2002 Science & Research Forum

Biosketch:

Rebecka Lundgren has worked for the Institute for Reproductive Health at Georgetown University Medical Center for almost five years. Ms. Lundgren contributes to the Institute’s operations research and behavioral research initiatives, including study design, implementation and monitoring. She has more than twelve years of experience in reproductive health research. Ms. Lundgren provides technical guidance to Institute projects in Latin America and Asia, focusing on qualitative and quantitative research, and the design and evaluation of programs for special groups such as rural families, men, adolescentand indigenous groups. Co-author: Maria Elena de Quan, Director, CEVIFA (Centro para la Educacion en la Vida Familiar), Oficina da CEVIFA, Antiguo local de la Conferencia Episcopal, Tegucigalpa, Honduras

Presentation Abstract:

Expanding Access to NFP in Honduras

Purpose. CEVIFA, a Honduran NFP organization, recently completed a diagnostic study to identify strategies to expand access to natural methods. CEVIFA offers natural methods through its Church-affiliated centers and through partnerships with public sector health services. The purpose of the diagnostic study was twofold: (1) to collect data to improve CEVIFA’s marketing and promotional strategies, and (2) to identify strategies to increase the percentage of clients learning the Billings Ovulation Method who were declared autonomous.

Methods. To assess potential demand for NFP and to identify strategies for reaching new users, in-depth interviews were conducted with sixty couples in rural and urban communities where CEVIFA provides services. To identify strategies to improve the efficiency of CEVIFA’s instruction, 48 open-ended interviews were conducted with couples at varying stages of learning the Billings method. Six couples were interviewed who planned to continue learning/using the method, and six couples were interviewed who had decided to discontinue the method at each of the following stages: outreach, initial counseling, follow-up visit, and autonomy.

Results. The results suggest that while CEVIFA is providing a valuable service to couples, they are not meeting the needs of many couples who want to use a natural method. Many couples that were using some form of periodic abstinence, most often incorrectly, were unaware of the existence of scientific, natural family planning methods. Couples who had heard of natural methods generally did not know where to go to learn how to use them. Some believed that they would be difficult and time-consuming to learn and to use. The results of the interviews with clients learning the Billings Ovulation method suggest that most were competent to use the method after three sessions.

Program Implications. Based on the results of this study, CEVIFA is currently testing a number of strategies; including 1) providing education to create a more supportive environment for natural methods; 2) marketing its services more broadly; 2) expanding services through the public health system, 3) streamlining its teaching protocol; and 4) adding the Standard Days Method (SDM) to the family planning options they offer. The SDM may appeal to couples that are interested in a method that does not require charting or observation and can be learned in one visit. It can easily be provided on a wide scale through community volunteers, thus reaching a large number of potential users. The SDM may also appeal to couples currently using some form of a calendar-based method.

Commentary:

Expanding Access to NFP in Honduras

This study looks at what needs to be done to more effectively bring natural family planning to Honduras. As we have found in the United Sates and other industrialized nations, education, marketing, and streamlining the "delivery of the goods" are all key ingredients for success. In this study there was a partnering of the church affiliated centers with public health services. Currently this has not been the approach in the United States. Should we reach out to the family planning clinics of our cities and counties and make more of an effort to reach women and couples through those systems?