The 131st Annual Meeting (November 15-19, 2003) of APHA |
Cathy Solter, CNM, MPH, Pathfinder International, 9 Galen St, Watertown, MA 02172, 6179247200 ext. 232, ghainsworth@pathfind.org and Sheila Webb, MPH, Technical Services, Pathfinder International, 9 Galen Street, Suite 217, Watertown, MA 02472.
Permanent and long-term contraceptive methods (PLTM) have advantages that make them important options for current and prospective contraceptive users. In Bangladesh, where desired family size is two children and age of marriage is low, PLTM can provide clients 20-25 years of inexpensive and convenient protection from pregnancy. Responding to declining PLTM-use rates, the NGO Service Delivery Program (NSDP) conducted a situational analysis of current clinic-level PLTM services. NSDP provides essential family health services, supporting 41 local NGOs to deliver maternal, child, reproductive, and general health services through 278 static clinics, 8,188 satellite clinics, and 6,213 community depotholders. The objectives of the assessment were to gauge the potential of the existing service delivery system to increase the quality, availability, accessibility and use of PLTM; assess training needs of providers and review existing clinical standards, guidelines, and curricula available for training in PLTM; identify equipment and supplies needed for scaling up service delivery in PLTM; and examine referral linkages among hospitals, NGOs, and the GOB. The assessment built upon findings of previous assessments and included reviewing literature; conducting in-depth interviews with policymakers, managers, service providers, community workers and clients; and visiting service delivery sites.
Findings are categorized by demand for services, access to services, and quality of services, and include: there is unmet demand for PLTM—albeit of unknown size; there are several policy barriers limiting access to PLTM, despite efforts to reduce these; sterilization-related mortality has decreased dramatically; and training of providers needs to be standardized and better followed up.
Learning Objectives:
Keywords: Family Planning, Developing Countries
Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.