_Family Planning Success in Two Cities in Zaire_ _2_ Family Well-Being). AZBEF established committees in each of the regions of Zaire. Much of the activity of the regional committees was to be based on volunteer efforts. The committees did prove useful in identifying individuals supportive of family planning in each region, though their effectivenecSs was limited by financial and personnel constraints.

Another important force in the family planning movement in Zaire since the 1970s was the network of Protestant churches, known as the Eglise du Christ au Zaire (ECZ, Church of Christ in Zaire). The individual churches constituting this umbrella organization founded schools and hospitals throughout Zaire long before independence in 1960, and they continue to provide some support to many educational and health facilities throughout the country. A number of Protestant hospitals incorporated family planning as part of their maternal/child health (MCH) services, and in some cases these were antenna clinics of the CNND (though most of the inputs, except contraceptives, were provided through the clinics and hospitals themselves). In 1982 the Eglise du Christ became one of three partners (along with the government of Zaire and USAID) in a large rural health project known locally as SANRU, which includes family planning as one of its activities.

A Contraceptive Prevalence Survey began in Zaire in 1982. Because of severe logistic and communication difficulties, the survey did not attempt a nationwide scope. Instead four urban and two rural areas were selected and sampled independently. Current use of modern **nIntrRentivAs** among women m u-ton in tc urbanareas was 4 pvrueut in Kinshasa, 8 percent in Lubumbashi, 3 percent in Kananga, and 2 percent in Kisangani. The rural surveys showed 11 percent in Vanga (which had an active Protestant hospital and family planning program) and 2 percent in Nkara (which did not) 131.

In 1983 a national Projet des Services des Naissances Desirables (PSND, Family Planning Services Project) was established with funding from the United States Agency for International Development (USAID). The mandate of this project was to legitimize the concept of family planning and to expand service delivery in 14 cities in Zaire. The project was designed to incorporate services into existing health facilities, not to establish additional (or vertical) family planning services. In certain locations the AZBEF antenna clinics became part of the PSND network for the purposes of supervision and resupply. The primary contributions of the PSND to service expansion between 1982 and 1990 were to (1) train doctors, nurses and counselors in service delivery, (2) provide standard equipment and supplies for clinic-based service delivery, (3) supply and resupply participating outlets with contraceptives (pills, IUDs, condoms, and spermicides; DepoProvera was available to some of these same outlets through AZBEF), and (4) provide periodic supervision. As of 1990, the PSND network included approximately 100 "units" (service delivery points). At the same time the PSND worked to further legitimize the concept of "naissances ddsirables" (birth spacing) among politicians and the population alike.

Zaire was one of the first francophone African countries to have all three major types of family planning service delivery: clinic-based, community-based distribution, and social marketing. Community-based distribution projects were initiated in 1981 in the Bas Zaire region, in a USAID-funded operations research project directed by Tulane University [4,51. The initial project, which included household distribution in both an urban and rural zone of Bas Zaire, was the forerunner to an expansion of the CBD approach to other cities in Zaire (Mbuji Mayi, Kisangani and two zones of Kinshasa) as part of the PSND activities. As of 1989 some 270