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Paraguay
>> Regional Overview >> Paraguay Overview Activity Data Sheet
PROGRAM: Paraguay
TITLE AND NUMBER: Increased Use of Voluntary Family Planning Services, 526-003
PLANNED FY 2001 OBLIGATION AND ACCOUNT: None
PROPOSED FY 2002 OBLIGATION AND ACCOUNT: None
STATUS: Continuing
INITIAL OBLIGATION: FY 1997 ESTIMATED COMPLETION DATE: FY 2001Summary: In 1994, the Government of Paraguay (GOP) made reproductive health and family planning a priority. The Ministry of Health's (MOH's) reproductive health plan endorsed reproductive health activities and established a variety of goals aimed at fighting the country's very high maternal mortality rate and estimated annual population growth rate (2.6%). The country continues to struggle with major reforms in health, education, and family planning services. The purpose of this Special Objective is to increase current contraceptive prevalence by expanding access and use of voluntary family planning services that reduce maternal mortality and unwanted pregnancies, especially targeting poor women, rural populations and other marginalized groups.
Key Results: : Three results are being achieved under this objective: 1) access to reproductive health services is being expanded by offering these services through existing public and private facilities which do not provide them, rather than establishing new facilities; 2) the quality of reproductive health and family planning services is being improved by the establishment of a range of modern family planning methods; and 3) the sustainability of family planning services is being advanced.
Performance and Prospects: Performance has been better than expected. A national reproductive health survey has demonstrated that contraceptive prevalence for women between the ages of 15 and 49 using modern methods has gone from 35% in 1990 to 48% in 1998. This upward trend is expected to continue. Couple-years of protection is expanding as a result of contraceptives supplied by the Ministry of Health, Population Services International, and the Paraguayan Center for Population Studies, the primary local non-governmental organization (NGO) supporting family planning services. Activities to assist the private sector organize cost-effective services are being carried out through local NGOs and U.S. cooperating agencies. USAID's support for expanded access to family planning services includes the expansion of community-based and alternative distribution systems, including an innovative contraception social marketing program, to reach under-served rural and marginal urban areas. In addition, program efficiency and sustainability are addressed through training and technical assistance in contraceptive logistics management, specialized clinical training, financial and program management, and closer coordination between the public and private sector.
Most Paraguayan NGOs have limited technical capacity and financial self-sufficiency. They also lack the political weight to effectively influence how conservation of key ecoregions will be implemented. Nevertheless, NGOs with interest in these matters do exist. Some are regionally based, while others are dedicated to particular elements of the environment, such as environmental law or compatible economic development. To fully assume key roles in regional environmental policies, these NGOs require technical training in both internal management and lobbying techniques. To better coordinate with international efforts, they also require improved ties to international NGOs.
USAID has continued introducing the concept of model quality service delivery in certain regions which more directly addresses specific community needs. This model included a basic package of selected family planning services for the community and established minimum service delivery conditions that assure quality family planning. The number of quality service delivery points has expanded quite rapidly.
Possible Adjustments to Plans: As this is the last year of implementation, no changes are anticipated at this time.
Other Donor Programs: USAID assumed a leadership role in donor coordination and is leveraging additional resources toward key reproductive health results and developing new approaches that can be followed by other partners. The World Bank budgeted $22 million to decrease maternal and infant mortality in six departments in rural areas of Paraguay through improved hospital facilities and equipment, mobile health clinics, procurement of medicine and supplies, human resources training, and other activities with community outreach. The Inter-American Development Bank is implementing a similar program to provide a parallel range of services in five additional rural departments. USAID has initiated demonstration projects that both of these banks can replicate on a larger scale.
The Pan-American Health Organization (PAHO) in Paraguay is working in health sector reform; the institutional development of the MOH; epidemiological surveillance of infectious diseases; and health promotion and prevention in maternal, child, and mental health. USAID collaborates closely with PAHO on policy development.
The United Nations Fund for Population Activities (UNFPA) is a key partner. Success in attaining family planning goals is facilitated by UNFPA's assurance of continued provision of contraceptive materials through 2002 and possibly beyond. PAHO and the United Nations Children's Fund (UNICEF) also provide technical assistance to primary care programs in family planning and reproductive health. The International Planned Parenthood Federation provides funding to its local affiliate for administrative and program costs. The German Technical Cooperation Agency provides support for a targeted adolescent reproductive health program.
The Japanese International Cooperation Agency is developing a decentralized health management model in the Department of Caazapa and is coordinating with USAID and the GOP under the U.S.-Japan Common Agenda to realize recommendations in reproductive health, such as training midwives and conducting information, education, and communication campaigns.
Principal Contractors, Grantees, or Agencies: USAID implements the program through the following U.S.-based organizations: Population Services International, EngenderHealth, Johns Hopkins University, the University of North Carolina, and the Centers for Disease Control. Local organizations involved in implementation are the Paraguayan Center for Population Studies, the Information and Resources Center for Development, and Promotion for Health Improvement.
Paraguay: 526-003
Performance Measures:
Indicator FY97
(Actual)FY98
(Actual)FY99
(Actual)FY00
(Actual)FY00
(Plan)FY01
(Plan)FY02
(Plan)Indicator 1: Quality service delivery points providing services in priority regions 3 17 22 42 30 NA NA Indicator 2: Percentage of young adults using contraception at first sexual intercourse NA 35 NA 48 40 NA NA Indicator 3: Income generated by CEPEP 38 52 55 61 44 NA NA Indicator 4: Couple-years of contraceptive protection (CYP) 109,000 132,000 146,000 167,000 156,000 NA NA Indicator Information:
Indicator Level (S)or(IR) Unit of Measure Source Indicator Description Indicator 1: IR Cumulative Number Ministry of Health's yearly assessment of the number of delivery sites that fulfill the criteria defined below. A quality service delivery point is a service delivery site where trained staff, adequate supplies and suitable facilities are present simultaneously for the delivery of a basic package of family planning services to meet client needs. These services include IUD insertion, three modern methods at a minimum, counseling, and adequate follow up. Priority regions are the departments of Cordillera, Central and Missiones, plus the city of Asuncion. Indicator 2: IR Percentage The 1990 and 1995/6 National Reproductive Health Surveys and 1998 Interim Maternal and Child Health Survey conducted by the Centers for Disease Control and the Paraguayan Center for Population Studies. Contraceptive use in this age group is a measure of access, reflecting knowledge and availability of services. Indicator 3: IR Percentage Paraguayan Center for Population Studies financial records The percentage of CEPEP's operational budget covered by revenues generated from sales of commodities and fees for services. Indicator 4: SO Number The Ministry of Health, Paraguayan Center for Population Studies and Population annual reports of contraceptive supply distribution The number of couples protected from pregnancy by family planning services during a one-year period, based on the volume of all contraceptives sold or distributed during that period. U.S. Financing
(In thousands of dollars)
Obligations Expenditures Unliquidated Through September 30, 1999 2,300 DA 27 DA 2,273 DA 0 CSD 0 CSD 0 CSD 0 ESF 0 ESF 0 ESF 0 SEED 0 SEED 0 SEED 0 FSA 0 FSA 0 FSA 0 DFA 0 DFA 0 DFA Fiscal Year 2000 2,000 DA 2,357 DA 0 CSD 0 CSD 0 ESF 0 ESF 0 SEED 0 SEED 0 FSA 0 FSA 0 DFA 0 DFA Through September 30, 2000 4,300 DA 2,384 DA 1,916 DA 0 CSD 0 CSD 0 CSD 0 ESF 0 ESF 0 ESF 0 SEED 0 SEED 0 SEED 0 FSA 0 FSA 0 FSA 0 DFA 0 DFA 0 DFA Prior Year Unobligated Funds 0 DA 0 CSD 0 ESF 0 SEED 0 FSA 0 DFA Planned Fiscal Year 2001 NOA 0 DA 0 CSD 0 ESF 0 SEED 0 FSA 0 DFA Total Planned Fiscal Year 2001 0 DA 0 CSD 0 ESF 0 SEED 0 FSA 0 DFA Future Obligations Est. Total Cost Proposed Fiscal Year 2002 NOA 0 DA 0 DA 4,300 DA 0 CSD 0 CSD 0 CSD 0 ESF 0 ESF 0 ESF 0 SEED 0 SEED 0 SEED 0 FSA 0 FSA 0 FSA 0 DFA 0 DFA 0 DFA
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Last Updated on: May 29, 2002 |
