The following requirements are essential for capacity building in population and reproductive health:
- Population programmes work best when they are applied from both directions: from the top-down, with appropriate high level political, institutional and financial support; and from the bottom-up, with grassroots community support. The capacity to create broad coalitions in support of population and family planning programmes is one of the key capacity building requirements.
- Research and policy analyses are an integral part of the capacity to formulate practical population policies. Research, both qualitative and quantitative, provides information on the causes and consequences of fertility, mortality, migration, and population growth, levels, trends, structure and differentials. It is also concerned with the operational and methodological aspects of integrating population variables into development strategies, and the impact of development policies and projects on demographic variables. Many governments have found it useful to forge permanent links with university research institutions and academies of social and political science. Such basic research is then fed into the policy making process, often carried out within ministries of planning.
- Good policy analysis depends on access to good basic data gathered from censuses, surveys and the collection of vital statistics. Governments must have the capacity to carry out socio-cultural research and data collection in order to give them a more sophisticated analysis of population needs, by county and region.
- It is important to have institutional mechanisms in place which allow governments to follow their chosen population and development strategies. In general, most governments have opted to set up population units in their ministries of planning or health. Whatever vehicle is chosen, national governments must have the institutional capacity to follow through with action-oriented programmes.
- Ultimately, population policies and programmes must be integrated into a broader agenda, one which focuses attention on providing girls and women with better educational opportunities and improved employment prospects. Education, however, is fundamental in giving women control over their own fertility. Studies have shown that women who have a secondary education have strikingly fewer children than those who do not. They are also better able to contribute to the health and welfare of their families and communities and play active roles in community development. Governments need to know why it is vital that girls stay in school longer, but they also must have the capacity to keep girls in school longer.
- Given other considerations, governments must have the capacity to deliver quality reproductive health including sexual health and family planning services to all who desire them. In order to do this, they must have a well-established network of health clinics capable of bringing services to the public. A number of countries are now integrating primary health care with reproductive health and family planning services. Essentially, there are two options available: setting up self-contained service structures, as in Indonesia, or setting up integrated services tied into the overall basic health care structure. Whichever system is used, the important thing is that the quality of care provided is adequate to meet the needs of the users.
- It is critical that institutional capacities are sufficiently strong to tackle the family planning challenges posed by rapidly increasing needs of women and men throughout their reproductive lives. Governments need to identify capable NGOs as potential partners in offering reproductive health and family planning services to the public.
- In conjunction with identifying suitable partners - whether public or private - governments often find it useful to promulgate an overall national reproductive health strategy and make appropriate resources available to insure its implementation. In doing so, governments must have functional mechanisms to allow budgetary allocations to population and development-related programmes. They also need to have population issues raised in Parliament, most likely through a special committee and supported by legislative measures. These ingredients are fundamental for building up national capacity in population and related activities.
- Increasingly, governments are involving active and effective NGOs, or private sector organizations, in providing RH/FP/SH services. This allows government investments to be made, for example, in squatter settlements and in rural areas where needs are outstripping supply and where other organizations may not be very effective in operating. Such a strategy permits some governments with limited budgets, Egypt, for example, to concentrate on those hardest to reach, while letting the private sector and NGOs provide the bulk of services to urban residents and the middle class. In countries like Colombia, a national NGO - in this case PROFAMILIA - has been very successful in bringing family planning services to the majority of the country's population. National governments must work closely with NGOs and the private sector in reinforcing their capacity to take on service delivery, family life education, IEC (Information, Education and Communication) activities and so on.
- The capacity to provide population and family life education in schools, with parental consent and involvement, is essential to any population strategy. Such a strategy will also help ensure that future mothers and fathers are better informed about population issues and better able to decide for themselves the spacing and number of their children.
- Finally, the capacity to launch well thought out and executed IEC campaigns is vital. Intelligent IEC campaigns can help raise awareness of the links between population and the state of the environment, the need for providing universal education for girls, and the health risks associated with births that are too early, too late, too many and too close together. A national IEC strategy can also provide couples with the vital information they need in order to plan their families, not have them by default, increase sensitivity to population and environmental issues and heighten awareness of the social and economic consequences of HIV/AIDS.
