PIP: Family planning in Malaysia is discussed. Family planning began in Malaysia about 15 years ago through the efforts of voluntary family Planning Associations in the various Malay states. In 1966 the Malaysian Parliament passed the National Family Planning Act setting up the National FAmily Planning Board to formulate policies and methods for the promotion and spread of family planning knowledge and practice on the grounds of health of mothers and children and welfare of the family. In 1967, the board set a target of 40,000 new acceptors of family planning and 90% of the target was reached. This represents 3% of the child-bearing married women aged 15-49. The target for 1968 of 65,000 new acceptors is being achieved. A survey of acceptors is to be carried out from December 1968 to April 1969 to ascertain how many women who accepted family planning continue to practice it. Malaysia's crude birth rate declined from 46.2 in 1957 to 37.3 in 1966 before the government program was instituted. Abortion attempts have been frequent. The main method of contraception used is oral contraceptives. According to a 1957 survey, 31% of the married women in the metropolitan areas and 2% of rural women were using contraception. Presently, in Malaysia there is a need to: 1) train personnel to provide services, 2) inform and motivate families to accept family planning, 3) continue a broad educational program, 4) reform Malaysia's antiquated abortion law, and 5) integrate family planning services more fully into the general health services of the country.
PIP: What proved to be a lively yet highly technical conference on the assessment of the acceptance and use-effctiveness of family planning methods was held in Bangkok last June by ECAFE on the initiative of Dr. C. Chandrasekaran, the regional demographic adviser. The meeting was attended by a strong contingent of demographers, sociologists and statisticans from the USA and by workers from Hong Kong, India, Indonesia, Korea, Malaysia, Pakistan, the Philippines, Singapore, Taiwan and Thailand. There were representatives of FAO, WHO and the Population Division of the UN. The conference considered and debated a wide range of issues involved in evaluation, from the definition of terms to detailed procedures in the calculation of indices and the detection of fertility trends. A certain amount of new ground was broken with the introduction of the concept of "extended use-effectiveness" (the study of pregnancy rates among acceptors of a method beyond the point of discontinuance) and the presentation of new methods of calculating births prevented by contraceptive use. Some progress was made towards laying down standards for the frequency of performance of surveys, both of K.A.P. in populations at large, and of contraceptive continuance and event-rates among acceptors. Attention was given to the special problems of evaluation presented by oral contraceptives, and by data on abortions and sterilizations. The proven usefulness of the life-table method of studying use-effectiveness was reaffirmed, and work on refining this now basic tool of evaluation was reported. A number of quite different schemes of data collection and processing for study of the characteristics of acceptors was described, and it was accepted by the participants that, although as much standardization as possible was desirable, each programme must make its own selection from the range of possibilities in the light of specific conditions. In addition to the main lines of analysis of use-effectiveness and programme effectiveness, the conference spent some time on discussion of such subjects as cost analysis, sensitive indices of fertility change, and the use of models in connection with programme study and evaluation. The specific evaluation needs and procedures of a number of countries in the ECAFE region were described. Although the conference fell far short of providing a comprehensive and agreed set of rules for the evaluation of family planning programmes. Indeed this was not its objective it admirably performed the function of acquainting theoretical and practical workers with each other's problems, and ensuring that all concerned were brought up-to-date on the progress being made in the region in the development and use of evaluation tools.
PIP: Organizational and content features of various national family planning programs are reviewed. The Thai program is cited as an example of a family planning program organized on a massive unipurpose compaign basis. The Korean and Taiwan programs have utilized special field workers while upgrading the general health care network. 3 major problems with family planning programs are: 1) the lack of experience with such programs; 2) lack of commitment at the highest political levels; and 3) medical conservatism. Utilization of all available contraceptive methods instead of reliance on 1 method would improve most programs. Nursing and auxiliary personnel could be trained to take over the work of physicians in family planning programs. This is already being done with IUD insertion and pill prescription in several programs. The postpartum tubal ligation approach has proven effective and should be extended. There is a place in all national programs for both the private and the commercial sectors. Incentives for clinics, personnel, and acceptors might spread family planning more rapidly.
PIP: A traditional birth attendant, also known as an indigenous midwife, is the main provider in many developing countries of obstetric services. Due to this unique position, the traditional birth attendant has been considered as possibly the ideal person to deliver family planning services in her local community. This consideration has influenced program policy in many countries and consequently there is information available to aid in the determination of whether to involve traditional birth attendants and, if so, how to best use them. There have been 2 opposing views in response to the involvement of traditional birth attendants. 1 view regards them as potential innovators. She is seen as ideally placed both physically and socially to act as a representative of the family planning program to her patients. The traditional birth attendant is the acknowledged and often prestigous expert on obstetrics matters, including at times traditional methods of birth control. The alternative view is less hopeful for rather than identifying the traditional birth attendant as an innovator it regards her as a firm opponent of innovation, a determined conventionalist. Pro gram experience in India, Pakistan, Indonesia and East Java and experime ntal studies in the Philippines, Malaysia, and Thailand along with anthr opological inquiries generally support the skeptical view but none of the findings imply that the traditional birth attendant should be ignored by the family planning programs. In the intermediate positions of many actual programs, the wisest plan seems to be to ensure that the potential contribution of the traditional birth attendant is neither overlooked nor exaggerated
PIP: Traditional midwives are active in most villages and many urban areas of Asia, Africa, and Latin America. They deliver babies, provide prenatal and postpartum care, teach folk methods of birth control, treat infertility, and enjoy the confidence of many women. Most official family planning programs make little or no use of these traditional midwives. Research should be conducted into the most effective ways of recruiting and rewarding midwives in family planning programs. They seem to function best when provided with adequate training, supervision, and incentives. Traditional midwives are participating in the national family planning programs in Pakistan, Indonesia, Malaysia, and the Philippines. Only in Iran do they participate in the medical aspects of family planning. Midwives in Iran do IUD insertions and their performance compares favorably with that of medical personnel.
PIP: In the 3 day workshop of the Southeast Asian Region on the Financial Management of Population/Family Planning Programs held from March 15 to 17 it was recommended that there by standardization of financial reporting procedures by country programs for population planning. Related to this recommendation was the proposal that measurement of cost benefit and cost effective analysis of country programs be undertaken by the Research and Evaluation Units of the respective population organizations in close coordination with the financial managers. Other major recommendations included: 1) closer coordination between donor agencies and policy making bodies of country programs in the disbursement of funds; 2) more exchange of experiences, ideas, technical knowledge on the financial management of country programs in the Inter G overnmental Coordinating Committee for Southeast Asian countries; and 3) inclusion of applicable financial management topics in the training of clinical staff and followup in actual operation. The priority areas identified for the Inter Governmental Coordinating Committee countries (Nepal, Malaysia, Thailand, Singapore, and the Philippines) are financial planning; generation of resources and budgeting and allocation of funds; accounting and disbursement of funds; financial management at the clinic level; use of and control of foreign aid; and cost effectiveness, benefit analysis and financial reporting.
PIP: 40 experts representing Nepal, Malaysia, Thailand, Singapore, Korea, and the Philippines participated in a 3-day workshop in Manila in March 1976 for the purpose of discussing and proposing ways of dealing with the financial problems confronting the population programs of the individual countries. The Inter-Governmental Coordinating Committee for Southeast Asia Family/Population Planning sponsored the workshop. The recommendations made at the meeting were: 1) standardization of financing reporting procedures by the region's country programs on family planning; 2) closer coordination between donor agencies and policy-making bodies of country programs in the disbursement of funds; 3) frequent exchanges of experiences, ideas, technicaL knowledge, and other matters pertaining to the financial management of such programs; and 4) inclusion of applicable financial management topics in the training of clinical staffs and those involved in follow-up operations. Additionally, a proposal was made that national population organizations or committees develop research and evaluation units. Workshop discussion sessions focused on financial planning and management, accounting and disbursement of funds, use and control of foreign aid, cost of effectiveness and benefit analysis, and financial reporting.
Matched MeSH terms: Health Planning*; Health Planning Guidelines*
PIP: At the Inter-Governmental Coordinating Committee Workshop on an Integrated Approach towards Family Planning and Health Programs held at Kuala Lumpur from March 23 to 25, 1977, the feasibility of integrating family planning with nutrition and parasite control through the proper planning of motivational considerations, resource allocation and coordination was studied in detail. Discussion focused on the experience of participating countries in generating community participation in total health programs. Malaysia reported that in the expansion of the national program into the rural areas functional integration has been the approach. In Indonesia nutrition has been an important objective of maternal and child health services. A total integrated development approach has been the objective in the Philippines where family planning information-education-communication has been integrated with nutrition programs and a pilot project on integration of family planning and parasite control has been conducted. Thailand reported on the introduction of an integrated family planning and parasite control program, while Sri Lanka reported on an integrated approach that included family planning with maternity and child health services. A recommendation of the meeting was that experimental pilot projects be established which include nutrition and parasite control elements within the framework of family planning services.