HEADLINES OF THE DAY: ANOTHER 15,000 PEOPLE DIED YESTERDAY BECAUSE THEY WERE TOO POOR TO LIVE. THE RICH INCREASED THEIR WEALTH YESTERDAY BY $0.3 BILLION. THE 21st CENTURY VERSION OF THE FRENCH REVOLUTION IS ONE DAY NEARER.
“O Ye rich ones on earth! The poor in your midst are My trust; guard ye My trust, and be not intent only on your own ease.”
Bahá’u’lláh
A preview of the unpublished book A CIVILIZATION WITHOUT A VISION WILL PERISH: AN INDEPENDENT SEARCH FOR THE TRUTH by David Willis at willisdavid167@gmail.com. CHAPTER 1: INDIFFERENCE TO POVERTY (Part 91). This blog is a continuation of the review of ENDING GLOBAL POVERTY: A GUIDE TO WHAT WORKS by Stephen C. Smith, published in 2005.
A culture of family planning
This program began in 1996 with a mission to improve the health status of women and children. In CARE’s program, an extension agent (or profession trainer) lives in a village for several months, working in a cluster of between four and nine villages with a local peasant’s association. The goal is to help establish “a culture of family planning” and a framework for community health. The CARE agent begins by identifying and working actively with natural leaders in these villages – people CARE calls “opinion leaders” rather than “political leaders.”
A key role as change-agents
The extension agent works to persuade these leaders of the importance of family planning. The leaders in turn play a key role as “change-agents” by convincing others, partly by setting an example through their own behavior. The CARE agent and community leaders often meet, sitting together in a large circle outdoors, to discuss family planning, health issues, or other concerns raised by participants. With the assistance of these opinion leaders, the CARE extension agent then identifies an appropriate local resident who was respected in the community and would serve as the reproductive health representative after the extension agent had transferred to another village.
Program financial sustainability
In the first months after moving on to another community, the CARE extension agent makes a few brief return visits for training. After that point there is follow up from the Ethiopian Ministry of Health, including programs to involve the representatives in immunization, in an anti-polio campaign, and in the distribution of Vitamin A supplements. The involvement of the ministry is intended to help promote program financial sustainability.
CARE says it works with tacit approval of the official leaders, by making courtesy calls to officials, introducing visitors, symbolically demonstrating respect and acceptance of their authority.
During a five-year project from 1996 to 2001, CARE extension workers trained and established 344 community representatives potentially serving some 260,000 villagers.
Contraceptive use rose from 4% to 24% in the Oromiya region south of Addis Ababa. The program worked better where men were more actively involved.
As of the end of 2004 these village family planning representatives were still active and linked to nearby government health facilities for supplies and technical support. This linkage is an important phase in the assumption of responsibility for the program by the local government.
An adequate, steady supply of contraceptives
Ensuring that an adequate, steady supply of contraceptives for the village was available after the launch was very important to maintaining use. If costs of contraception cannot be kept very low, the villagers cannot afford them, so continued subsidies will likely be needed for some time. Consistent involvement by community based organizations and the Ethiopian government is needed to ensure the new “culture of family planning.” In this way, an escape from the high fertility trap might be secured.