Research changes government policy in Zambia
Progress in human reproduction research 1996(38): 5-6
1996
ISSN/ISBN: 1564-0655 PMID: 12320519 Document Number: 301848
An assessment of contraceptive needs undertaken in Zambia in 1995 resulted in calls for fundamental changes in the provision of reproductive health services. The assessment team found that use of the diaphragm, IUD, foam, injectables, and implants was negligible due to constraints in the service delivery system, client and provider misinformation, and weaknesses in the management support system. Increases in the number of methods available at a given service delivery point did not, in themselves, enhance contraceptive choice. For example, many clinics in the 13 districts visited had adequate IUD supplies; however, they lacked personnel with the experience to perform pelvic examinations, detect sexually transmitted diseases, or insert the device. A review of these findings at a national workshop attended by 120 community and government representatives led to the recommendation that user-friendly service delivery guidelines be developed and field-tested and--ultimately--to production of the document, "Family Planning in Reproductive Health: Policy Framework and Guidelines." The Ministry of Health has adopted these guidelines as its future agenda for health services research. Any introduction of new contraceptive methods will be based on an assessment of both users' needs and service capabilities. For example, Norplant will be available only at a small number of urban centers capable of backing up this method with adequate program support and quality of care. The assessment was conducted according to a three-stage model devised by the UNDP/UNFPA/WHO/World Bank Special Program of Research, Development, and Research Training in Human Reproduction. Stage II research will accompany the introduction of Depo-Provera to selected Zambian districts and explore the need for emergency contraception.