Provision of Family Planning Services in Lesotho

'Maletela Tuoane, Nyovani Janet Madise and Ian Diamond
International Family Planning Perspectives
Vol. 30, No. 2 (Jun., 2004), pp. 77-86
Published by: Guttmacher Institute
Stable URL: http://www.jstor.org/stable/3181030
Page Count: 10
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Provision of Family Planning Services in Lesotho
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Abstract

Context: One of Lesotho's population goals is to achieve replacement-level fertility by 2011, but the contraceptive prevalence rate of 41% is considerably below the target of 70-75%. Methods: A situation analysis framework was used to assess family planning providers' readiness to provide services and women's perceptions of service delivery. Data were collected in 1997-1998 through surveys of 38 service delivery points and 52 providers, and focus group discussions with 50 women. Results: Most facilities were open five days a week, during working hours; closure during lunchtime and on weekends restricted access by employed people. There were no clear guidelines on the provision of family planning methods, and providers created their own rules and restrictions. Some women were discouraged by provider bias, lack of visual privacy and recurrent shortages of their preferred brand of pills. Although the government had a uniform pricing policy for contraceptive methods, costs varied and generally were higher in rural than in urban areas. In rural areas, transportation costs increased the overall cost of using family planning methods. Conclusions: Expanding women's access to service sites, developing guidelines for family planning providers and ensuring that standard prices are adopted should be government priorities if contraceptive prevalence is to increase. /// [Spanish] Contexto: Una de las metas demográficas de Lesotho es lograr el nivel de reemplazo de la fecundidad para el año 2011, aunque la tasa actual de prevalencia de anticonceptivos del 41% es considerablemente inferior a la meta fijada del 70-75%. Métodos: Se utilizó un marco resultante de un análisis de situación para evaluar la disponibilidad de los proveedores de servicios de planificación familiar para ofrecer esos servicios y las percepciones de las mujeres con respecto a la distribución de los mismos. Se recopilaron datos en 1997-1998 a través de encuestas realizadas en 38 lugares de distribución de servicios y con 52 proveedores, y se mantuvieron reuniones de grupos focales con 50 mujeres. Resultados: La mayoría de las instalaciones estaban abiertas al público durante cinco días de la semana, en horas regulares de oficina; se mantenían cerradas durante la hora de almuerzo y los fines de semana, lo cual restringía el acceso a las personas empleadas. No había directrices claras sobre el suministro de métodos de planificación familiar y los proveedores establecieron sus propias reglas y restricciones. Algunas mujeres se sintieron desalentadas por una actitud de prejuicio de los proveedores, la falta de privacidad y los frecuentes casos de escasez de la marca de las píldoras anticonceptivas preferidas. Si bien el gobierno tenía una política uniforme con respecto a los precios de los métodos anticonceptivos, el costo variaba y generalmente era más elevado en las zonas rurales que en los centros urbanos. En las zonas rurales, los costos del transporte aumentaban aún más el costo general de los métodos de planificación familiar. Conclusiones: Si el gobierno considera que es prioritario incrementar la prevalencia del uso de anticonceptivos, se deberá facilitar el acceso de las mujeres a las instalaciones de expendio de servicios de planificación familiar, desarrollar directrices para ser utilizadas por los proveedores de estos servicios y asegurar que se respeten los precios regulares de los métodos anticonceptivos. /// [French] Contexte: L'un des objectifs démographiques du Lesotho est d'atteindre une fécondité de remplacement d'ici 2011. Le taux de prévalence contraceptive de 41% est toutefois largement inférieur à la cible de 70% à 75%. Méthodes: Un cadre d'analyse de situation a servi à évaluer la disposition des prestataires de planning familial à offrir leurs services et les perceptions féminines des prestations reçues. Les données ont été recueillies en 1997-1998 au moyen d'enquêtes menées auprès de 38 points de prestations et 52 prestataires, ainsi que de discussions de groupe avec 50 femmes. Résultats: La plupart des établissements étaient ouverts cinq jours par semaine, pendant les heures de bureau. Leur fermeture à l'heure du déjeuner et le week-end en limitait l'accès aux travailleuses. Il n'existait aucune directive claire quant à l'offre de méthodes de planning familial. Les prestataires définissaient eux-mêmes leurs règles et restrictions. Certaines femmes étaient découragées par le parti pris des prestataires, l'absence de confidentialité visuelle et les pénuries répétées de leur marque de pilule préférée. Malgré la politique tarifaire uniforme établie par l'État pour les méthodes contraceptives, les coûts étaient variables et généralement plus élevés en milieu rural qu'urbain. En milieu rural, les frais de transport accroissaient le coût global des méthodes de planning familial. Conclusions: Pour qu'augmente la prévalence contraceptive, l'État doit accorder la priorité à l'élargissement de l'accès des femmes aux lieux de prestations, à l'établissement de directives applicables aux prestataires de services de planning familial et à l'assurance de prix uniformes.

Notes and References

This item contains 37 references.

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