Organizing for effective family planning programs.

TLDR: Following an introduction chapter general environments (social political cultural and economic) in which family planning programs operate are discussed and the critical importance of the interaction between programs and client populations are emphasized.

Abstract: Following an introduction chapter general environments (social political cultural and economic) in which family planning (FP) programs operate are discussed. The task environment: a more direct set of factors affecting program activity; and the technological and resource (money; personnel; infrastructure; facilities) environments are also examined. Program management and elements are discussed in terms of context e.g. fitting programs into national structures; operational planning; integration of FP with other service delivery; developing human resources; demand generation; and program logistics. (A shortage of logistics literature is noted.) Special modes of delivery: community-based distribution under public and private sponsorship; related marketing technics; social marketing; and the role of private clinics and physicians are examined. The critical importance of the interaction between programs and client populations are emphasized. Such interaction includes visits by extension workers; service providers; and indirect contacts with leaders or professional personnel through printed materials and the media in a variety of settings: clinics; community-based FP programs; and commercial distribution systems. Ways in which user and to an extent community incentives and disincentives have been used in different countries are assessed with reference to changes over time for example in India and Singapore. Methodological issues: the measurement of inputs and contraceptive availability; the similarity of the concepts of availability and accessibility; and cost-effectiveness measurement; issues connected with measuring the causal impact of family planning; and the separation of the effects of social and economic conditions on contraceptive use and fertility. Suggestions are made for future research: little empirical evidence exists concerning several crucial elements of program implementation.