2002 Science & Research Forum

Authors:

Dr Loveleen Johri, MD, DNB (Obs&Gyn), DGO, Technical Specialist (Birth Spacing and Safe Motherhood), Population & Reproductive Health Sector, CARE India, New Delhi, India, main author. Co authors: Dr Y P Gupta, Sector Director, Population & Reproductive Health Sector, CARE India, New Delhi, India and Rebecka Lundgren, Clinical Researcher, Georgetown University, Washington, DC, USA

Presentation Abstract:

Introduction and Adaptation of the Standard Days Method in a Community Based Rural Reproductive Health Program in India

CARE India, in collaboration with Georgetown University, Washington has introduced an operations research on the Standard Days Method (SDM) in one of their rural, community based, reproductive health programs in Uttar Pradesh, India. The Standard Days Method is a knowledge based fertility awareness method of family planning. The method is based on educating women about their fertile and infertile days. For this, a necklace has been developed by Georgetown University, Washington, and adapted and field-tested by CARE India, to use as a tool to educate illiterate women about their fertile and infertile periods.

Uttar Pradesh, where this research is being conducted, is one of the four most backward and populous states in India having various reproductive health indicators much below the national averages. The unmet need for all family planning methods has been estimated to be about thirty percent (National Family Health Survey, India). The ongoing project addresses the reproductive health needs of the community through educating and empowering men and women on their reproductive health rights and generates demand for the services on one hand and improves the service delivery aspect on the other side. The project also addresses gender issues and has good male involvement.

The operations research on the SDM was introduced in the project with the objectives of testing the incorporation of the natural method of family planning into CARE`s reproductive health programs in Uttar Pradesh and determining whether male and female volunteers can successfully teach the method. Another objective was to explore user satisfaction; effectiveness and continuation rates of the SDM in a community based reproductive health program. Since the project has a good number of male volunteers also, the project will also compare the effect of providing information and counseling on the SDM to women alone, versus providing counseling to men and women both. The operations research study results will provide vital information to guide the potential expansion of the SDM into government family planning program.

The SDM is being introduced through the volunteers selected from the community in the rural areas of Sitapur district of Uttar Pradesh. The method is being implemented in 48 villages (24 women focused villages and 24 villages as an experimental model with male involvement). The research began in April 2001. Some of the preliminary findings of baseline survey show that the women and men in these areas had no knowledge of their fertility. Women did not know about their fertile and infertile periods even though some were using some form of periodic abstinence. Those who did know, had wrong information. This paper shares the study design, project implementation strategies and preliminary findings from the baseline survey.

Commentary:

Introduction and Adaptation of the Standard Days Method in a Community-Based Rural Reproductive Health Program in India

The Standard Days Method (SDM) is one of a number of natural family planning options for couples. It is a method that can be easily learned, and has a reasonable effectiveness in women who have normal cycle lengths with little variability. This pilot study focuses on some of the poorest in India, a country where it is estimated that one third of the population has unmet family planning needs. It has a community health perspective, acknowledges the need for better education and delivery of service, and supports the idea of having men and women involved in the teaching process. If successful, the program could be expanded into other reproductive health programs throughout India.