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The Population Institute released today a report (“USAID Graduation from Family Planning Assistance: Implications for Latin America”) prepared by Dr. Jane T. Bertrand at the Tulane University School of Public Health and Tropical Medicine. The report, which was finalized in October of 2011, examines how plans by USAID to phase out family planning assistance in Latin America could affect family planning and reproductive health in the region. The report looked at six countries in Latin America, including three countries that are currently scheduled for graduation (Honduras, Nicaragua, and Paraguay) and three countries that have not yet met the USAID criteria for graduation (Bolivia, Guatemala, and Haiti).
In releasing the report, Robert Walker, the President of the Population Institute, said, “USAID’s family planning assistance program in Latin America has been a great success story, but the job is far from over.” During the past forty years, contraceptive prevalence rates in the region have gone up significantly, while fertility rates and maternal and infant mortality rates have fallen dramatically. Walker warned, however, that, “Despite the gains that have been made, not all countries in the region have progressed at the same rate, and in several countries there is a continuing need for assistance from USAID, UNFPA and other donors if contraceptive security and reproductive health are to be maintained.”
In recent years, USAID has been phasing out assistance to countries in Latin America and elsewhere, based upon a set of criteria that takes into consideration the country’s fertility rate, contraceptive prevalence, the range of contraceptives that are available, and the ability of other service providers, including the commercial sector, to meet the country’s contraceptive needs.
While “graduation” is a desired outcome, it’s important that the gains that have been made are not endangered by the phase-out of family planning assistance. In some of the countries that were studied, the availability of contraceptives is still a problem, and indigenous populations, the rural poor, and adolescents, in particular, may be underserved.
The report recommends that USAID:
1) Closely monitor the situation in the graduating countries to ensure that they are able to maintain (if not increase) contraceptive prevalence and equitable FP access to all segments of the population, including the rural poor and adolescents.
2) Assist in finding sources of funding for future DHS surveys that will provide valuable data for internal purposes as well as continued tracking by the international community.
3) Continue to provide assistance to Bolivia and Guatemala, especially in reaching poor, indigenous, rural populations and adolescents, as well as systematically evaluate the strategies used as a means of better understanding how best to reach the “hard-to-reach” populations.
4) Continue to provide much-needed FP assistance to Haiti and use the experience to identify and test strategies for providing FP to internally displaced populations and in emergency settings for use in future emergencies elsewhere in the world.
5) Commission an in-depth study of USAID graduation to determine its medium-term effects on TFR and MCPR, especially among indigenous populations, the rural poor, and adolescents.
In releasing the report, the Population Institute thanked Dr. Bertrand and Tulane University for the extensive research and investigation that went into the preparation of this report, and strongly encouraged USAID to act on its recommendations. “While ‘graduation’ is an important goal,” Walker said, “we must not imperil the progress that has been made in Latin America and elsewhere.”