View from Louisiana

Abstract

This is a report of the first 2 years of the nonprofit Louisiana Family Planning Program Incorporated consisting of 10 principles of this organization with methods results and future objectives interspersed. The goal of the program is to provide contraception for 130000 medically indigent women in all 64 parishes of Louisiana by August 1970 using the following principles. 1) Study the population. In Orleans Parish 26% of fertile women were poor but contributed most of the live births illegitimate births stillbirths maternal and infant deaths and births to girls under 18. In comparison 90% of the upper classes practice effective contraception. 2) Develop a responsibly led organization. Family planning specialists from Tulane University compose the Board of Directors. 3) Design goals: systematic service to all in need within a specific time. Those contacted in order of priority were women who delivered or aborted in a state Charity Hospital women estimated from vital records to be at high risk who delivered within 3 years women not at high risk who delivered within 3 years. Non-identifiables were most effectively recruited by grapevine. The most cost-effective element of the recording and follow-up system was the practice of sending a letter and if necessary paying a home visit immediately after a missed appointment. 4) Locate and coordinate all existing family planning services. 5) Allow time (2-5 months) for development after funding. 6) Contact all eligible patients within specific time. In 18 months all postpartum and high risk candidates in Lincoln Parish were reached 85% kept an initial appointment 90% of these continued for 1 year. The auxiliaries mature intelligent peers of the patients contacted patients. 7) Expanding family planning services can be the first step in improving total health care. 8) Maintain scrupulously patients privacy dignity and right to choose. 9) Use efficient management techniques. 10) Obtain evaluate and report program results. In 1967 in Lincoln Parish indigent births dropped 32% compared with 6% in control parishes illegitimate births dropped 23% compared with 13% increase in control parishes and second illegitimate births dropped 41.5% compared with 6.2% %increase in control parishes.