_3_

**_Overviw_** _offwnm planning In Zaire_

distributors were working in eight health zones in Zaire. Matadi, one of the two cities described in this paper, was part of the original project, and reflects the benefits of this type of activity.

One of the most successful contraceptive efforts in Zaire has been the social marketing project, initiated by Population Services International (PSI) and funded by USAID; it currently serves as an implementing agency for the Bureau Cen! 'al de Coordination (BCC) of the National AIDS Committee. This project developed and tested brand names and package designs for the sale of condoms (ocally called "Prudence") and spermicides (nGraine"). Commercial sales of these products began in Kinshasa in late 1987 and increased exponentially during the next several years [6]. Part of the success of the social marketing program can be attributed to the growing awareness of AIDS during the late 1980s, since condoms had not traditionally been widely accepted for use within marriage for family planning purposes. However, the parallel brisk sales of the spermicide "Graine" suggest the effectiveness of social marketing for family planning purposes, as well as for prevention of sexually transmitted diseases (STDs).

These activities in service delivery were paralleled by work in the area of population policy, intended to result in an official government policy with demographic objectives for Zaire. Efforts in this area, under the USAID-funded OPTIONS project, led to considerable consciousness-raising among decision-makers in Zaire and to greater acceptance of the concept of family planning. However, a population policy drafted in 1986 had still not been signed five years later.

While the majority of family planning activities in Zaire are supported by USAID, two other important players were IPPF and UNFPA (the United Nations Population Fund). For more than 15 years, IPPF provided contraceptives and program support to its affiliate CNND (now AZBEF). While continuing some support of service delivery, IPPF's main activities by the late 1980's were training and public education, as well as coordination of their regional committees in the interior. UNFPA in the 1980s helped mainly to develop the Department of Demography at the University of Kinshasa and to support census work of the Institut National de la Statistique (INS). However, in the late 1980s UNFPA became more directly involved in family planning program activity, including support for the information-education-communication (IEC) component of the national family planning program and some contraceptive procurement.

In sum, as of 1990, family planning services existed in the major cities of Zaire, as well as in a number of clinics in rural areas, especially those supported by Protestant churches and/or participating in the SANRU rural health program. Social marketing products were found in the pharmacies of the major cities; and a limited number of zones benefitted from a network of CBD distributors.

Among francophone African countries, Zaire had one of the most diverse family planning programs. However, the effectiveness of the program was limited on one hand by administrative and logistic problems faced by the national family planning agencies, and on the other by sociocultural barriers to family planning acceptance.