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

Over the past 30 years, family planning programs have helped millions of people to have the smaller families that they want. As programs have learned how to meet people's needs, contraceptive use has spread rapidly.

What makes a family planning program work? Population Reports has identified 10 key lessons about what makes programs succeed, based on a consensus of opinion among respondents to a new survey and a review of family planning research and program findings.

(1) Family planning demand. Most women want to avoid unintended pregnancies, and most couples want to plan their families. Given the opportunity, people chose contraception because it meets their personal needs.

(2) Contraceptive access. Successful programs offer services not only in clinics but also in retail outlets, community centers, places of employment, and people's homes. They maximize access by overcoming geographic, social, economic, informational, psychological, and administrative barriers between people and family planning services.

(3) Choice of contraceptive methods. Successful programs provide a range of contraceptive methods, not just one or two. Offering a variety of methods helps to meet people's diverse needs and helps programs serve the changing needs of women and men over their reproductive lifetimes.

(4) Client-centered quality. For many people, the quality of services is an important factor in the decision to use family planning. Clients are more likely to be satisfied and to continue using family planning if they are able to make informed choices in a climate of respect for their needs and decisions.

(5) Communication. Communication campaigns have helped millions of people become more aware of family planning and better informed about modern contraceptives. Both mass media and interpersonal communication have helped people make informed choices to adopt healthier reproductive behavior.

(6) Well-trained providers. Programs that train their staffs well are better equipped to meet their clients' needs. Strengthening the technical and interpersonal skills of family planning providers enhances the quality of care and thus increases clients' satisfaction with services.

(7) Program leadership. Most successful programs have strong and stable leadership, whose determination, innovation, and managerial skills have brought services to the less educated and the poor as well as the middle class and to hard-to-reach rural areas as well as cities.

(8) Research and evaluation. Programs that analyze their performance improve their performance. Pilot projects, experiments, surveys, evaluations, and other studies guide the development of the most successful programs.

(9) Political commitment. Strong endorsement both from the top of government and from community leaders gives family planning high priority. Political support helps assure adequate resources for programs and also confirms that family planning is the norm.

(10) Financial resources. Well-funded family planning programs accomplish more and accomplish it better. The level of funding helps determine both the extent and the quality of services that programs can offer.

• Satisfy the remaining unmet need for family planning among millions of married women who want to avoid pregnancy now;
• Extend information and services to the young and the unmarried and to men;
• Offer broader reproductive health services that also address issues of safe childbirth, abortion, AIDS, and other sexually transmitted diseases.
• Generate the resources needed to support and sustain high-quality family planning services through the 1990s and into the next century.