Integrated family planning: the Chilean experience.

PIP: To determine the most effective method for incorporating contraceptive services into a general health program, researchers analyzed the results of an IUD-based family planning program in three separate areas of Chile: two similar towns representing all social strata, and one working-class district in Santiago. From 1964 to mid-1970, IUD contraceptive services were provided in special family planning departments within hospital and outpatient clinics operated by Chile's National Health Service (SNS); information and education were offered in pediatric and obstetrical waiting rooms and postpartum wards. In 1968, SNS restricted the number of acceptors, and in mid-1970, individual family planning units were closed and contraceptive services became the responsibility of maternal-child health units. Prior to 1970, all three sample areas recorded a steady increase in the number of accumulated acceptors and a steadily decreasing birthrate; after 1971, birthrates increased and the number of acceptors declined. A 1964-1969 decrease in the number of hospitalizations for incomplete abortion, particularly in the working-class district of Santiago where a bortion has been the only known method of contraception, was reversed with program termination. Data suggests that family planning is most effectively integrated into existent health services when offered in separate facilities. Direct integration into maternal-child health units may result in the neglect of the family planning aspect of preventive health, and will deny services to two important contraceptive groups: childless women, and men.^ieng