7TH SEMINAR OF THE EUROPEAN

SOCIETY OF CONTRACEPTION

Contraception Practice in Europe: Differences in Availability and

Accessibility

12-13 September, 2003Budapest, Hungary

Community-based Health Service Approach For Effective Family

Planning

Prof. Dr. S. Sinan ÖZALPOsmangazi University Faculty of MedicineDepartment of Obstetrics and GynecologyEskisehir, Turkey

CBHS Programs

These programs should focus on: Common and important health

problems of the community Health problems for which there are

effective remedies Services and supplies that are relatively

safe and easy to deliver

CBHS Programs

In these programs: Lay workers from the community

provide important services and supplies with minimal reliance on clinics, professional medical personnel, or complex diagnostic, screening, and record-keeping procedures.

CBHS Approach For Effective FP

FP is one of several primary health measures that can be delivered safely, effectively, and cheaply through CBHS.

CBHS Approach For Effective FP  

This method increases access to services andsupplies in four ways:

By overcoming geographical barriers By overcoming cost barriers By eliminating bureaucratic problems By overcoming cultural and communication

barriers

CBHS Approach For Effective FP

The aim of this presentation is to discuss CBHS model for effective FP

Two projects that were implemented by using the CBHS model are discussed.

CBHS Approach For Effective FP

The aim of the first project was to inform men on FP and sexually transmitted diseases and therefore to contribute to the improvement of family health by exhibiting a model of well established relationship between the volunteers and governmental organizations

The project was designed by the FPAT and submitted to the Ministry of Health. Within the framework the protocol signed upon the approval of the MH and with the financial support of GTZ)

OOzalp S., Hassa H., Koral S., Cevikbilen T., Satiroglu H.: The project on health education of men on zalp S., Hassa H., Koral S., Cevikbilen T., Satiroglu H.: The project on health education of men on family planning and sexually transmitted diseases in the province of Balikesir, Turkey. family planning and sexually transmitted diseases in the province of Balikesir, Turkey. 7th Congress of the European Society of Contraception, 10-13 April, 2002, Genoa, Italy).

CBHS Approach For Effective FP

Education was given by 24 male community workers who were trained by conferences, group meetings and panels.

Information, education and communication materials were developed and distributed.

The members of the local and national mass media were informed on the project activities as well as reproductive and sexual health and their support was ensured.

CBHS Approach For Effective FP

Total of 12.945 men were informed through personal talks by the male community workers.

At the end of the project, the ratio of those who reported to use the FP methods were increased from 57.8 to 79.2%.

CBHS Approach For Effective FP

From this project, it was found that well-organized man to man education was very effective in male involvement for family planning and STD prevention

CBHS Approach For Effective FP The aim of the second project was to mobilize the community’s

own resources, and women leaders and field supervisors were selected and trained to take part in fieldwork

This project was a part of ‘Safe Motherhood Project’ of FPAT and received financial support from UNFPA and was implemented under a sub-contract to the Ministry of Health ‘Global Safe Motherhood Project’.

There were 10.557 married women in the area and %98.4 were reached.

Ozalp S., Koral S., Topkara N.: The influence of community-based health service approach on effective contraceptive choice in a slum area of Ankara, Turkey. Contraceptive Choices and Realities, eds, van Lunsen RHW, Unzeitig V, Creatsas G. The Parthenon Publishing Group, New York. 2000, p. 221-227).

CBHS Approach For Effective FP

As a result of information/motivation during house visits, 36% of women using modern methods were raised to 74.6%.

Majority of the women were educated on family planning, motivated to use an effective method and change of behavior was accomplished.

CBHS Approach For Effective FP

How the system works: Most CBHS programs are started by voluntary

agencies, often with support from the International Voluntary Organisations

Contributions from the local community, including fees for service

Governments may provide medical backup and partial funding

Some programs have substantial research components

CBHS Approach For Effective FP

Difficulties in a CBHS programs Recruiting and training workers Providing continued supervision Coordinating backup with the existing medical system keeping supplies flowing

Evaluating the program and revising it as needed.

CBHS Approach For Effective FP

What happens when the financial support ceases in CBHS system Effect of the project may continue (how long and how effective?)

The continuation and evaluation of the activities may become a problem (when and at what degree?)

CBHS Approach For Effective FP

Conclusions Research is needed to evaluate the effect of the previous projects after the financial support ceases

For the new projects, continuity of the services after the project ends, must be a part of the project