Planning and implementation of Family Planning

objectives By the end of this session, students will be able to: Discuss global goals. Analyze global situation. Identify barriers to progress. Suggest a strategy to accelerate progress. Clarify action plans. Explain strategy of primary care integration. Identify different program areas.

Introduction Planning is a process based on situation analysis that defines who does what, when, how and for how much. Planning is for tomorrow. Management is for today. Purposes of planning : 1-matching limited resources with many problems. 2-eliminate wasteful expenditure and duplication. 3-develop best course of action to accomplish objectives.

Cont. Planning includes 3 steps: 1- plan formulation. 2- implementation. 3- evaluation. A set of well defined indicators should be included to monitor the implementation of the plan of action. Planning should always identify monitoring mechanisms.

Cont. A slow progress has been made in improving reproductive and sexual health over the past decade. International development goals would not be achieved without renewed commitment by the international community. Requesting WHO to develop a strategy for accelerating progress towards attainment of international development goals and targets related to reproductive health.

GLOBAL GOALS Experience has shown that, even in low-income settings, innovative country- specific approaches can considerably reduce maternal mortality and morbidity. The challenge now is to formulate innovative national strategies for making health services accessible to the people in greatest need, such as adolescents and the poor, in order to attain international goals.

Global situation Each year, eight million pregnant, suffer life- threatening complications leading to long-term morbidities and disabilities. Globally, the maternal mortality ratio has not changed substantially over the past decade. Regional inequities: 99% of maternal deaths occur in developing countries. More than 50% of women living in the world’s poorest regions - higher than 80% in some countries - deliver their babies without the help of a skilled birth attendant.

Barriers to progress Inequities related to gender, gender disparities in health Adolescents’ exposure to risk, taboos and norms about sexuality ( child marriage, female genital mutilation and early sexual initiation) Inequities related to poverty and access to health services inadequate human resources

Cont. health-sector funding concentrate resources on specific diseases and interventions. poor performance and high turnover of health-care professionals. laws, policies and regulations may hinder access to services Social and cultural factors, women’s lack of decision-making power, Failure to use appropriate strategic planning

THE STRATEGY TO ACCELERATE PROGRESS human rights, including the right of all persons to the highest attainable standard of health. strengthening health systems capacity. improving information for priority setting. mobilizing political will. creating supportive legislative and regulatory frameworks. strengthening monitoring, evaluation and accountability.

Actions to be taken 1. Making reproductive and sexual health central to national planning and strategy development processes. 2. Ensuring that reproductive and sexual health is appropriately reflected in national health-sector plans. 3. Prioritizing reproductive and sexual health in essential service packages under health- sector reforms.

Cont. 4. New financing mechanisms such as cost sharing are being introduced, to facilitate access to services by adolescents, poor people and other disadvantaged groups, to monitor the effects of such policies and to adapt them to local conditions. 5. Determining essential requirements at all levels for numbers and distribution of health workers with the skills needed to perform reproductive and sexual health interventions.

Cont. 6. Assessing and improving work environments, conditions of employment and supervision. 7. Formulating a strategy to motivate and retain skilled personnel. 8. Promoting policies that enable health- care workers to use their skills to the full. 9. Quality in service provision.

Cont. 10. Reviewing and modifying laws and policies in order to ensure that they facilitate universal and equitable access to reproductive and sexual health education services. Improving out-reach of services for vulnerable groups e.g. urban slums, tribal population. Involving NGOs and voluntary organizations.

Cont. 13. Ensuring that regulations and standards are in place so that necessary commodities, which meet international quality standards, are available 14. Setting performance standards and devise monitoring and accountability mechanisms for the provision of services.

Integrating primary health services in middle- and low-income countries 70% of women get their contraceptive advice from GPs. An area where GPs may be the real experts. Specialists in FP are available in some areas. All interventions of fertility regulation, maternal and child health, reproductive health for both women and men are integrated together.

Cont. The concept of integrating health-care services at the primary health care level emerged out of health sector reform policies. Integration strategies vary from country to country, depending on financial sustainability aspects, availability of competent human resources, management capacity, and political commitments.

Program Areas Promoting Family Planning: To ensure that, by 2015, all primary health- care and family planning facilities are able to provide the widest range of safe and effective family planning methods. Improving Maternal and Perinatal Health: To widen the range of products and technology to improve maternal and perinatal health, especially in resource-poor settings.

Cont. Preventing Unsafe Abortion: to assist countries in reducing unsafe abortion by improving access to safe abortion, to the fullest extent allowed by law, and quality post-abortion care. Controlling Sexually Transmitted and Reproductive Tract Infections: To improve strategies for controlling (STIs) (RTIs), including strategies to prevent mother-to-child transmission of HIV.

Cont. Adolescent Reproductive Health: to develop programs, policies and guidelines integrating adolescents’ unique perspectives. Sexual Health: To promote optimal sexual health and a positive view of sexuality for women, men and young people.

Thank you