Pakistan:The Medical Social Research Project at Lulliani

Abstract

The activities of the Medical Social Research Project (MESOREP) ope rating in Lulliani Pakistan in cooperation with the Population Council the University of Punjab and the Pakistan Ministry of Health is the suject of this report. The program focused on gaining community leader support meeting the health needs of the community while promoting family planning and conducting an intensive educational program. The educational program was carried out by the development of family planning visual aids training courses in family family planning for influential members of the community and midwives performing skits with a family planning theme home visits by male and female social workers to couples with 3 or more children conducting pediatric gynecological and family planning clinics at the Health Center and organizing volunteers and shopkeepers for the promotion of family planning and the distribution of contraceptives. The Health Center provides free gynecological and contraceptive services and performs IUD insertions. After 17 months 233 clients (12% of the total married fer tile women) from Lulliani and 343 clients from outlying areas were taken into the program. Midwives appeared to be the most effective in persuading clients to accept an IUD. About 20% of the couples visited at home accepted an IUD though the cost of the net increase in IUD users provided by home visits is high (Rs. 500 = U.S. $105 per insertion). Of the conventional contraceptives used 70% of the patients use vaginal foam and 23% use the condom. An oral contraceptive study conducted by MESOREP at Ali Raza Abad showed that only 4 of the 45 women neglected to take their pill more than 2 days. Among the conclusions presented it was judged that 1) a program of maternal medical and nutritional care is an effective setting for recruiting family planning clients; 2) midwives can be helpful in promoting family planned if they are monetarily compensated; 3) negative reports of side-effects with IUDs can inhibit word-of-mouth promotion method; 4) trained volunteers are effective in creating a favorable climate for further promotional efforts; and 5) illiterate village women are capable of regular and continued use of oral contraceptives.