NoturaFamil1y /44-- Planning Development of National Programs Editors Claude A. Lanct6t Mary Catherine Martin Mary Shivanandan with Technical Editors Elizabeth Barber Gould Jeff Spieler Nancy Williamson IFFLP/FIDAF * Washington, D.C. 3 Natural Family Planning, Development of National Programs"'as produced as part of the proceedings of the Third International Congress of the Interna­ tional Federation for Family Life Promotion held in Hong Kong, November 1983. The production and publication of this monograph was supported in part under contract with Family Health Intema­ tional, Research Triangle Park, NC, and partiallylo funded by the United States Agency for Ittema­ tional Development. The views expressed by the contributors do not reflect the views of Family Health International, the United States Agency for International Development, or the International Federation for Family Life Promotion. Art direction by Joseph A. Taney Photographs supplied by members of IFFLP except one by the Irish Tourist Board Production by KM Associates, Bethesda, MD Set in Garamond by Litho-Comp, Bethesda, MD © 1984 by International Federation for Family Life Promotion. All rights reserved Library of Congress Catalog Card Number 84-080847 Printed in the United States of America Acknowledgments This monograph on the development of States), Catholic Fund for Overseas national natural family planning (NFP) pro- Development (United Kingdom), Comit6 grams worldwide is the result of significant Contre la Faim et pour le Development teamwork. The International Federation (France), and the Latin American Commit­ for Family Life Promotion (IFFLP) first ex- tee of the United States Catholic presses appreciation to Dr. Malcolm Potts, Conference. Director of Family Health International IFFLP extends special thanks to the (FHI), who supported this international Catholic Marriage Advisory Council seminar and monograph project at the (C.M.A.C.) of Hong Kong. Dr. Ramon Ruiz Third IFFLP International Congress in and his wife, Dr. Irene Osmund, with their Hong Kong in November 1983. FHI sub- local organizing committee provided con­ sidized more thar half the participants to gress participants with their most memor­ the seminar from various national pro- able congress to date. Professor Alfredo grams and also subsidized significantly the Perez of Chile made substantial contribu­ production, editing, and publishing of this tions in the initial conceptualization of this monograph. seminar and in his work as chairman of the The major authors of this work, both sessions in Hong Kong. those who shared with IFFLP their national In the preparation, editing, and publish­ program experience and those who con- ing of this monograpi, iFFLP expresses its tributed t vpmatic and special interest gratitucle to Mary Shivanandan, Director of papers, deserve particular thanks. In addi- KM Associates, who undertook the task of tion to these authors and the several coordinating the editing and production of national delegates who enriched the pro- this first major monograph for IFFLP. ceedings either by their comments or reac­ ti,_ ns, IFFLP expresses 2ppreciation to the The editorial committee included M. funding agencies who subsidized either Shivanandan, Dr. Claude Lanct6t, Execu­ partially or completely the participation of tive Director of IFFLP and Project Coor­ many NFP manyprogram delegates to the Hong educationaldinator, and andDr. NFPMary consultantCatherine Martin,to the Kong Congress and to this seminar in par­ ticular. Among those who, besides FHI, Federation. Dr. Martin also acted as provided travel scholarships from the facilitator and prepared the summary of the public sector were the United Nations Fund major themes and program issues. for Population Activities, the World Health The committee was ably assisted in Organization, Family Planning Interna- Hong Kong by Dr. Nancy Williamson, the tional Assistance (a major U.S. AID in- project officer for FHI, and Jeff Spieler, termediary), and the United States Agency who also provided editorial consultation. for International Development directly via Elizabeth Gould rendered invaluable assis­ IFFLP's African project. Private funding tance in the technical editing of the papers. agencies included Misereor, Adveniat, Finally a special word of appreciation is Missio (all. from Germany), Propagatione offered to Sonia A. Arsich and Shirley Fide (Rome), Development and Peace Hearn, secretaries of the IFFLP Washington (Canada), Catholic Relief Services (United office, for typing and translation services. 5 Table of Contents 5 Acknowledgments 9 Preface 10 Introduction 12Africa 14 Family Life Program Development in French-speaking Africa: FrancoisGuy 21 L'Action Familiale of Mauritius: Herv Juste 27 The Family Life Movement of Zambia: Raymond Muchindu and RichardCremins 32 Rwanda 33 Seychelles 34 South Africa 35 Tanzania 3Americas 38 Development of a National NFP Program in Chile: PatricioMena-Gonzalez 44 L'Action Familiale of Haiti: Fritz Francois 51 Diocesan Development Program for NFP: James T. McHugh 58 Argentina 59 Canada 61 Mexico 62 Peru 6Asia/Oceania 66 Australian Council of Natural Family Planning: John P. Gallagher 7i The NFP Movement in India: Kathleen Dorairaj 83 AustraliaIWOOMB 84 Bangladesh 86 Calcutta 88 Korea 89 Pakistan 6 go Europe 92 Centre de Liaison des Equipes de Recherche: Jean Mutricy 97 Catholic Marriage Advisory Council of Ireland: Andrew Kennedy 101 Austria 102 Italy/CISF 103 ItaIy/NFPSRC 104 Malta 106 Portugal 107 United Kingdom/CMAC 108 United Kingdom/NFPTA Il Program issues 112 Development of National Natural Family Planning Programs: Marie-PauleDoyle 117 Experiential Learning and the Professional in NFP: Thomasina Smith Borkman 125 Comments: 125 Stephen Burke, United States of America 127 Kathleen Dorairaj, India 128 FdgarPaz-Gonzalez, Venezuela 130 Discussion 132 NFP Education, Training and Service Development: Anna Flynn 140 Family Fertility Education Resource Package: W DonaldClarke 143 Comments: 14 5 Maureen Ball, New Zealand 144 Thomas Iilgers, United Statys of America 145 Andrew Kiura, Kenya 147 Notker Klann, W. Germany 148 Clara Lockhart, Dominican Republic 150 Mary atherineMartin, United States of AmericallFFLP 151 Discussion 155 NFP Program Evaluation and Accountability: Ron H. Gray and Robert Kambic 167 Research on Natural Family Planning in the Phillipines: John E. Laing 178 Comments: 178 Marie Mignon Mascarenhas,India 180 Ku'ang-lHo Meng, Korea 182 Sheilagh O'Rourke, Ilaiti 183, Discussion 186 Summary of Program Issues 195 Appendix: List of NFP Centers Selection of Books and Pamphlets Newsletters and Periodicals Survey and Review Articles Audiovisual Materials 7 Two roads diverged in a wood, andI- I took the one less traveled by, And that has made all the difference. ROBERT FROST Preface During the past 10 years, there has been acting and working with many of the con­ a broadening interest and excitement in tributors of the present monograph. The natural family planning (NFP). Much of this proceedings of the Airlie House Con­ interest has resulted from advances in ference were published in a.book that may understanding of the methods as well as have helped change the tcrminology from research in evaluation and accountability, rhythm to natural family planning. The Positive program experiences from all definition that evolved was: "Natural fain­ parts of thc world combined with the ily planning methods are means by which work of investigators using the latest tech- a couple uses the daily observations of niques have begun to bring credibility to signs and symptoms of the fertile and in­ the NFP movement, fertile phases of the menstrual cycle to Beginning in the 1930s, Dr. Ogino in guide the timing of intercourse according Japan and Dr. Kn2.us in Austria identified to their desire to achieve or avoid a the time of ovulation in relation to the pregnancy. " menstrual cycle and helped to develop the This definition emphasizes that absti­ calendar-rhythm method. Their theory, nence is a part of the method, hence the which was based on the length of previous term "periodic abstinence." Natural cycles, was limited in effectiveness by ir- methods are more than techniques cf fer­ regularities that occur in many women's tility control. They also involve the cycles. Their work did, however, mark the challenging task of education in which beginnings of what are now called natural conjugal love is intimately linked with methods of conception control. From this openness to life. there deve.oped during the 1950s the In November 1983 the Third Inter­ temperature or thermal method, and, by national Congress of the International the end of the decade, the sympto-thermal Federation for Family Life Promotion and cervical mucus methods. The latter (IFFLP) was held in Hong Kong. Since the two methods, which use either several meeting brought delegates from all over parameters (sympto-thermal), or a single the world, it provided an ideal focal point index (cervical mucus), are a great advance to examine the developmental aspects of a beyond the Ogino-Knaus method, since representative sample of NFP programs as they depend on scientifically based obser- well as the resources, instruments, and ma­ vations for determining the fertile period. jor curricula for teachers. Through this ex­ In 1970 two American groups, the Na- change, narticipants were able to enhance tional Institute of Child Health and Human their own programs and assist others. This Development and the Human Life Founda- fruitful exchange resulted