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  • Title: [Integration in family planning programs].
    Author: Trias M.
    Journal: Profamilia; 1987; 3(8):24-8. PubMed ID: 12268899.
    Abstract:
    The question of whether family planning programs should be integrated with other activities or limited strictly to contraception has been debated for years without achievement of consensus. Profamilia, the Colombian family planning organization, has been a firm advocate of a vertical program without other activities. A large body of economic and demographic data and evaluations of numerous programs in numerous places support the Profamilia position that both economic development and family planning programs are important in achieving demographic objectives, but if only 1 is possible in a given country, a good family planning program gives better results. Profamilia, a private, nonprofit organization, is responsible for 2/3 of the contraception practiced in Colombia. Profamilia's success appears to demonstrate that an effective program, even in a country no more promising otherwise than any of its neighbors, can achieve excellent results. For government-run programs, it may be politically impossible to avoid an integrated family planning program; the public is likely to question the emphasis on family planning if other urgent health needs go unattended. But even government-run programs may create separate structures with separate funding and personnel for specific problems such as malaria control, suggesting recognition of their greater efficiency. A nongovernmental organization such as Profamilia, faced with a continuing struggle for funding, must concentrate its resources on fulfilling its mission of allowing couples to decide freely on the timing and extent of their reproduction. Vertical programs, tolerant if not enthusiastic governments, and abundant demand are the 3 factors that have led to high rates of contraceptive usage in some countries; sthe contraceptive prevalence rate is 60% in Colombia. A number of studies in the late 1970s and early 1980s have shown that funds directed to family planning have a far greater demographic impact than do equal amounts directed to rural female education, nutrition, or control of infant mortality. Verticality in a family planning program should be understood to include all activities that attract potential family planning acceptors, as well as all services which generate funds that can be channeled to family planning programs and that contribute to program efficiency. Pregnancy tests, Pap smears, gynecological or urological consultations, social marketing, antiparasite campaigns, and treatments of infertility, sexually transmitted diseases, or sexual dysfunctions are all appropriate components of a vertical family planning program. True and unacceptable integration views contraception as a remote and secondary goal, while the type of "false" integration described above views family planning as its epicenter and does everything possible to promote and facilitate contraception.
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