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Evaluation of natural family planning programmes in Liberia and Zambia

Published online by Cambridge University Press:  31 July 2008

Ronald H. Gray
Affiliation:
Johns Hopkins University, School of Hygiene and Public Health, Baltimore, Maryland, USA.
Robert T. Kambic
Affiliation:
Johns Hopkins University, School of Hygiene and Public Health, Baltimore, Maryland, USA.
Claude A. Lanctot
Affiliation:
International Federation for Family Life Promotion, Washington, DC, USA.
Mary C. Martin
Affiliation:
International Federation for Family Life Promotion, Washington, DC, USA.
Roselind Wesley
Affiliation:
Family Life Office, Archdiocese of Monrovia, Liberia
Richard Cremins
Affiliation:
Family Life Movement of Zambia, Lusaka, Zambia

Summary

Studies to evaluate use-effectiveness and cost-effectiveness of natural family planning (NFP) were conducted in Liberia and Zambia. The Liberian programme provided uni-purpose NFP services to 1055 clients mainly in rural areas; the Zambian programme provided NFP services integrated with MCH to 2709 clients predominantly in urban areas. The one-year life table continuation and unplanned pregnancy rates were 78·9 and 4·3 per 100 women-years in Liberia, compared to 71·2 and 8·9 in Zambia. However, high rates of loss to follow-up mandate caution in interpretation of these results, especially in Zambia. More women progressed to autonomous NFP use in Liberia (58%) than in Zambia (35·3%). However, programme costs per couple-year protection were lower in Zambia (US$25·7) than in Liberia (US$47·1). Costs per couple-year protection were higher during learning than autonomy, and declined over time. These studies suggest that NFP programmes can achieve acceptable use-and cost-effectiveness in Africa.

Type
Research Article
Copyright
Copyright © Cambridge University Press 1993

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References

Bertrand, J. T., Mangani, N., Mansilu, M., McBride, M. E. & Tharp, J. L. (1986) Strategies for family planning service delivery in Bas Zaire. Int. Fam. Plann. Perspect. 12, 108.CrossRefGoogle Scholar
Chieh-Johnson, D., Cross, A. R., Way, A. A. & Sullivan, J. M. (1988) Republic of Liberia: Liberian Demographic and Health Survey, pp. 3940. Ministry of Planning and Economic Affairs, Monrovia, Liberia; and Institute for Resource Development Westinghouse, Columbia, Maryland.Google Scholar
Farley, T. M. M. (1986) Life-table methods for contraceptive research. Statist. Med. 5, 475.CrossRefGoogle ScholarPubMed
Huber, S. C. & Harvey, P. D. (1989) Family planning programmes in ten developing countries: cost effectiveness by mode of service delivery. J. biosoc. Sci. 21, 267.CrossRefGoogle ScholarPubMed
Jamieson, E. (1989) World Population Profile: 1989, p. 64. US Department of Commerce, Bureau of the Census, Government Printing Office, Washington, DC.Google Scholar
Kambic, R. T. & Gray, R. H. (1991) Factors related to autonomy and discontinuation of use of natural family planning for women in Liberia and Zambia. Am. J. Obstet. Gynec. 165, 2060.CrossRefGoogle ScholarPubMed
Kambic, R. T. & Martin, M. C. (1988) Evaluating client autonomy in natural family planning. Adv. Contracept. 4, 221.CrossRefGoogle ScholarPubMed
Kulkarni, P. M. & Potter, G. R. (1976) Extrapolation of IUD continuation curves. Popul. Stud. 30, 353.CrossRefGoogle ScholarPubMed
Labbok, M. & Shah, F. (1988) Operations Research Findings in Four Church-sponsored Programmes in Kenya. IIP Occasional Paper No. 3. Institute for International Programmes, Johns Hopkins University, Baltimore.Google Scholar
Liskin, L. S. & Fox, G. (1981) Periodic Abstinence. Population Reports Series I, No. 3, pp. 3371. Johns Hopkins University, Baltimore.Google Scholar
Potter, R. G. (1973) Application of life table techniques to measurement of contraception effectiveness. In: Single and Multiple Decrement Life Table Procedures for the Analysis of the Use Effectiveness of Contraception, p. 1. Edited by Sinquefield, J. C. University of Chicago Community and Family Study Centre, Chicago.Google Scholar
Reynolds, J. & Gaspar, K. C. (1985) Cost Effectiveness Analysis. PRICOR, Centre for Human Services, Chevy Chase, Maryland.Google Scholar
Rider, R. V. & Tayback, M. (1983) A note concerning the couple years protection (CYP) index adjusted for age. In: Evaluating Population Programmes: International Experience with Cost Effective Analysis and Cost Benefit Analysis, p. 217. Edited by I, Sirageldin & D, Salkever. St Martins Press, New York.Google Scholar
Ross, J. A., Rich, M., Moszan, J. P. & Penak, M. (1988) Family Planning and Child Survival: 100 Developing Countries. Centre for Population and Family Health, Columbia University, New York.Google Scholar
Sheon, A. R. & Stanton, C. (1989) Use of periodic abstinence and knowledge of the fertile period in 12 developing countries. Int. Fam. Plann. Perspect. 15, 29.CrossRefGoogle Scholar
Trussell, J. & Grummer-Strawn, L. (1990) Contraceptive failure of the ovulation method of periodic abstinence. Int. Fam. Plann. Perspect. 16, 5.CrossRefGoogle Scholar
WHO Task Force on Methods for the Determination of the Fertile Period (1981) A prospective multicentre trial of the ovulation method of natural family planning. II. The effectiveness phase. Fert. Steril. 36, 591.CrossRefGoogle Scholar
Wishik, S. M. & Chen, K. (1973) Couple-years of Protection: A Measure of Family Planning Programme Output. International Institute for the Study of Human Reproduction, Columbia University, New York.Google Scholar
World Health Organization/British Life Assurance Trust (1982) Family Fertility Education: A Resource Package for Teachers of Natural Family Planning Methods. WHO, Geneva.Google Scholar