Project Fact Sheet

Overview:
A lack of reproductive health (RH) care is a major cause of illness and premature death among Lao women, especially those in remote ethnic communities. Women lack access to services such as modern family planning, emergency obstetrics, and prevention and management of sexually transmitted infections (STIs). For more than 75 percent of births in the last five years, there was no antenatal care and less than a quarter of deliveries were attended by health professionals

The government has identified RH and family planning services as essential components of its primary health care programme. Under UNFPA’s first Country Programme (1993-1996, LAO/93/P03), selected maternal, child health and birth spacing services were introduced in 80 provincial and district referral hospitals. In the second Country Programme (1997-2001, LAO/97/P01), selected RH and family planning services at the sub-district health centre level were expanded in response to the policy goals and objectives of the National Population and Development Policy (NPDP), adopted in 1999. An evaluation of LAO/97/P01 recommended improvements in service quality, a broadening of the range of services offered and more fully integrated service delivery at all levels, including community level.

Improving access to RH care and knowledge can not only reduce mortality and illness among women, it can reduce gender inequality and help sustain a balance between population, resources and socio-economic development.

Objectives:
· Increased availability of a core package of integrated RH services and counseling to women, men and adolescents with a special focus on members of ethnic groups. Services in selected pilot provinces include family planning, antenatal, delivery and post-natal care, reproductive tract infections, sexually transmitted infections, prevention of HIV/AIDS and management of post-abortion complications. Nationwide availability of family planning services for women, men and adolescents in the public sector is also sought.
· Strengthened capacity of relevant counterpart divisions for development of different types of behavior change communication (BCC) materials and programmes.
· Increased utilization of quality, integrated RH services and RH information to promote responsible, safe sexual behaviour among men, women and adolescents.
· To create an enabling environment for provision of quality, integrated services and information, as well as counseling on RH and reproductive rights.

Implementation:
In order to achieve the three specific outputs mentioned above, interventions and activities will include:

1. Establishing management teams for coordinated programme implementation at central, provincial and district levels
2. Conducting advocacy for reproductive rights, quality RH information and services and RH policy development;
3. Revising service and logistic reporting and recording requirements for contraceptive supplies, and developing and implementing a national RH commodity security strategy
4. Assessing capacity and training needs of service providers at all levels – taking into consideration the particular needs of ethnic groups – to delivery a core package of RH services in the selected provinces and districts. A training plan will be developed based on its results
5. Providing training on the provision of RH care and counseling, supervision and monitoring. Logistic management systems, quality of care, additional family planning methods (such as emergency contraceptive pills and vasectomies) and syndrome management of RTI/STIs at different levels is required as appropriate
6. Providing health facilities with equipment and commodities to improve delivery of a core RH package in the selected provinces and districts, including essential drugs for emergency obstetric care;
7. Conducting training for village volunteers on RH information and revolving drug funds which will include contraceptives, community-based distribution of selected contraceptives and safe delivery as appropriate;
8. Supporting multi-purpose PHC mobile teams (EPI, malaria etc.) to increase coverage of integrated health services including RH, to remote areas;
9. Promoting male involvement and responsibility in family planning and contraceptive use through community and clinic-based BCC activities;
10. Introducing RH curricula at the Faculty of Medicine and the National Institute of Public Health to address RH issues and services.
Update on achievements:
1- The percentage of women of reproductive age receiving family planning services at government facilities increased from 5.8% in 1997 to 28% in 2004;
2. The percentage of Service Delivery Points providing at least three family planning methods grew from 87% in 2003 to 92% in 2004;
3. Improved monitoring and management of contraceptives through LMIS;
4. Improved client access through expanded outreach activities integrating health services such as EPI, malaria and RH;
5. The final draft of the National RH policy has been submitted to the Minister of Health;
6. Improved coordination between and among local stakeholders through the establishment of sub-office in Saravane; and,
7. Streamlined management and financial channels through direct provincial accounts in line with decentralization