New Ways to Deliver Family Planning Services in Sub-Saharan Africa: A Regional Conference

Abstract

100 representatives from a diversity of backgrounds representing 29 Sub-Saharan African countries met in 1986 in Harare Zimbabwe to discuss FP program design. Zimbabwe served as a good host country because of the success of its FP program which has covered 80% of its population through community-based distribution and through the training of 600 local workers. Nigerian market-based programs have set health workers up in public market places to sell subsidized contraceptives and other health aids to women who come to shop for other items. Non-health worker vendors have also been used although they cannot sell oral contraceptives and their wares are not subsidized and therefore expensive. In Kenya the demand for contraceptives appears not to be met by the government FP programs that serve 58% of contraceptive users and efforts are being made to introduce FP to health services provided by religious hospitals and private companies and an important Kenyan womens organization. Social marketing programs have been initiated in Ghana with the support of a pharmaceutical company. Pharmacists have been trained and the willingness of some government officials to permit the advertising of contraceptives has been overcome. Some other problems have included the expensiveness of quality programs like the Zimbabwean program; the instability of governments and government funding; the unwillingness of Western-trained physicians to give up professional ground; the controversial question of using illiterate health workers for distribution; and conservative attitudes especially among African men.