Promoting family planning for better health: policy and programme implications

Renewed emphasis is being given to the role of family planning health care programs. This review of the lessons learned during the past decade provides guidance to policy makers and program managers on ways to improve maternal, infant, and child health through family planning and related health and development activities. It covers policies and laws, accessibility to services, acceptability and quality of services, provision for the special needs of high-risk groups, the use of communications programs, the importance of improving the status of women and the quality of life, and the resources needed to implement such a program globally. Practical steps for integrating family planning fully into maternal and child health care are described.

Women's program impact on village women's contraceptive and reproductive behavior in rural Bangladesh

The author examines the impact on contraceptive and reproductive behavior of a social program designed to teach trade skills and family planning to women in rural Bangladesh. The focus is on "whether a social program that is designed to use a particular group as catalysts brings about any change in [the] contraceptive and reproductive behaviour of the community that is indirectly exposed to the program." A sample of 625 women indirectly exposed to the program and 312 women from non-program, control villages were interviewed; baseline data are from the 1976 Bangladesh Fertility Survey. It is found that "the indirectly exposed and unexposed women are very similar in their contraceptive and reproductive behaviour. The impact of the directly exposed women (trained women) in family planning was trivial even after three years of program operation. Socio-economic and demographic characteristics of both the groups are also similar....The current use among the indirectly exposed women was only 12% as compared to 10% for the unexposed women."

Integrated sexual healthcare: the development and review of one model of service delivery

Sexual health is topical with many factors impacting upon its concept and hence provision. In 1995 the Sexual Health Service in East Berkshire was formed by the integration of the clinical services of Family Planning, Genitourinary and HIV Medicine with Sexual Health Promotion. The philosophy of the service is to provide holistic sexual healthcare in one visit, on one site by one clinical team. This article outlines the practical developments and the strengths and weaknesses of this model of service.

Implementing the integration of component services for reproductive health

In the wake of the 1994 International Conference on Population and Development in Cairo, considerable activity has occurred both in national policymaking for reproductive health and in research on the implementation of the Cairo Program of Action. This report considers how effectively a key component of the Cairo agenda--integration of the management of sexually transmitted infections, including human immunodeficiency virus, with maternal and child health-family planning services--has been implemented. Quantitative and qualitative data are used to illuminate the difficulties faced by implementers of reproductive health programs in Ghana, Kenya, South Africa, and Zambia. In these countries, clear evidence is found of a critical need to reexamine the continuing focus on family planning services and the nature of the processes by which managers implement reproductive health policies. Implications of findings for policy and program direction are discussed.