RFI: 'Sustainability of Family Planning Projects' (2)
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And by the way, is there anyone on Afro-Nets who is working in Ma-
lawi? Or does anyone know the email address for JSI (STAFH) Project
in Malawi, National Family Welfare Council?
I have been doing a fair amount of work recently with JSI-STAFH in Ma-
lawi in relation to the evaluation of the training on syndromic manage-
ment in STDs. Currently I understand that they are having problems with
their CompuServe access (only some of the staff have access anyway, and
on an individual basis) and they are trying to change their service
provider. Otherwise JSI in Boston might help.
I would like to rise just a teeny bit to the bait of Tione's further
challenging question ...
I am an MPH student at Boston University, School of Public Health. I
am completing my MPH thesis and I am writing on 'Sustainability of
Family Planning Projects', although my main focus is Malawi, but I
believe information on the whole Sub-Saharan Africa might help.
Does anyone have any information on programmes that have worked i.e.
beyond the donor's contribution, factors that lead to its success?
Information on projects that did not go beyond donor's contribution
and factors that lead to their failure?
... however, I am not sure what is meant here by 'Family Planning Proj-
ects', and the words 'success' and 'sustainability' are of course the
centre of much current debate. It seems too soon after Cairo to see the
results of any change in the Family Planning world (as opposed to the
'Development' world or even the 'Health' world) towards inclusion of a
people-centred approach, still less to find any parameter of success in
this latter regard. The parameters of success in relation to pre-Cairo
thinking (uptake of services, prevalence of contraceptive use) seem
much too well hammered even to entertain debate.
One difficulty I wouldn't mind discussing in relation to success is the
different goals and requirements of community work and service work --
since we should in theory be seeing an upsurge in people-centred work
post-Cairo. It seems clear that people working for societal changes in
relation to Sexual and Reproductive Health are doing something very
different from those working with the technologies of health. Commu-
nity-centred work evolves continually with the changes in the ways in
which people interact, and therefore requires facilitators who are po-
litically and socially adept and flexible. Service-work tends to be
pre-defined and those working with it have to have very different
skills and resources. Therefore the objectives for the work and the pa-
rameters of what is successful and how it is supported will differ
greatly. Hence what is required for sustenance will differ. Despite
this statement of the obvious, I do not believe that many of those run-
ning Family Planning programmes have thought through the implications
of this in terms of evaluation or the implications for their staff and
programmes of taking on this type of work. I would be glad to hear from
anyone who would put me right on this.
I remain discouraged by the fact that success is still rarely measured
in relation to the measures that might be established by ordinary peo-
ple for their own improvements in their sexual or reproductive health,
so it would also be nice to hear if anyone else on this discussion
group knows of family planning programmes that have moved towards rec-
ognition of the people's side of health in this way and the independ-
ence from the services of their contributions to sexual and reproduc-
tive health. I do know of sexual health programmes that are doing this,
but only of a few Family Planning programmes that have altered in this
way.
Anyway, I look forward to seeing what others might say on this. One
small thought as a stimulus: why is it so hard to find a 'failed' proj-
ect? I don't think I have ever heard one described as such in a major
conference! Ergo, the vast majority of projects have been successful?
So Tione won't have such a hard search?
Cheers,
Tony
P.S. If anyone wants a copy of a presentation on these and other impli-
cations post-Cairo that I made last month to the Working Group on Re-
productive Health in Washington, I'll be glad to send it.
--
Anthony Klouda
London (UK)
mailto:anthonyk@aklouda.demon.co.uk
or Anthony_Klouda@compuserve.com
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