CONTENTS
Chapters
- Thirty Years of Family Planning Programs
- Family Planning Demand
- Contraceptive Access
- Choice of Contraceptive Methods
- Client-Centered Quality
- Communication
- Well-Trained Providers
- Program Leadership and Strategic Management
- Research and Evaluation
- Political Commitment
- Financial Resources
Population Reports is published by the Population Information Program, Center for Communication Programs, The
Johns Hopkins School of Public Health, 111 Market Place, Suite 310, Baltimore, Maryland
21202-4012, USA
Volume XXII, Number 2
August, 1994 |
Lessons Learned
Perhaps the most important lesson learned from this review of the experience
of the past 30 years is that family planning programs succeed when they
meet people's needs (see Lesson 1, Family
Planning Demand). This statement is not as obvious as it may
appear. A common view of developing countries has been that "traditional"
people—poor, rural, and little educated—are not interested in having smaller
families, and thus that programs must "generate demand" for family planning,
or that family planning will be widely adopted only after economic development
has taken place. While it is true that total demand is less among the poor
and rural than among the rich and urban, experience shows that there is
substantial existing demand for family planning among most groups, that
much potential demand remains unsatisfied, and that widespread, latent demand
for family planning has almost always existed before family planning programs
began to provide services throughout the country.
How can programs best meet the demand? There is widespread
agreement among the Population Reports questionnaire respondents
and in research and program findings that the following elements
are vital to success:
At the service delivery level:
- Convenient access to contraceptive services;
- Choice of a range of contraceptive methods;
- High-quality, client-centered services;
- Sustained information, education, and communication; and
- Trained personnel;
At the program administrative level:
- Stable program leadership capable of strategic management; and
- Research and evaluation; and
At the government policy level:
- Political commitment; and
- Adequate financial support.
Some of these lessons, such as the importance of making
services accessible and of offering a range of methods, have been
widely known and followed for a long time. Others, such as the
importance of client-centered services and of sustained
communication, have become more widely recognized recently.
Characteristics that questionnaire respondents in some countries
identified as lessons were identified as challenges by
respondents in other countries, perhaps a sign that family
planning programs are at different stages.
Challenges and opportunities. Even successful family
planning programs face new opportunities and challenges. Most
respondents to the Population Reports questionnaire, as well as
recent studies, agreed that family planning programs must respond
to several critical concerns including:
- Satisfying the rising demand for high-quality family planning services;
- Serving young people better;
- Improving reproductive health care, including addressing unsafe abortion; and
- Generating new funding needed to support and sustain programs.
Despite past successes, "tens of millions of people
worldwide are frustrated in trying to exercise their right to
plan their families by lack of access to good-quality family
planning services," a recent IPPF report observes (74). The
programs that have learned the lessons of the past three decades
of family planning experience will be best equipped to provide
better access and services and to meet the challenges of the
1990s. |
