A MAQ francophone conference followup questionnaire was sent in August 1995, 5 months
post-conference, to 76 participants (54 delegates, 16 Technical Committee members and 6
USAID HPNOs). The purpose of the questionnaire was to determine the extent to which
participants had implemented their country action plans. The following are highlights of
responses received from 56% of participants surveyed from all 10 countries represented at
the conference:
58% reported that the most significant objective of the
conference—to improve service accessibility and quality—was met to a great
extent
75% of country plans received official endorsement, primarily from heads
of FP divisions
81% of the action plans or selected activities have been integrated into
a national 5-year Maternal and Child Health (MCH)/RH/FP plan or strategy, particularly
removal of access and quality barriers, with 77% reporting the consistency of the plan
with current national objectives as a major factor in implementation
80% of respondents have become more professionally active in advocating
changes in FP/RH policies, programs and practices
However, 50% of respondents cited funding shortages as a major barrier in attempting to
implement their country action plans, with half of these respondents coming from countries
where USAID has closed its missions.
Plans have been made to conduct in-depth interviews with the delegates to determine the
extent to which the MAQ initiative has contributed to strengthening RH programs in the
region. Highlights of these interviews will be included in upcoming issues of the French
version of the MAQ bulletin.
In early June 1996, Senegal’s first FP service delivery
guidelines (SDGs) were approved by the Ministry of Health. The guidelines were drafted by
a comprehensive working group of representatives from all Senegalese FP partners including
Ministry officials, training institutions and schools, and private sector service provider
organizations. As the first family planning SDGs ever written in Senegal, their
development represents a notable milestone towards achieving FP services that are
standardized to provide maximum access and quality for Senegalese women and men.
Highlights of Senegal’s New Guidelines2
Who can provide services
- Nurses, midwives and physicians can provide IUD and Norplant implants services.3
Unnecessary physical examinations reduced
- Pelvic exams will only be required for women seeking the IUD or minilaparotomy.
Client restrictions reduced
- All methods will be available to unmarried and/or nulliparous women.
Services standardized
It is hoped the SDGs will ensure standardized and effective infection prevention (IP)
practices and reduce inconsistencies in FP services. For example, the guidelines specify
that:
- 3 packets of pills can be provided to oral contraceptive clients at the first visit
In the past, instructions regarding resupply of pills as well as the timing of return
visits for other contraceptive methods have been inconsistent. The new SDGs have
established the return visit intervals shown below in Table
1.
After field testing a variety of guideline formats to determine the most user-friendly
and appropriate way to present this new material to service providers, the guidelines will
be printed and disseminated first by means of a national launch at the end of 1996, and
then at regional level seminars for service providers. The guidelines, which are currently
written as two documents, Family Planning Policies and Norms and Protocols for Family
Planning Services, will be integrated into curricula, supervisory checklists, FP clinic
forms and IEC materials.
Table 1. Return Visit Intervals Specified in Senegal
Guidelines
| Contraceptive Method |
First Return Visit |
Subsequent Visits |
| Oral Contraceptives |
2 monthsa |
every 3 months |
| Norplant Implants |
1 month |
3 months, then every 6 months |
| Injectables |
DepoProvera: 3 months
Noristerat: 2 months |
DepoProvera: every 3 months
Noristerat: every 2 months |
| IUD |
1 month |
6 months, then one year |
| VSC |
1 week |
|
aWomen are given 3 packets of pills but asked to
return when beginning the 3rd packet (i.e., at the end of 2 months) for resupply.
2Although there were no previous guidelines in
Senegal as a baseline against which to measure the extent and range of the changes in
service delivery that these new guidelines will bring, anecdotal information about
formerly existing practices provides insight into the impact some of these changes will
have on reducing barriers to contraceptive services.
3Even before the guidelines were written, during the
introductory phase of Senegal’s Norplant implants introduction program, Senegal
granted official approval for nurses and midwives to provide Norplant implant services
(see, Senegal and Mali: Ground Breakers in Norplant Implants
Introduction). Nurses and midwives were also allowed to provide IUD services
before the guidelines were written.
More
