Also, after 1994, new clients were more likely to be unmarried, especially in clinics where at least half of the staff had been to the workshops and referred to the protocols. Stanback is currently studying the impact of guidelines and dissemination workshops in Senegal. In 1996 and 1997, the Ministry of Health in Paraguay developed new national family planning guidelines and service delivery protocols. Following field testing, the new guidelines were revised. In 1998, the ministry held three dissemination workshops and follow-up training workshops, with FHI providing technical assistance.
Many potential obstacles exist to ensuring that providers actually follow the new guidelines.
We do not even have the necessary logistics to put them into practice. At each step, it is a question of cost. National guidelines must be revised periodically to reflect new scientific information, which is also expensive. Informing clients about new national policies, and how these affect services, is a difficult task. Still another concern is the scope of guidelines.