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A. a.(1)(a) i) a)DocumentҲa1DocumentE+gw;Document StyleP /=(g/'8!*gF *  ׃  2qea2DocumentE+gw;Document StyleP /=(g/'8!*g*    a3DocumentE+gw;Document StyleP /=(g/'8!*g0     a4DocumentE+gw;Document StyleP /=(g/'8!*g   . a5DocumentE+gw;Document StyleP /=(g/'8!*g  2Ke p p ca6DocumentE+gw;Document StyleP /=(g/'8!*g  a7DocumentE+gw;Document StyleP /=(g/'8!*g ` ` ` a8DocumentE+gw;Document StyleP /=(g/'8!*g ` ` ` Tech Init"6&Initialize Technical Style8"*gw;.'8E  1 .1 .1 .1 .1 .1 .1 .1 Technical2 } -^ a1Technical+gw;Technical Document Style/=(g/'8#*g 4!     a2Technical+gw;Technical Document Style/=(g/'8#*g *    a3Technical+gw;Technical Document Style/=(g/'8#*g'   a4Technical+gw;Technical Document Style/=(g/'8#*g&   28 $  .  a5Technical+gw;Technical Document Style/=(g/'8#*g&   . a6Technical+gw;Technical Document Style/=(g/'8#*g&!"  . a7Technical+gw;Technical Document Style/=(g/'8#*g&#$  . a8Technical+gw;Technical Document Style/=(g/'8#*g&%&  . 24j epssPleading8$6&Header for numbered pleading paper*gw;.'8E'(   ,#x  @;X@# X  y*dddyy*dddy HH1 HH2 HH3 HH4 HH5 HH6 HH7 HH8 HH9 H10 H11 H12 H13 H14 H15 H16 H17 H18 H19 H20 H21 H22 H23 H24 H25 H26 H27 H28   ӼHeading 2(6&Underlined Heading Flush Left(*gw;.'8E)* Heading 1)6&Centered Heading(g/'8)*gw;.'8E+,* Ã  Bullet List6&Indented Bullet List/'8**gw;.'8E-.` ` ` 27Xp 1w;.'8+6&ZP /=(g/'8+*gw;.'8E/0Heading'8,6&Chapter Heading=(g/'8,*gw;.'8E31 2 *  ׃  Right Par-6&Right-Aligned Paragraph Numbers*gw;.'8E<34@    Subheading6&Subheading/=(g/'8.*gw;.'8E.5 6  2}^iqn81-Head.'8/6&boldP /=(g/'8/*gw;.'8E78 1-Photos806&Return, "Photos" UL, bold: indent*gw;.'8E9: Photos: ` ` ` 1-text.'816&boldP /=(g/'81*gw;.'8E;< Text: 1-Line.'826&Full baseline, followed by Head text*gw;.'8E=>yxdddy 2 !g}"#vDefault Para6&Default Paragraph Font/'83*gw;.'8E ;?;@#XN\  PXP##A\  PP#";.'856&Small Circle=(g/'85*gw;.'8E!AB"a128E+gw;Right-Aligned Paragraph Numbersg/'88*g"8CD@   a228E+gw;Right-Aligned Paragraph Numbersg/'88*g#AEF@` `  ` ` ` 2 $C%&'Ja328E+gw;Right-Aligned Paragraph Numbersg/'88*g$JGH` ` @  ` `  a428E+gw;Right-Aligned Paragraph Numbersg/'88*g%SIJ` `  @  a528E+gw;Right-Aligned Paragraph Numbersg/'88*g&\KL` `  @hh# hhh a628E+gw;Right-Aligned Paragraph Numbersg/'88*g'eMN` `  hh#@( hh# 2%(;) 0a728E+gw;Right-Aligned Paragraph Numbersg/'88*g(nOP` `  hh#(@- ( a828E+gw;Right-Aligned Paragraph Numbersg/'88*g)wQR` `  hh#(-@pp2 -ppp Ыx  @;X@<  9`("Courier 10cpiXx  @;X@<  9`("Courier 10cpiXXN\  PXP\  `*Times New RomanTTXA\  PP\  `*Times New RomanTTxp7,xA`&UniversScalable^H  @S ^@>  9`(2Courier 7pt (Land PX SC)^X~xP7XP,xA`&Univers (Scalable)XTxP7P,xA`&Univers (Scalable)xp7,xA`&UniversScalable&*0 x 7&) `(CG TimesScalable&xp 7,xA`&UniversScalablex  @ ;X@<  9`("Courier 10cpiX2&&#|x#xp7#' TURKEY FY 1997 Economic Support Fund Request:p(#C$60,000,000 FY 1997 Development Assistance Request:p (#D$5,700,000 ă  Introduction. Turkey is a close and valued ally of the United States. It occupies a strategic location between Eastern Europe, the Middle East and the New Independent States, and is a key member of NATO. From the establishment of the Republic until 1980, Turkey was an insulated, statedirected economy. In 1980, however, the country embarked on a new course. Increased reliance on market forces, decentralization, exportled development, lower taxes, foreign investment, and privatization became the basis for the new economic philosophy. The U.S. has an interest in encouraging and supporting the growth and stability of a westernoriented Turkey following sound, freemarket and democratic policies. The Development Challenge. The USG has not maintained a fullscale bilateral foreign aid program in Turkey since the mid1970's. The country achieved an advanced standing in the developing world at that time and has continued to modernize. Nevertheless, the economic situation, while at times experiencing dramatic growth, has been unstable, rife with internal structural problems resulting from state intervention and bloated government bureaucracies. Economic problems are further exacerbated by excessive population growth, fueled by heavy rural to urban migration and relatively low prevalence of modern contraceptive usage. Turkey is also encountering a separatist and terrorist campaign from within the country, and this fight has resulted in alleged and confirmed human rights violations. Turkey has made substantial progress towards implementing an ambitious program for correcting the underlying macroeconomic imbalances which have plagued the economy over several years. In 1994, the Government of Turkey (GOT) was able to achieve some measure of stabilization in terms of foreign exchange and external payments. The austerity package introduced in April 1994 was inconsistently applied and failed to eliminate Turkey's high inflation rates of over 65%. A severe currency crisis during the early months of 1994 put Turkey at risk of not meeting its external debt payment commitments. However, macroeconomic policy adjustments initiated by the government in April 1994, and supported by an International Monetary Fund (IMF) standby arrangement have led to a more favorable outlook for the sustainability of debt servicing by the country. By the end of 1994, the external currency account had improved significantly, foreign currency reserves restored to pre-crisis levels, and the composition of external debt had shifted further toward medium- and long-term commitments with average maturity of more than eight years. In 1995, the Turkish economy grew robustly. GNP grew nearly eight percent in the first nine months of the year and overall manufacturing capacity increased to 80% in the last quarter of 1995 compared with 76% at the end of 1994. Most analysts expect far slower growth in 1996 as a new coalition between center right parties moves to implement a new austerity program which will probably be similar to that of 1994. Other Donors. The principal form of U.S. assistance is through the cash transfer mechanism. The purpose is to support Turkey in implementing economic and democratic reforms. These resources, in conjunction with those provided by other donors and private lenders, enable Turkey to continue servicing its large debt, and help support its economic reform program and structural adjustment efforts. The International Monetary Fund (IMF) and World Bank have provided standby and project loans to the GOT to encourage and reward major economic reform measures. Moreover, the UN Fund for Population Activities and the International Planned Parenthood Federation support activities in less developed areas and with indigenous organizations respectively. FY 1997 Program. ČUSAID supports an economic policy reform program under the Economic Support Fund (ESF) cash transfer program, which has spurred a dramatic increase in exports. The ESF program dwarfs all other activities USAID finances in Turkey. The second largest program supports a focused population assistance program, which is guided by a fiveyear strategy. The strategy calls for a rational phaseover of activities to the GOT and the private sector by the end of the century. The strategy supports the U.S. Embassy's interest in broadening the bilateral USTurkey relationship beyond military cooperation. Strategic Goal: Social Stabilization Population issues are developing into a major priority of the GOT, given that its current population of almost 61 million is expected to double by the year 2025. Surveys show that Turkish couples use less reliable traditional methods. Modern contraceptive prevalence, while increasing, is just approaching 35%, which is below countries like Bangladesh and Egypt. USAID donates approximately 90% of all GOT contraceptive commodities. Recently, the Government of Turkey has demonstrated a sense of commitment to reducing population growth. Together USAID and the GOT have developed a plan for enhancing private and public ability to meet consumer contraceptive demand independent of USAID support. Thus in FY 1995 USAID began implementing this agreed upon plan for enhancing contraceptive availability as part of a 5year phase down strategy ultimately promoting Turkish private and public resources to take USAID's place as the main provider. The USGapproved Population Strategy for Turkey 199599 contemplates the following activities. The USAID program is strengthening the GOT policy environment, forging ties among private firms and facilitating increased nongovernmental organization (NGO) participation. The project works to train counselors and care providers to improve their quality of services and depth of knowledge. It seeks to expand access to services by integrating them into existing health care delivery networks. Finally, on a decreasing scale, USAID provides funding for contraceptive commodities. The program, implemented by a number of U.S. Cooperating Agencies, has seen many gains. Family planning training has been integrated into eight university teaching programs, midwifery and nursing schools, as well as the Ministry of Health (MOH) inservice family planning sites. The MOH adopted the firstever national family planning guidelines and operates model family planning clinics throughout the country. The MOH and social security organization agreed to begin purchasing contraceptives. The USG is working with the cooperating agencies to foment more synergistic implementation and sustainable impacts. The strategy, which includes a fiveyear phase down approach, will provide important guidance and impetus for results. Strategic Objective:Improved sustainability of social benefits and services Strategic Goal: Crosscutting and Special Initiatives This special initiative works to maintain economic and political strength and stability in Turkey. Turkey is a key ally and plays an important role in the region. While peace prospects have improved in some parts of the Middle East, hot spots are evident throughout the Caucasus, Central Asia, Cyprus and Iraq/Iran. The instability surrounding Turkey and the internal civil strife distract the government from major economic reforms. Growing religious conservatism could make reform more difficult. In addition, the GOT must take much more drastic steps to reform the economy, for example, through fullscale privatization and reduced government expenditures. These significant changes in the economic system require international financial support to ease the burden and maintain stability.   USAID assistance will be used primarily for balance-of-payment support, including the servicing of nonmilitary U.S. and international lending institutions' debt. USAID's strategy is to provide resources, which, in conjunction with those provided by other donors and private lenders, will permit continued implementation of Turkey's economic reform program, while allowing it to continue importing the goods and services it needs for economic growth and stability. #^H  @S ^@#*#X~xP7XP# Ã W'TURKEY =FY 1997 PROGRAM SUMMARY *#TxP7P# ă r ddx$ tt8 ddx$ tt8 r &  & Strategic ObjectivesEconomic Restructuring Democratic TransitionSocial StabilizationCrosscutting / Special InitiativesTotal&. . &Social Benefits4,000,000 b/ 4,000,000&. . &Crosscutting / Special Initiatives 60,000,000 a/60,000,000&~     ~     &TOTAL 4,000,000 b/60,000,000 a/64,000,000` `   a) Economic Support Fund b) Development Assistance Director, Office of European Country Affairs: David Cowles #xp7# ACTIVITY DATA SHEET#&*0 x 7&#ѐ #xp 7# PROGRAM: TURKEY TITLE: Social Benefits, 000S003.2 STATUS: Continuing PROPOSED OBLIGATION AND FUNDING SOURCE: FY 1997: $ 5,700,000 DA INITIAL OBLIGATION: FY 1995; ESTIMATED COMPLETION DATE: FY 1999 Purpose: Improved sustainability of social benefits and services. Background: Turkey's rapid population growth is a deterrent to its social and economic development. Turkey has a population of 61.8 million, which under current conditions will double in just 33 years. Desired fertility in Turkey is 2.1, while the actual fertility is 2.7. Although overall contraceptive prevalence is 63%, only about half of that represents modern method use. There are 11.5 million married women of reproductive age, 9.6 million of whom want to use contraceptives, but only 4.4 million of whom are using modern contraceptive methods. Thus over five million couples (over 40% of all Turkish couples) have unmet demand for modern family planning methods. The Government of Turkey (GOT) has recently demonstrated an elevated sense of commitment to population and family planning issues. USAID Role and Achievements to Date: USAID has provided funds for population programs in Turkey since the 1960s. Today's USAID assistance focuses on sustaining a reduced rate of population growth and a financially sustainable program, able to continue in the absence of donor resources. To achieve this end, USAID and the U.S. Embassy in Ankara, developed a fiveyear strategy for 19951999. According to the strategy, the assistance budget will be phased down to insignificant levels by the end of 1999. The program focuses on policy, management development, training education, communication and service delivery. Twentyone percent of the 1995 USAID population assistance budget was earmarked for contraceptive commodities for the public sector. The strategy also includes a phaseout plan for commodities, whereby the GOT will assume full responsibility for procurement of contraceptives by the year 1999. The convergence of a number of factors have created ideal conditions for impact in Turkey. The most salient factor is the GOT's elevated sense of commitment to population and family planning issues and the willingness to develop the role of the commercial and nongovernment sectors an endeavor seen to promote program sustainability. The GOT, commercial sector, and nongovernmental organizations have all requested technical assistance in reaching their individual and mutual goals contributing to the increasingly productive partnership between USAID and Turkey. The coordination of the program rests with a Joint Programming Team comprised of USAID/Washington and U.S. Embassy representatives. Description: USAID's activities focus on increasing the availability and effective use of quality family planning and reproductive health services; improving Turkey's selfreliance in family planning and reproductive health by enhancing the public and private sector ability to meet consumer demand for these services independent of USAID support. There are three USAID strategic approaches for achieving the program's strategic objectives: 1. Strengthen policy and GOT budgetary support for the family planning program; 2. Improve the quality of family planning and reproductive health services in the public and private sectors; 3. Expand access to family planning and reproductive health services and information in the public and private sectors.  Host Country and Other Donors: The Turkey's Ministry of Health, the Social Insurance Organization (SSK), NGOs and the commercial sector collaborate with USAID programs. With USAID as the lead donor both in financial and programmatic terms of the program, several other donors contribute to the program. The United Nations (UN) endorses an integrated approach to improve maternal, child and family planning services and focusses on underserved populations, covering the most remote 28 provinces in eastern and southeastern Turkey. The International Planned Parenthood Federation (IPPF) supports the Family Planning Association of Turkey (FPAT), its local affiliate, in supporting various small projects, mostly educational activities, aimed to religious leaders, adolescents, men, and policymakers. The Japanese International Cooperating Agency (JICA) plays a limited role, in funding the establishment of a hightech studio for the development of audiovisual materials for the MOH. In addition, The European Union (EU) and the German Technical Cooperation Assistance (GTZ), have recently committed small grants to local NGOs to carry out small scale family planning service delivery projects. Finally, the World Bank supports a large five year health sector loan, however, it does not focus on population and family planning. ÌBeneficiaries: This effort seeks to directly benefit women of reproductive age, their husbands and children through helping them meet their desired family size and improving the health status of women and children. Indirectly, this effort seeks to benefit the entire population of Turkey by reducing the population pressures on the economy, environment, housing and social services. Principal Contractors, Grantees, or Agencies: Cooperating groups are: the Johns Hopkins Program for International Education in Reproductive Health (JHPIEGO), the Johns Hopkins Population Communication Services (PCS), the Futures Group International through the Social Marketing Project (SOMARC) and through OPTIONS for Population Policy Project, Pathfinder International, Access to Voluntary and Safe Contraception (AVSC) International, Management for Sciences for Health through the Family Planning Management Development Project (FPMD), John Snow Incorporated through the Family Planning Logistics and Management Project (FPLM) and through Family Planning Service Expansion And Technical Support Project (SEATS). Major Results Indicators: Achievement of strategic objectives by the end of 1999 will be measured quantitatively or qualitatively, as appropriate, using the following markers: Existence and implementation of a strategic plan for the national family planning program. Contraceptive prevalence of modern methods increased from 34.5% to 45% Improved method mix by increasing longterm methods (DepoProvera, male & female sterilization, pills) Decreased discontinuation rates of modern contraceptives Reduction in the rates of reported abortions. GOT procuring all public sector contraceptives, including injectable. MOH has a family planning line item in its annual budget. The private sector will provide 75% of modern contraceptives (condoms, pills, DepoProvera) #x  @ ;X@#