| SAPLER Population Trust | |
| Splendidly Alive People Within Limited Environmental Resources | |
Family Planning Motivation, Support and Services as an Essential Part of Population Stabilisation in South Africa
Report by: The SAPLER Population Trust
May 1995
Think Global Act Local (and spiral up to self-help as soon as possible)
ZA 303 (56) SAPLER Population Trust Review
This report is the result of a grant given by the Goldfields Foundation to the SA Nature Foundation on March 1, 1994, for a survey on the unmet need for family planning in South Africa.
The survey was undertaken by the SAPLER Population Trust and the work was done by Caroline Argent, Julian Weinberg and Ann Weinberg. The reports on Natal and on the Winterveld project were written by Caroline Argent, the report on Sterilisation by Julian Weinberg and the rest of the report by Ann Weinberg.
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(For references see Index)
It is now internationally recognised that there is an "unmet need for family planning" in developing nations. This means that there are millions of women who would use family planning if it was properly explained to them and if opportunities to begin using it were in place.
This has been long understood by Peter Dodds who started a rural family planning scheme in Rhodesia/Zimbabwe in the 1970s. He found that there was always one woman in no matter how isolated a place who immediately understood the point of planning her family. She herself was then used to start a grassroots scheme. Once this was in place, the community, including the men, began to accept it.
With thanks:
To Johannes Jordaan. Firstly for writing his book, Population Growth - Our Time Bomb. Anyone in doubt about the dangers of overpopulation can read his Foreword in Appendix (i). Thankyou too for the Baruch quote, for the Paarl motivation page and - perhaps above all at this moment in South Africa - for the page on Jamaica.
To Peter Dodds. For his persistent and insistent and very securely based conviction that lay people can be taught family planning techniques. Also for permission to use extracts from his letters to me.
To John Hanks. For his suggestion that this survey be done, and to the Southern African Nature Foundation (SANF), of which he is the director, for administering the funds.
To The Goldfields Foundation for funding the survey, and particularly to Willie Jacobs for seeing the point of doing it.
To Ian Macdonald of SANF - for modifying my exasperation.
To Letitia Enslin and her team of TPA workers. For being prepared to defy the government by continuing to do family planning motivation and support after being told not to, and for their willingness to share their insights with us.
To Dr Pohl de Villiers. For being the only person in South Africa who sees to it that all four steps are all the time in place: Grand motivation, practical motivation, support, and services.
To Dr Liz Standing. For starting the Bekimpilo Trust and understanding the value of prevention.
To Shirley Ngwenya and Mankuba Ramalepe. For their lively and practical attitudes - and for not being "politically correct".
To Sister Siphiwe Ubisi for her eagerness to embrace the SAPLER - nompilo scheme.
To Sally Sawyer. For the Ecolink booklets, and for permission to quote from Our Family.
To Frances Gamble, for permission to use the Enviroteach articles.
To People and the Planet. For the quality of their articles and for their open permission to use material.
To John Kane-Berman. For understanding that when the old RSA budget was put together with the old homelands budgets, the black people in the old RSA would receive less than they had before.
For conversations and/or material from Mitchell Warren of the Society for Family Health, Anne Halsted of Marie Stopes International, Marj Dyer of ARAG, Diana Darvell of SteriPlan, Jay Parsons of UNFPA, Dr Clive Evian, Helen Schneider and Natalie Stockton.
For reports from WHO/Ministry of Health, Western Cape Population Forum, PDP, TPA, Planned Parenthood (PPASA).
To The Women's Project (Wits). For permission to use the article from the Women's Health Conference News.
For quotes from Dr Ayo Ajayi and AVSSA.
For reprints from Time magazine, Scientific American, the Star, and Donald Henderson (WHO).
To all the hospitals and health departments who sent us statistics.
To all the people mentioned in this report for their willingness to talk to us about the issues.
To Jane Furze Hospital, Wits Rural Facility and the Hans Merensky Estate for accommodation.
To Zanele Mfono, for her loyalty to the youth and for all our conversations and arguments.
To Caroline Argent. Without her there would be no "Winterveld Project". She has doggedly gone to Winterveld in all weathers and at all times, including Sunday mornings. She has had to fix the car several times on her own, because of the impossible Winterveld roads. She has been shot at. She has listened and listened and listened to the people of Winterveld and overcome numerous hitches.
To Julian Weinberg. For reading Paul Harrison and Paul Ehrlich and being convinced by them. For thereafter giving his loyal support to SAPLER. For getting the entire survey going with his phonecalls to people all over the Transvaal. These conversations have been written down by him in clear writing and are available at SAPLER .or anyone to read.
And for the sterilisation survey.
Ann Weinberg
Johannesburg
27 April 1995
Explanations and Abbreviations
SUSTAINABILITY IS THE BOTTOM LINE: This statement means that humans must behave in such a way that organic life on the planet can continue.
Places:
SA South Africa since April 1994. The New South Africa. Includes the ten homelands. When Southern Africa is meant the words will be spelt out.
Homelands: This refers to all ten previous so-called independent states, i.e. Transkei, Ciskei, Venda and Bop plus the self-governing territories of Gazankulu, Lebowa, Kangwane, KwaNdebele, KwaZulu and QuaQua.
RSA The previous Republic of South Africa, which excluded the ten homelands.
The provinces: The old provinces of the RSA, i.e. Transvaal, Natal, OFS and the Cape. The budgets of the nine new provinces will be in place from April 1995.
Organisations and Workers:
Advisers: People trained by the NFPP to teach family planning methods.
ARAG - Abortion Reform Action Group
AVSSA - Association for Voluntary Sterilisation in SA
CHWs - Community Health Workers. They inform and help in health matters but are not trained as nurses.
ICPD - International Conference on Population and Development, held in Cairo in September 1994.
NFPP - National Family Planning Programme (1975)
NPA - Natal Provincial Administration
NPPHCN - The same as PPHCN with the word "National" added.
PA - "Provincial Administration". Used by the TPA.
PDP - Population Development Programme. A government programme set up in 1984 to solve the population programme through "development" and through "population education".
PPHCN - Progressive Primary Health Care Network. An association of PHC NG0s.
RESA-nompilos: The original name for our SAPLER-nompilos. RESA stands for "Reach Every South African" - the concept of universality. But our Winterveld workers prefer to be called "SAPLER-nompilos".
TPA - Transvaal Provincial Association
SANF - Southern African Nature Foundation
SAPLER - "Splendidly Alive People within Limited Environmental Resources." A non-governmental, non-political organization started in 1990 to investigate the problem of population growth.
SAPLER-nompilos: Grassroots workers specifically trained in family planning motivation, support and an understanding of fp methods. Also trained in STD prevention.
TPA - Transvaal Provincial Administration
UNFPA - The United Nations Fund for Population Activities.. Their representative, Jay Parsons is setting up an office in Pretoria.
WHO - World Health Organization
Women's Project: A dept of the Centre for Health Policy, which is a branch of Wits Medical School.
Terms
Acceptances or Attendances: The number of visits a hospital or clinic gets for fp, e.g. 12 visits to collect pills for a year + 2 sterilisations + 4 visits a year for Depo would be shown as "18".
Acceptors: The number of people protected by fp that year. In the above example this would be "4", assuming that the 12 visits for pills and the 4 visits for Depo were each by one person only.
CBO - Community based organization
Depo - The Depo Provera injection, now well-accepted as an outstandingly safe contraceptive method.
fp - Family planning. Using contraceptives.
HIV - Testing positive for the HIV virus. Usually refers to people not yet suffering from AIDS symptoms.
NGO - Non-governmental organization
POP-LIM - Population Limitation. Limitation of the population size of a nation to a level at which all citizens can develop.
PHC - Primary Health Care: At one time this meant "preventive medicine" - i.e. "of primary importance". It now tends to mean the first nurse or doctor whom you see, usually at a clinic, when you are actually suffering.
QUANGO - Quasi-NGO. An independent organization which gets some or all its money from the government.
Sustainability: l. (long-term) The ability of organic life on earth to continue.
2.(short-term) The ability of a business to continue. (No businesses will be able to continue in the absence of water, topsoil and air.)
STDs - Sexually-transmitted diseases. Although AIDS is mainly a sexually-transmitted disease it is usually referred to separately as in "AIDS and STDS". Most STDs are able to be diagnosed by examination. AIDS requires a blood test. STDs make people more susceptible to the AIDS virus.
TFR - Total Fertility Rate. This refers to the average number of children a group of women will have in their lifetime.