Self-Assessment Questions (SAQs) for Study Session 2

Now that you have completed this study session, you can assess how well you have achieved its Learning Outcomes by answering these questions. Write your answers in your Study Diary and discuss them with your Tutor at the next Study Support Meeting. You can check your answers with the Notes on the Self-Assessment Questions at the end of this Module.

SAQ 2.1 (tests Learning Outcome 2.2)

Describe the most common family planning service delivery modes in Ethiopia and the services being given at each of them.

Answer

The most common family planning service delivery modes are as follows:

Door-to-door service delivery: these services are provided by Health Extension Practitioners and mainly include education, counselling and the provision of oral pills, condoms and injectable contraceptive methods.

Facility-based service delivery: this approach provides family planning services in Ethiopia through public health centres and hospitals. Medically complex methods, such as IUCDs, hormonal implants, and sterilisation, can be provided at these health facilities.

Read Case Study 2.1 about kebele Y and then answer the questions that follow.

Case study 2.1  The demographic and health situation in kebele Y

Kebele Y is one of the kebeles in woreda Z, having a total population of 5,000. The kebele is located 20 km away from the woreda’s health centre and town. There is one Health Post with two Health Extension Practitioners. According to a demographic and health survey (DHS), one major health problem of this kebele is a very high maternal and child mortality rate. In addition, women of the kebele, on average, are estimated to have seven live births in their lifetime. The DHS survey also reveals that 40% of couples in the kebele know only one method of contraceptive as a means of birth control, and very few, only 5% of respondents, have received orientation on using condoms to prevent pregnancy.

According to the Health Post’s annual report (5 Hamle 2002 Ethiopia Fiscal Year (EFY)), the Contraceptive Acceptance Rate (CAR) for the fiscal year was 25%. For comparison, the national target is 65%.

Hint:

  • Proportion of Women of Reproductive Age Group (WRAG) 15–49 years = 22%
  • Proportion of currently pregnant women = 4%
  • Proportion of eligible women for family planning = 18%.

SAQ 2.2 (tests Learning Outcomes 2.1 and 2.3)

Using the information in Case Study 2.1, answer the following questions. You will need to refer to Section 2.2.1 (Developing and using work plans), and the sample Gantt chart in Table 2.1.

  • a.Calculate the eligible population in kebele Y (showing the steps in your calculation).
  • b.In preparing your operational plan for the family planning programme, indicate the following:
    • Two to three possible objectives (using given baseline data).
    • List at least one major activity against each objective.
    • Suggest one or more indicators for monitoring performance.
  • c.Finally, have a go at organising your annual plan into a Gantt chart, using Table 2.1 as a guide.

Answer

a.  The number of eligible population in kebele Y is 900 women. Your working out is as follows:

Given data:

Total population = 5,000.

Proportion of women of reproductive age group (WRAG) 15–49 years = 22%

Proportion of currently pregnant women = 4%

Proportion of eligible women for family planning = 18%

Eligible population

= % WRAG ­ (% currently pregnant women) × total population

= 22% ­ 4% × 5,000
= 18% × 5,000
= 900 women.

b.  In preparing the operational plan for the family planning programme implementation, you can apply the following simple steps:

Possible objectives (you may have suggested other equally good objectives):

  1. To increase CAR from current 25% in year 2002 to 65% in year 2003. OR
  2. To provide contraceptives to 585 women of reproductive age group 15–49 years (WRAG) by the end of year 2003. OR
  3. To educate 85% of the couples on methods of contraception as a means of birth control by end of year 2003.

Possible major activities for the above objectives could be:

  1. Secure contraceptive commodities.
  2. Secure Information, Education and Communication/Behaviour Change Communication (IEC/BCC) materials.
  3. Conduct community sensitisation workshops.

Indicators for monitoring performance:

  • Number of months without contraceptive supply in stock.
  • Percentage of community members attending a sensitisation workshop.
  • Percentage of women who accept contraceptive methods.

c.  One way in which you could organise objective (1) in your work plan into a Gantt Chart is shown below:

Family planning implementation schedule (X woreda, Y health post, 2003 EFY).

Objective Major activitiesImplementation PeriodResponsible person
Hamle–MeskremTikmet–TehsasTir–megabitMiazia–Sene
(1) To increase CAR from current 25% in year 2002 to 65% in year 2003.Secure contraceptive commoditiesXMulu, Gete, Buli
Secure IEC/ BCC materialsXMulu
Conduct community sensitisation workshopsXXXMulu, Gete

SAQ 2.3 (tests Learning Outcome 2.3)

Suppose you started implementing what you have planned in kebele Y. How do you monitor progress?

Answer

You can use the following methods to monitor progress against what has been planned:

  • Conduct timely and regular supervision.
  • Carry out regular performance monitoring.
  • Conduct participatory performance review meetings.

SAQ 2.4 (tests Learning Outcome 2.3)

What are good performance indicators to measure programme outputs?

Answer

The following are some of the good performance indicators for measuring programme outputs:

  • Number of new clients, recorded by choice of contraceptive method
  • Number of households covered
  • Number of community meetings and number of people informed at sensitisation workshops
  • Number of referrals for clinical methods of contraception
  • Number of contraceptives distributed for each contraceptive method.

SAQ 2.5 (tests Learning Outcome 2.3)

List impact indicators and describe how you measure programme impact.

Answer

Programme impact in the area can be evaluated by one or more of the following indicators for the area:

  • Contraceptive prevalence rate (CPR)
  • Crude birth rate
  • Induced abortion rates (if available)
  • Total Fertility Rates (TFR)
  • Infant mortality rate
  • Maternal mortality rate
  • Rate of high-risk births (to women over 35 years who have given birth to five babies or above).

Additionally, your answer could point out that most of the impacts cannot simply be calculated from routine service data. Population-based impact evaluation/research is needed.

SAQ 2.6 (tests Learning Outcome 2.4)

(a)  Suppose you dispensed the following contraceptives over a period of six months. For each product, calculate the Average Monthly Consumption (AMC):

  • 300 cycles of Lo-femenal
  • 450 vials of Depo-Provera (DMPA)
  • 1,500 male condoms.

(b)  What would be your ‘months of supply’ if currently you had in hand:

  • 500 cycles of Lo-femenal
  • 750 vials Depo-Provera
  • 5,000 male condoms.

The first one has been done for you as an example (see below).

Product = (a)Amount dispensed during 6 months = (b)AMC = (b) ÷ 6 months = (c)Stock in hand = (d)Months of supply = (d) ÷ (c)
Lo-femenal 300 cycles50500 cycles10

Calculation:

  • AMC of Lo-femenal is 300÷6 = 50
  • Stock in hand = 500
  • Months of supply = 500÷50 = 10

So, based on current stock in hand, the provider can safely provide Lo-femenal pills for 10 more months before running out of stock.

Answer

(a)  Based on the information given, you can calculate AMC and ‘months of supply’ as follows:

Product = (a)Amount dispensed during 6 months = (b)AMC = (b) ÷ 6 months = (c)Stock in hand = (d)Months of supply = (d) ÷ (c)
Lo-femenal 300 cycles50500 cycles10
Depo-provera (DMPA)450 vials75750 vials10
Male condoms1,500 condoms2505,00020

(b)  Based on current stock in hand, you can safely provide Lo-femenal pills and Depo-provera (DMPA) for 10 more months, and male condoms for 20 months, before running out of stock.

SAQ 2.7 (tests Learning Outcome 2.5)

Describe the best ways of communicating about the family planning programme in your locality.

Answer

The following may be the best ways of communicating about the family planning programme in your kebele:

  • Use model households and community volunteers to convey family planning messages to the community.
  • Make use of traditional forms of entertainment, such as role plays, folk songs, theatre and puppet shows, in order to transmit information with regard to the programme.

Summary of Study Session 2