Educational efforts in the implementation of rural family planning programs in East Pakistan

The pilot family planning studies reported in this paper were conducted in a rural area adjacent to the city of Dacca in East Pakistan. It reports the preliminary findings of action-research in the implementation of educational efforts to reach rural villagers of a developing country.Preliminary analyses of the records identify two significant educational problems: (1) most of the villagers (85-90 percent of the couples) who initially accepted contraceptives do not truly adopt and become continuing users and (2) the continuing users (10-15 percent of the initial users) are generally characterized by large families. (Later data show an even lower percentage of continuing users.)The field activities in the development of various educational approaches to family planning are described. Three separate geographic areas (from 15,000 to 20,000 population) were each approached in a different way, varying in the number and educational qualifications of the workers and in the degree of involvement of village leadership. Preliminary analyses of field records indicate that these variations of approach apparently have little effect on the percentage of the population willing to accept contraceptive supplies.It is the opinion of the writers that more intensive educational efforts are necessary at the village level to develop social support for continuing use of contraception and to gain adoption of contraception by younger married couples primarily for spacing of births.The impact of introduction of the IUCD in populations where condoms and foam tablets have been available for one to two years has also been reported. Preliminary findings indicate that the IUCD encourages adoption by previous non-users and may increase the over-all percentage of contraceptive users.     

CharacteriStics and utilization of midwives in a selected rural area of East Pakistan

The purpose of this study was to obtain information about the utilization of midwives (dais) by village women and to learn more about the characteristics and practices of those dais. Two interview schedules were prepared. The first was used to interview 632 village women to determine who performed or assisted with their last two deliveries. The second was used to obtain information from 21 dais.The results of the first phase may be summarized as follows: (a) 38 per cent of the women were delivered by relatives; (b) 33 per cent of the women delivered their own children; (c) 14 per cent were delivered by neighbors; (d) 6 per cent were delivered by dais; (e) 2 percent were delivered in hospitals; and (f) the remaining 7 per cent were accounted for by several minor categories.The results of the interviews with dais are summarized as follows: (a) they are mainly widows and older women; (b) they have no formal training; (c) they work for friends, neighbors, and relatives and receive a sari as compensation; (d) they cannot handle complicated deliveries; (e) they deliver 3-4 children a year; (f) their sterilizing procedures depend upon soap, water, and folk beliefs; (g) most think midwifery is a worthwhile service; (h) about one-half have a general understanding of the reproduction process; (i) most do not know how to prevent conception; and (j) about half think that it is a good idea to participate actively in a family planning program.