1. P E R U National Family Planning and Optimal Birth Spacing Carlos Sanchez C., MD, MPH, Fellow Population Leadership Program - PLP

2. Population by Sex and Ages 2000 Almost 28 million people (2005) Annual Growth Rate: 1.6% Urban 71.9% - Rural 28.1% Birth Rate is 22.6 / 1,000 Mortality Rate is 6.2 / 1000 Life Expectancy at Birth Men 68.5 Women 73.3 Global Fertility Rate Urban 2.3 Rural 4.3 Source: National Institute of Statistics and Information (INEI) Peru - Demographic Data

3. 49% lives in poverty - 18% in extreme poverty (70% and 35% in rural areas) Literacy 88% - 40% of indigenous women do not have access to education 20% of rural households have electricity, 60% have water and 30% have sanitary sewage system. 25% of the population doesn’t have access to health care 25% of children under 5 years are chronically undernourished (5 – 80%) 50% of the population does not have access to medicines. Socio Economical Situation

4. PERU’S NATIONAL FAMILY PLANNING – BRIEF REVIEW Environment - - Politics and Public Policies - Health Sector Reform - Economic Support

5.   Client Demand and Use - - Contraceptive prevalence - 59% to 69% - - Modern Contraceptive 41% to 61% (from 18% to 40% in rural areas)   Services - -MOH -NGO’s PERU’S NATIONAL FAMILY PLANNING – BRIEF REVIEW

6. Market Segmentation PERU’S NATIONAL FAMILY PLANNING – BRIEF REVIEW

7. Financing

8. Catalyst Consortium – Pathfinder International, USAID Peru’s Optimal Birth Spacing – 2003 / 2006 – Questionnaire Field Policy and training materials - - MOH no offers policy articulating a recommended birth interval - No standards or guidelines, no service training Programmatic Implementation - Mass media no mention of benefits of birth intervals for mother and child - Newly married is not a target population Barriers to FP/Birth Spacing - “Machismo” mentality - Contraceptive products shortage - Youth restrictions

9. Awareness - Services do not consider zero parity women as being “eligible” to receive contraceptive services or counseling services to postpone first birth. Emergency contraception (EC) is available from pharmacies, not public sector. Evidence-based interventions - Increased percentage of women who have a met need for spacing, 15% in the rural areas, and 8% in the urban areas Ayacucho and Huancavelica 19% and 22% respectively Peru’s Optimal Birth Spacing – 2003 / 2006

10. Catalyst Consortium – Pathfinder International, USAID Initiative based on research - Dr. Agustín Conde-Agudelo, Rutstein, Shea, and in focused group developed in Bolivia, Perú, Egipto, India y Pakistán. Objectives: - Include OBSI guidelines in national FP norms - Sensitize health authorities - Conduct technical assistance activities – Empowerment individuals and families - Results : 93 Events with 3350 participants