Development of the Zimbabwe family planning program

Family planning was introduced in Zimbabwe as a voluntary movement in the 1950s. Volunteers formed a Family Planning Association in the mid-1960s. The government became interested in family planning in the late 1960s after analysis of the 1961 population census. It gave the Family Planning Association an annual grant, allowed contraceptives to be available through Ministry of Health facilities, and allowed nonmedical personnel to initiate and resupply family planning clients with condoms and pills. But before Zimbabwe achieved independence in 1980, family planning was viewed with great suspicion by the black majority, so the program's effectiveness was limited to the urban few. A new era began after independence. The new government took over theFamily Planning Association and changed its outlook completely. Through government and international donor support, the family planning program was restructured and expanded. The number of family planning personnel more than doubled in some units. More service delivery points were set up - particularly in rural areas. And the information, education, and communication and evaluation and research units were established. Through a World Bank-assisted project (with grant funding from Norway and Denmark), the Ministry of Health began strengthening its family planning capabilities. These efforts helped increase the contraceptive prevalence rate from about 14 percent in 1982 to 43 percent in 1988. But the program's growth is beginning to stall. More effort and resources are needed if the program is to grow or even maintain its present status. Particularly important are the following: designing innovative strategies to reach hard-to-reach populations; giving more emphasis to information, education, and communication, especially for men and youths, using multimedia; involving other sectors in the delivery of family planning services; broadening the mix of contraceptive methods (especially promoting long-term and permanent methods); making use of alternative family planning delivery systems, such as the use of depot holders, volunteers, and government extension workers; establishing a national population policy; and considering cost recovery and other measures for self-sustainment and program growth.