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PubMedDate not supplied

Sterilization approval and follow-through in Brazil.

The purpose of this study was to examine the factors that affect approval for and completion of sterilization in Rio de Janeiro. Of 2,186 new female family planning clients, 1,256 requested sterilization and 925 were approved for surgery. Among the approved women, 639 scheduled surgery and, of these, 595 were sterilized within three months of approval. While approval is dependent mainly on demographic variables, especially age and parity, follow-through by a woman is related to her education and income. The steps that a woman must complete to obtain a sterilization also affect whether she ultimately undergoes surgery. Almost no women were scheduled for sterilization during their initial clinic visit. Women who were not scheduled because they lacked certain documentation were more likely to follow through than women who, in addition to lacking documentation, were asked to switch from an inefficient contraceptive method (or no method) to a more modern one. The lessons to be learned from this study provide useful information to programs in other countries that are concerned about maintaining high standards but do not want to discourage women in their efforts to be sterilized.

Adult↗
PubMed1996

Learning shortcuts to success. Africa.

The exchange of experiences and lessons has been a feature of JOICFP's IP in Africa since the project's earliest days, particularly at the local level. At the end of 1995, this exchange system was expanded to the regional level with the swap of study teams between Zambia and Tanzania. Five personnel from Tanzania visited Zambia from October 14 to 28 and four IP personnel from Zambia visited Tanzania from November 4 to 18. For both teams the experience was one of learning and provided insights into different approaches to such areas as logistics, operational strategy, service delivery, organization setup, administration, income-generation and sustainability, data collection, analysis and reporting and cost-effectiveness. The Tanzanian team was impressed with the effective use of the health advisory committees at the village level in Zambia to reach local people. The steering committee structure ends at the ward level and not the village level in Tanzania. They also noted the strong involvement of men in the project and the dual existence of clubs for men and women. In one of the villages visited, the team joined an IP Open Day attended by over 5000. The study visit to Tanzania was also effective for the Zambian team, which was impressed with the IP system for the collection and analysis of CYP/CPR data. The members noted the close UMATI-government collaboration and joining of forces for FP service delivery. Tanzania's success with systematic CBD/CBS deployment was another impressive feature for the Zambians.

Africa↗
PubMedDate not supplied

Low-income women's perceptions of family planning service alternatives.

A sample of 665 low-income women from a predominantly rural area of north central Florida rated the value of 25 features of family planning providers and reported their perceptions of how characteristic each feature was of different types of providers. A well-trained, trustworthy and friendly staff, the presence of a doctor if you need one and a staff that is gentle with the examination were the most desirable features of family planning services. The respondents' perceptions of public health clinics suggest that the strongest qualities of such facilities are that they treat people from different backgrounds, accept Medicaid, are easy to find and teach you how to avoid pregnancy and how to take care of yourself and stay healthy. Features thought most characteristic of private physician services were a well-trained staff, privacy and the presence of a doctor if you need one. Voluntary organizations were seen as providing services for people of different backgrounds, having a friendly staff, serving as a referral agency and teaching about staying healthy and avoiding pregnancy. However, voluntary organizations were rated lower than public health clinics or private physicians on nearly all features. The total scores for public health clinics and private physicians were not significantly different from each other, but both were noticeably higher than the score for voluntary organizations. Ethnicity affected ratings dramatically, with black respondents clearly more favorable toward public health clinics and private physicians than white respondents; conversely, whites were more positive toward voluntary organizations than were blacks. For many of these low-income respondents, the high ratings of private physicians may have represented their expectations rather than their actual experience.

Adolescent↗