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Haiti seminar discusses voluntary sterilization.

Network 1984
Devising strategies to meet the growing demand for voluntary sterilization in Haiti was a major topic of discussion during a week-long seminar November 28-December 2 organized by the Division of Family Hygiene (DHF) of the Haitian Department of Public Health and Population. More than 30 physicians trained in laparoscopy and minilap who provide services through the DHF program met to summarize progress and discuss problems of the program to date, review technical aspects of female sterilization, introduce technical aspects of vasectomy, and set goals for 1984. FHI provided 2 consultant-speakers for the seminar, Dr. Lise Fortier, medical director of Planned Parenthood of Los Angeles, and Dr. Liliane Toumi, consultant for training in male and female sterilization. The DHF has given high priority to its voluntary sterilization program, which has recorded a slow but steady increase in the number of individuals sterilized since its beginning in 1979. Postpartum minilaps account for the highest percentage of procedures (69%) of cases reported to the DHF in the 1st 1/2 of 1983), with most of the remainder consisting of laparoscopy. In 1983, there was also an increasing emphasis on vasectomy, accounting for 5% of all cases reported in the 1st 6 months. 3 physicians attending the seminar had just returned from Sao Paulo, Brazil, where they were trained in vasectomy by Dr. Marcos de Castro. An additional 3 are scheduled for training in Sao Paulo early this year. These 6 physicians will form the basis of an in-country vasectomy training program for their colleagues. Data from an ongoing FHI Maternity Care Monitoring pilot project at Hopital Universitaire de l'Etat d'Haiti support the observation of physicians at that center that 65%-70% of potential candidates for sterilization there are not sterilized. Discussion at the seminar identified the following possible reasons for the unmet need for sterilization: requirements for laboratory tests, lack of space for procedures and recovery, irregular supplies, and need for better patient education and motivation during the prenatal period. 1 suggestion to increase the access of rural populations outside of Port-au-Prince was to offer sterilization services through mobile clinics operating out of health centers around the country. FHI is continuing its assistance to the DHF program by helping to establish reporting and to maintain data on sterilizations performed throughout Haiti. Initially, the Division will use FHI female sterilization and male sterilization patient summary forms for monitoring cases in the 6 centers doing a large proportion of the procedures. The consensus of those attending the seminar was that a strong voluntary sterilization program is of the utmost importance in meeting Haiti's family planning needs.

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