, or the comics, may yet prove to be the most effective media, if not the most effective, for spreading the country's development messages. Long criticized by intellectuals and the social elite, the comics have been grossly underrated in their potential to inform, persuade, and even influence the life-style of the people. The government's Commission on Population (Popcom) has developed an information-education-communication program using the comics, among other media, to disseminate stories on family planning, responsible parenthood, and related topics. Its best quality is popular appeal, and for publishers and distribution outlets, the comics provide good business. A review of these materials shows that their themes reflect the following topics or issues: 1) population trends and consequences; 2) socioeconomic benefits of family planning; 3) customs which influence family planning; 4) family planning concepts; 5) family planning methods; 6) human sexuality and reproduction; 7) the husband-wife relationship; 8) guides for family planning motivation or communication; and 9) guides for teaching family planning. The materials were developed with 4 qualities in mind so as to attract audience or reader interest: simplicity, familiarity, realism, and attractiveness of materials. The consensus is that in the comics, population and development agencies may have found a "secret weapon" in getting these messages across, and that this new-found use for the illustrated magazines may be giving them a new respectability without in any way diminishing their popular appeal.     

Bicol hospital reaches out to rural folk

The Ago General Hospital in Legaspi City of the Philippines was opened in 1965, antedating the national family planning movement by 5 years. The 180 bed hospital integrates family planning into the overall hospital service; sterilization is the main method used. Of the 3600 patients per year, 15% are family planning acceptors. The hospital employs 3 family planning strategies: inhospital, out patient and supportive. Inhospital strategies center on sterilization counseling and motivation. The counseling sessions include patient education. Primary targets include high risk pregnancies and young couples with a lot of children. Outpatient strategies include a referral system involving hospitals and agencies with family planning programs, lectures for community organizations and personal visits to other clinics and rural health units. The hospital's mobile clinic, staffed mainly by students, provides information, deworming, and pediatric services to the community. Supportive program strategies consist of mass communication, and an acceptor's club for previous acceptors of sterilization. These clubs meet regularly to share and discuss experiences.     

India: orientation camps boost new motivational strategy; group discussion on the social aspects of the family welfare program

About 40,000 orientation camps for influential village leaders were planned to reactivate India's family welfare programme. Each camp averaged 40 participants, and total participation was estimated to be 1.6 million. Emphasis is placed on interpersonal communication and group communication. Special informative and motivational materials; film shows and folk-art programs were provided at the camps. This endeavor has resulted in improving the climate in relation to family planning. Approximately 100,000 community health volunteers are involved in these efforts. A group discussion organized on the family welfare program in September 22, 1979 brought out the following issues: 1) the use of incentives/disincentives in persuading people to accept family planning; 2) predominant factors in the rural areas such as malnutrition which undermine population programs; 3) need for involving voluntary organization in the family welfare program, in addition to creating an awareness of the demographic situation through educational channels; 4) introduction of some insurance schemes for old-age security; 5) approaching family planning programs at the macro level to improve the economic situation, and at micro level to intensify motivational aspects of the program; and 6) more competent handling of the vasectomy program by trained experts.     

Pakistan: FPAP projects reflect integrated approach

The Family Planning Association of Pakistan has conducted a number of projects reflecting the government's integrated approach to family planning. The youth project aims at alerting young people to the need for family planning. A full-scale feasibility scan was conducted prior to implementation of the project to determine the best way to reach people. Volunteers were recruited among college students. The project's strategy for 1979 included organization of a youth leadership national workshop and oratorical contest on the topic, "Whatever your cause, it is a lost cause without population planning." Other FPAP projects include a group of "better living projects" which aim to educate young mothers in child care and family nutrition. Projects in the organized sector include a program at the Pakistan Mint, where a motivation center and clinic are set up. Training projects concentrate on fieldworkers and traditional birth attendants (dais). A 3-day course for dais includes reorientation on septic deliveries, child care, maternity care, and record keeping. In the cities, FPAP has a network of multipurpose centers in slum areas, where adult education and income generating activities are integrated with family planning.     

Spiritual civilization in family planning advocated by government

The National Conference on Exchange of Experience in the Building of Socialist Spiritual Civilization in the Implementation of the Family Planning Program met recently to focus on ways to help the people of China understand and support the family planning policies of the government and to change their childbearing concept. Spiritual civilization in the implementation of the family planning program can be summarized in terms of "4 educations:" the people should be united by a common ideal to carry out family planning conscientiously; the new morale and custom in the practice of family planning should be fostered and developed among the people; knowledge about population theory and family planning technology should be popularized; and the people should be guided to observe family planning regulations and policies. More than 80 papers were presented at the meeting. The experience of Keshan County in the Heilongjiang Province emerges as typical. The people's childbearing concept in Keshan County has undergone a radical change as a result of longterm education. This is the case, although this county's economic development is no better than the national average.     

NFP promotion in the Philippines: all program components covered

At least 50 of the 105 agencies in the Philippines listed in the "Directory of Agencies with Population Activities" are actively participating in the promotion of natural family planning (NFP). Of these, 40 offer instruction on its use, 22 provide training to clinic personnel or field workers, 19 conduct information/education/communication (IEC) activities, and 6 undertake research. The Population Center Foundation's (PCF's) Information Support to Population Projects (ISP) has prepared a preliminary inventory of programs and projects on NFP, covering some of those that were done in recent years, are being implemented, or have been proposed. Some projects described in the inventory are reviewed. Recent research or research proposals are showhow related, all leading to how the method can be effectively promoted and how couples can be taught its proper use. Instruction on NFP appears in all training activities of Popcom's regional offices, particularly in their refresher courses. Program managers are being trained in managing and monitoring activities to promote the method. In 1980 outreach workers, doctors, nurses, and midwives were trained by Popcom to motivate couples to practice the method and to teach them how to use it correctly. That same year, Popcom's office in the Ilocos region introduced the rhythm dial calendar, a simplified version of the rhythm slide rule. The Ministry of Health National Family Planning Office incorporates natural family planning instruction in its training seminars for the Ministry's health personnel in the regions. As in training, all regional offices of Popcom promote NFP along with other methods that they make available to prospective acceptors. This is in keeping with the program's "cafeteria approach" to family planning. In 1982 Popcom began intensifying the provision of services in NFP, allocating around 4 million pesos to preparations for its effective promotion. In support of service delivery efforts are IEC activities such as the development, production, and distribution of brochures and other reading material on NFP, schoolroom instruction, and lectures. The intensification of IEC efforts in the private sector to promote the modern and scientific techniques of NFP is most clearly evident in a fairly recent seminar sponsored by the Communication Foundation for Asia. Program agencies with activities in natural family planning are listed.     

Programmed learning: a training alternative for population workers

Self-instruction (SI), also termed programmed learning, is a fairly new family planning training tool adopted in 1975 by the National Population Program in the Philippines. According to Antonia Coronel, project officer of the Population Center Foundation (PCF), SI uses carefully designed materials in order to meet specific objectives. The information is presented in logically sequenced small frames or sets and is followed by a series of practice exercises requiring immediate feedback from the learner. The learner's reward takes the form of correct answers at the frames' end. There are many forerunners to SI, including the Greek philosopher Socrates, the Roman orator Quintilian, and the American social scientist Sidney Pressey who thought of a programmed instructional review and multiple-choice testing materials as devices which required the learner's active participation and provided immediate knowledge of his/her accuracy. SI has 6 characteristics: emphasis on the needs of the learner shown by allowing self pacing, meaning, the learner proceeds at his/her own learning rate, and stressing feedback from the trainer who holds individual meetings with the learners; a clear statement of objectives; a breakdown of learning tasks into smaller and easy to absorb units; a self administered posttest which enables the learner and others to see whether or not the objectives have been realized; inclusion of frequent practice exercises relevant to the objectives and the posttest; and provision of immediate feedback, which reinforces and lets the learner improve his/her comprehension and retention. Operationally, the method takes 4 steps: the objectives of instruction are specified in terms of learner behavior; the learner is rated as to his/her level of knowledge with respect to the objectives; instructional activities built into SI modules are designed to bring about the intended objectives; and the learner's attainment of the objectives is evaluated. The modules referred to are the 12 SI modules on various aspects of family planning developed by the PCF. In the Philippines the need for programmed learning became apparent with the signing of Presidential Decree No. 79. Among the provisions of this decree are the following: nurses and midwives can dispense oral contraceptives (OCs) and insert IUDs; large business firms and factories must provide family planning services to their employees; and family planning services like sterilizations costs can be charged to Medicare. The SI method met the criteria of giving uniform training, cutting down training costs, and ability to upgrade knowledge, attitudes, and skills. Thus far there are 21 completed program learning materials and these are identified and described.     

吉林省基层人口和计划生育工作干部队伍建设的现状、问题和对策

根据2006年对吉林省、市(州)及基层人口和计划生育干部进行的调查,对人口和计划生育干部的数量、年龄、学历、政策水平等进行研究。为全面准确地掌握吉林省、市(州)及基层人口和计划生育干部队伍建设的情况,增强全省人口和计划生育系统干部队伍培养的针对性,更好地完成新时期人口和计生工作任务提供了有效依据。     

A broadcast on family planning in Hefeng County]

New ideas for the promotion of family planning among distant regions is the objective of this report which states that rural communities lack effective means of communication mainly due to poor transportation facilities, a serious illiteracy problem, and the fact that in certain regions, households are virtually inaccesible because of mountainous terrain. Such is the situation in He Feng County, Hubei Province, in southern central China. It has a population of 180,000 people composed of 3 ethnic groups. The communication barriers mentioned above act to hinder the promotion of effective family planning. In a study carried out in He Feng County, it was found that bad transportation facilities were a contributing factor to the region's backward education. Moreover, the illiteracy and semiilliteracy rates in He Feng County comprise 20% of the population. The problem is compounded by the fact that its 40,000 households are scattered throughout the mountains. In an effort to combat the prevailing situations, the author suggests that an effective means of family planning promotion would be the installation of loudspeakers in almost every household in the county (a total of 25,000 loudspeakers). This would provide suitable family planning education to males and females of different age groups and would foster knowledge of its significance and importance, thereby changing existing rural attitudes about family planning. Furthermore, the government could provide support groups in these regions in order to promote family planning objectives.     

Indonesia; World Bank assists Second Population Project

Indonesia's First Population Project, funded jointly by the International Development Association and UNFPA, was started in 1972 and provided for construction of service and training facilities, equipment, research and evaluation studies, education, and communication activities. The national family planning program has made progress in the last 20 years. Acceptor and family planning personnel statistics are given. The World Bank has recently awarded Indonesia a loan to fund its Second Population Project, to aid in reaching the goal of a 50% reduction in fertility by 2000.     

The present task of family planning as suggested by the findings of the National Sample Survey of Fertility]

Results from the 1982 census show great progress has been made in the field of family planning because of close cooperation between the people and the government. Under the influence of the high birth rate in the 1950s and 1960s, a large number of youths are reaching the age for marriage each year, and they are bringing heavy pressure on the population growth. As a result of this situation, family planning work is still urgently needed. A great difference exists between cities and rural areas in family planning work. Economic conditions, cultural and educational levels, occupational characteristics, living environments, and concepts of population growth have contributed to this difference. Henceforth, special emphasis should be placed on family planning work in rural areas, so that the large scale population groth in the countryside may be brought under control. In areas of scientific management, propaganda and education, and technical measures for family planning, modern and and progressive methods should be used in order to reach the national goal of controlling population growth.     

Sri Lanka: current status of family planning

In Sri Lanka the family planning program is closely related to socioeconomic and cultural variables. The expectation is that in the near future family planning will be included as a component of a network of social services. The official program is a response to the economic necessities and welfare demands of individuals and families. The method of family planning most frequently requested is female sterilization, and no attempts are being made to direct people to other methods. 12 United Nations Fund for Population Activities assisted projects have provided the framework and basis for the institutional coverage of family planning activities in Sri Lanka. However, the experience of these projects revealed a lack of facilities, shortage of personnel and management inadequacies, all related to the delivery of family planning services. The following steps are suggested as a means of overcoming the current problems and expanding the program: 1) establish a pattern of interacting relationship between the mass media, community health education and the available services; 2) provide an operational approach to program management, monitoring and periodic reviews of the program; 3) involve the private sector health facilities; and 4) incur additional capital cost to increase the capacity for delivery of better health facilities and personnel.