Evaluation of natural family planning programmes in Liberia and Zambia.
Studies to evaluate use-effectiveness and cost-effectiveness of natural family planning (NFP) were conducted in Liberia and Zambia. The Liberian programme provided uni-purpose NFP services to 1055 clients mainly in rural areas; the Zambian programme provided NFP services integrated with MCH to 2709 clients predominantly in urban areas. The one-year life table continuation and unplanned pregnancy rates were 78.9 and 4.3 per 100 woman-years in Liberia, compared to 71.2 and 8.9 in Zambia. However, high rates of loss to follow-up mandate caution in interpretation of these results, especially in Zambia. More women progressed to autonomous NFP use in Liberia (58%) than in Zambia (35.3%). However, programme costs per couple-year protection were lower in Zambia (US$25.7) than in Liberia (US$47.1). Costs per couple-year protection were higher during learning than autonomy, and declined over time. These studies suggest that NFP programmes can achieve acceptable use- and cost-effectiveness in Africa.
Gray
R H
RH
Johns Hopkins University, School of Hygiene and Public Health, Baltimore, Maryland.
Kambic
R T
RT
Lanctot
C A
CA
Martin
M C
MC
Wesley
R
R
Cremins
R
R
D000328:Adult; D003362:Cost-Benefit Analysis; D003906:Developing Countries; D005193:Family Planning Services / Q000191:economics*; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007988:Liberia; D008519:Medicine, Traditional; D012252:Natural Family Planning Methods; D011247:Pregnancy; D015024:Zambia