REPORT ON THE IMPLEMENTATION OF TQS PROJECT IN VIET NAM

Dr PHAM XUAN TIEU - VIET NAM

WHAT IS TQS ?
 

It is a short cut way of writing of a natural family planning method namely "Tu Quan Sat" in Vietnamese. It has been translated from the french term  Méthode d'Auto Observation (MAO). We call il also  Self Observation Method (SOM) in English.


THE SITUATION OF CONTRACEPTION IN VIET NAM
 

VietNam gained the UN Population Award on 9 June 1999 for its significant contribution and representative approach to the development and coordination of national population policy, and for the provision of reproductive health care in large and small communities. That is a real honour and also a pride of our country, a poorest one in the world with GDP around 200 USD, and per capita agricultural land of 0,1 ha. It marks an important achievement of our Family Planning Program initiated from 1963, but more active and effective from 1993.


The national statistics showed that :
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But shortcomings still exist : according to statistics of the public health service, there were more than 1,4 millions abortion cases in 1995, of which 40% pregnancies were over 6 weeks.
Among contraceptive users, the distribution of contraceptive methods of selected years was as follow :
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It is remarkable that :
-  The two less reliable methods (periodic abstinence and withdrawal) gave us a high prevalence ranking, second after IUD. But ogino only as known.
- "Non contraceptive use" people include mostly catholic people who account contrywide for 8% or the population.
 

WHY DO WE DEVELOP NATURAL FAMILY PLANNING IN VIET NAM ?
 

Based on above mentionned facts, we recognize that : to contribute effectively to the fast and stainable reduction of fertility rate and for the sake of population objective achievement and to the minimization of abortion number for the sake of reproductive health care, nothing would be better than good training on correct use of NFP. Moreover, learners on NFP use can benefit good additional knowledge about Reproductive Health and Reproductive health self care.
These undeniable advantages gave rise to our program's ultimate objectives.


WHAT WE HAVE DONE ?
 

Our NFP program originated form 1990. By that time, on the subject of yearly visit on Maternal and Child Health care (MCH) activities assistance to our country, a french couple namely Marie Joly and Doctor Jean Bernard Joly, president of the french Leïla Fodil Fund, introduced in several seminars on MCH the current prevailed naturel method namely MAO in France.

In 1993, they planned together with us a programme focusing on :
- Sensibilisation on NFP use, to diversify our country contraceptive methods.
- Testing a training program including pedagogical skill for various educational levels.
- Fostering participant¹s knowledge about Reproductive Health, on the occasion of NFP use training.

We first worked with the Vietnam Family Planning Association (VINAFPA) an organisation in charge to develop government policy in Family Planning, closely linked to government health services. First training courses took place in HàNôi.
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In 1996, it was noted in the National Committee for Population and Family Planning 5-years plan as follows :
"Attention should be paid on the diversification of contraceptive methods and dissemination of NFP among intellectuals and catholics..."
In 1996, a first 3-years plan (1996-1999) has been signed between Leïla Fodil Fund and the VINAFPAs of HàNôi, Nam Dinh and Ninh Binh.  Leïla Fodil Fund brought  technical and financial support, with financial help of "Kirche in Not" from Köln, Germany.

Nam Dinh and Ninh Binh VINAFPAs requested first to train their staff :
doctors, midwifes, nurses in charge or Family planning. Progressively, they asked us to go mostly in crowded catholic people areas : district of Kimson-Ninh Binh (of which 48% of the population is catholic) and Xuan Thuy-Nam Dinh (55% of catholics)
In HàNôi,we work in two directions :
- The Communist Women Union of HàNôi, to reach  "non contraceptive users"
-  HamLong and ThaiHà catholic parishes, to train "ogino users" and the catechists in charge of marriage preparation.

1998 : we had a good chance to introduce in details this method to more than 100 catholic nuns of Da Nang, Hue ( in the center of VietNam) and Ho Chi Minh city (in the south) (they usually live together with the people and have to help them frequently by explaining and directing on how to solve their confidential private or familial problems, especially male and female adolescents)

1998 saw an important progress in program sensibilization due to
       - training course sound,
       - widely distribution of a TQS leaflet,
       - a seminar on NFP held by the Research Center for Gender, Family and
Environment in Development (CGFED, a vietnamese NGO)
       - followed by two sessions of TV transmission aiming at introduction to this seminar and the content of TQS method,
       - some articles answering to widely NFP development.
 

Profitting from 96-98 experience, in 1999 we have modified our actions: new courses are essentially reserved for "non contraceptive" or young Calendar users, particularly for "couple learners" in view of training them to become "couple monitors".  Up to now, about 30 couples become real and enthousiastic users with 0 failure rate of use. And now we are going on training them to become couple monitors.  By the end of 1999, a couple monitor opened the first NFP consulting
office in Ham Long parish in HàNôi.
By the year 2000, development of our program become larger and larger due to encreasing demands throughout the country on training course organisation.  We are doing our best to train a contingent of TQS trainors for 3 regions of our country : the North (HaNôi), the center (DaNang and Hué) and the South (Ho Chi Minh City)

PEDAGOGIC ITEMS
 
To achieve good effectivenesss of this knowledge transmission, we had to continuously improve teaching skill as well as the way of idea expression to make it easy to understand by everybody and being in line with educational level of various participants, especially the sheer peasant ones.

We produced :
- TQS chart
- leaflet presenting TQS. It is now distributed to all future couples in HàNôi parishes.
- booklet for TQS users
- booklet for TQS monitors with pedagogic advice
- "une règle à coulisse" to explain the cycle
- a series or paintings preserved between plastic papers,  and a TQS chart drawn on formica board for teaching in rural areas.
 


REMARKS AND CONCLUSION
 

- Program sensibilization could be considered as successful due to demands of method introduction and training courses provision become greater and greater.
- Successful couple-user courses in rural areas proved that :
       - teaching methodology is somewhat appropriate
       - NFP is not dedicated to intellectuals only
       - religion contributes its important part to the motivation of NFP users
- To achieve good results of training and using the method, it is essential to have advocacy and commitment of the government, mass organisations and religion authorities.
- To have a contingent of enthusiastic and firm users with effectiveness, it is essential to have adequate organisation with close and active motivation, follow-up and help to users. To achieve this we have to :
       - train a contingent of good and enthusiastic monitors. But to become a good monitor it is essential firstly to be a good user.
       - frequently improve and simplify teaching methodology and materials.

Hence we wish
- To have response and effecrive assistance from FP-related governmental, non governmental and mass organisations.
- To have continuing all-aspect assistance of Leïla Fodil Fund and help from other foreign organisations interested to the correct development of NFP methods in family planning movement.
- To have active response of current NFP users as well as people having not yet had any appropriate contraceptive method.


CONTACTS

European Institute of Family Life Education Institut Européen d'Education Familiale Milan 28 juin-2 juillet 2000 "Natural Family Planning : future role and developments"
Local Organizing Commitee : CAMEN  e-mail : centro.camen@tiscalinet.it
WEB.TISCALINET.IT/Metodinaturali