UNFPA has supported mother and child health care and family planning in the country for 20 years. Following ICPD, the Ministry of Health is going further, to include the full range of reproductive health and family planning services in all 959 health centres.

Two-thirds of the health centres already provide the full range of services. To bring the remaining third up to standard, UNFPA has provided diagnostic equipment and training for midwives and family planning specialists. Clinics and health centres have been upgraded for early detection and referral of high-risk pregnancies. Community health motivators have also been trained to promote breast-feeding, vaccinations for babies and young children and AIDS awareness.

The Ministry of Health has set up special warehouses in each of the country’s 14 provinces, where logistics officers keep track of the supply of contraceptives and essential drugs by computer. This system has greatly improved service delivery. The Ministry now requires all newly graduated doctors to spend two years in an underserved area before they are allowed to open their own practice.

The effect of these improvements, and the extent of the problem, can be seen at a health centre in the village of Harran Al-Awamied, about 30 kilometers west of Damascus. Abdul Muniem noted a poignant story from the centre’s records. "This woman had her first pregnancy at age 16, her next was four years later, at 20. Her third pregnancy was at 21, her fourth at 22, and she is now pregnant with her fifth child at 23."

"We are slowly educating the local people that smaller families are better, healthier families," responds Dr. Mohsen Kanaan, Director of the Centre. "But changing entrenched attitudes takes time." What used to be a family planning clinic is now a fully-equipped health centre, with a dentist and a pharmacy as well as a range of reproductive health services. The average family size in the village is six, but the contraceptive prevalence rate is 35 per cent and climbing towards the national average.

"We still have to upgrade over 300 health centres," says Dr. Reem Dahman, National Project Director for the Ministry of Health, "but steady progress is being made, and we certainly wouldn’t be so advanced without UNFPA’s strong support."

top