The Government of Bangladesh has made a major commitment to reducing its population growth rate and improving the health status of women and children. This commitment extends from the central level of the government all the way down to family planning programs at the village level, where existing government and private programs are being examined and restructured for greater effectiveness and increased coordination. In Bangladesh, family planning programs are being expanded to include additional community-based volunteers who can rely on the already established government clinics for back-up health, family planning, and immunization services.
The country is divided up into administrative districts called Upazilas, each of which contains approximately 200,000 people. Each Upazila is divided into unions, which are each made up of three wards. Dayamir is one of the 14 unions of the Balaganj Upazila. Dayamir has a population of some 22,000 people, which is approximately nine percent of the Upazila population. Contraceptive prevalence is estimated at 16 percent of the 3,188 eligible couples. Married couples or couples in consensual union who are potential family planning clients are called eligible couples (ELCOs).
In Dayamir, the government set up a new project to expand family planning services. The overall goals of this project are to:
The specific objectives to be achieved by the end of the first year of the project are:
Pre-project activities included: collecting demographic statistics on each union, such as population size of Upazila and the unions and the population density; counting the number of eligible couples in the union; mapping out the project area to show square kilometers, the location of villages, and the number and types of community clubs; and gathering statistical data such as the infant mortality rate, maternal mortality, immunization coverage, literacy rates, etc. These statistics form a baseline against which future results will be measured.
The main activities of the project are directed at gaining support from community leaders for family planning program initiatives, motivating eligible couples to practice family planning, updating information on contraceptive use by the couples, and distributing contraceptives. Volunteers from each community provide information and non-clinical contraceptive methods to interested couples. Volunteers are given a per diem allowance for attending monthly meetings and a semi-annual stipend in recognition of their community work.
Based on these objectives, project staff developed an annual work plan that listed the activities required to achieve each objective. For the purpose of this example, a selection of the activities developed for the first objective is listed below. The key to the abbreviations used below is below.Objective 1: To increase contraceptive prevalence from 16 percent to 40 percent by the end of the year.
| Project Activity | Month/Week | Persons Responsible | Material Resources/Cost* (Local currency = Taka) |
|---|---|---|---|
| Organize ELCOs into sub-units of 30-40 ELCOs per sub-unit (90 units total) | Jan., Feb. | FPAs, FWAs | Area maps/no cost |
| Identify households within each unit | Jan., Feb. | FWA | No cost |
| Prepare ELCO maps for volunteers | Jan., Feb. | FWA | Map preparation cost/ 90xTk.20 = Tk. 1,800 |
| Identify one volunteer per unit (90 volunteers) | Feb. | FPAs, FWAs | No cost |
| Conduct needs assessment on volunteer training | Jan., Feb. | UFPO | No cost |
| Develop training curriculum | Jan., Feb. | UFPO, MO/MCH | No cost |
| Develop training materials | Jan., Feb. | FPA, UFPO | Paper costs, copying, honorarium/Tk. 995 |
| Schedule volunteers for training (3 groups) | Feb. Week 3 | FPA | No cost |
| Train volunteers | Feb., Mar. | UFPO, MO/MCH | Transport cost/ (90 vols. x 3 days x Tk. 30) = Tk. 8,100 |
| Conduct house-to-house visits | Daily All year | FWA/Volunteer | Carrying bags/ (90 vols. xTk.100) = Tk. 9,000 |
| Supply contraceptives to new and old acceptors | Daily All year | FWA/Volunteer | No cost |
| Refer couples to clinics for permanent methods | Daily All year | FWA/Volunteer | No cost |
| Update ELCO registers | Daily | FWA | List of registers/ (90 vols.xTk.20) = Tk.1,800 |
* Because this is a public sector program, only material costs are included in the work plan. The cost of the salaries and wages paid to regular program personnel are calculated separately and included in the budget. Private sector programs, however, often incorporate the cost of staff time for each activity directly into the work plan.
In addition to the activities listed above, the work plan includes activities relating to project publicity and preparation, the selection and training of volunteers, recruitment and follow-up of family planning acceptors, reporting, administration, and monitoring and evaluation. Another Gannt chart shows a summary of some of these major activities and illustrates their chronological sequence.
Key to acronyms:
| MO/MCH: | The Medical Officer for the Maternal and Child Health Unit of the Directorate of the Ministry of Health and Family Planning |
|---|---|
| UFPO: | Upazila Family Planning Officers are responsible for implementing a coordinated family planning program throughout their respective Upazilas. |
| MA: | Medical Administrators are responsible for record-keeping at the clinic level. |
| FPA: | Family Planning Assistants assist the UFPO in managing the project in the local area and supervise FWAs. |
| FWA: | Fieldworker Assistants have considerable training; they work at the community level and supervise and help train the community volunteers. |
| FWV: | Family Welfare Visitors are often midwives and can administer injectable contraceptives. They work at the village level and/or satellite clinics. |
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