Program planning for family planning services

This exchange of opinions was occasioned by an article which appeared in the October 1969 Perspectives under the title Family Planning Services in the U.S.: a National Overview, 1968. Mr. Sieverts criticizes the article as follows. The ratio of unmet need claimed to available facilities is considered not properly stated in that all indigent girls and women from their midteens through their midforties do not need such services every year and that clinic services do not represent the total of such services available. Many have no such need. The private physician and hospital clinic provide much service. Development of new services should also consider demands, resources, and alternative solutions. Other health services must also be coordinated. Mr. Jaffe's defense follows. The stated need is an approximation by applying the Dryfoos-Pulgar-Varky (DPV) formula to the 1966 census figures. The need figure which results is about 5 million out of a total of over 8 million poor and near-poor women in the age group 15-44. This estimate is considered reasonably accurate. The number included but not in need is partially offset by some below the age of 18 who are also in need. Poor families have relatively less access to private physicians than others. This is shown by the number of women who deliver their babies on the ward service of hospitals without the presence of a private physician. Also, private physicians tend to give less attention to contraception for low income patients than do clinics. Many women depend on nonmedical and unreliable birth control measures. Family planning is not a one-time educational process. Revisits, continuing supervision, and check-up examinations are advocated particularly for IUD users and those taking pills. With current contraceptive technology adequate family planning services contemplates care extending for most of the patient's reproductive years. Resources require allocation. The study rests on the findings that the poor have a higher incidence of unwanted fertility than the nonpoor with significant adverse health and social consequences for both the individual and society. The study was a systematic attempt to achieve a national goal of providing modern family planning services to all who need and want them but cannot afford private care.     

Geriatric planning: planning for our elderly

The objective of this article is to persuade policy-makers that we can improve planning for our elderly. An alternative model is presented--The Geriatric Centre--with location based upon city neighbourhoods, suburban and rural communities, and having neighbourhood responsibility, accountability and a comprehensive service delivery.