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In: Operations research family planning database project summaries, [compiled by] Population Council. New York, New York, Population Council, 1993 Mar.  p. (ZAI-10)This project grew out of the need to monitor the quality of care in the various community-based contraception distribution (CBD) projects which were subprojects of the Tulane Family Planning Operations Research Project. The objectives of this activity were to: 1) assure that women who use the services of CBD workers were properly screened for use of oral contraceptives (if that was the method they chose), that they received correct information about the methods and their use, and that they were referred to other levels in the health system when appropriate; 2) to strengthen the position of existing CBD programs if they were to come under attack in the future over the issue of quality of service; and 3) to develop a methodology that could be used in other CBD programs, including those outside of Zaire. The project consisted of a series of activities designed to improve the quality of care in CBD programs, including conducting workshops among project personnel and standardizing medical norms and program procedures. A system for evaluating distributor performance, based on a knowledge test, observation of interactions with clients, and a client survey, was developed and tested in the field. A guide for implementing contraceptive CBD programs and a manual for training CBD distributors were produced to standardize many of the procedures used in the CBD programs and to provide certain norms for service delivery. A methodology was subsequently developed for evaluating distributor performance which included: a knowledge test for distributors to assure that they were able to answer basic questions about the contraceptives and other medications they sold (correct use, side effects, contraindications); an observation guide consisting of a list of points which a distributor should cover during visits to a potential (new) client as well as to a continuing user; and a subjective measurement of rapport between distributor and client. A short questionnaire was prepared for clients to determine whether they knew the correct use of the method chosen and whether they were satisfied with the services of the distributor. This 3-pronged approach to the evaluation of distributor performance was tested at 2 sites: Kisangani and Matadi. The knowledge test was also administered in Mbuyi Mayi and Miabi. While the knowledge test proved to be a quick way to determine whether distributors were informed on key points, the full evaluation approach proved too labor-intensive to be practical as a tool for continuously monitoring distributor performance. Based on experience with the full model, a supervisory form was developed which included some of the same elements but was more practical for routine use in the field.
In: Jain SC, Kanagaratnam K, Paul JE, ed. Management development in population programs. Chapel Hill, University of North Carolina, School of Public Health, Dept. of Health Administration and Carolina Population Center, 1981. 113-51.This case study examines the management development aspect of the Korean national family planning program which was initially adopted in 1962. The nation's goal in the 1st 10 years of the program was to reduce the rate of population growth from 2.9-2.0%. Subsequent targets were established to reduce the growth rate to 1.5% by 1976 and 1.3% by 1981. Recent census figures indicate that these latter figures were not reached. The total fertility rate declined from 6.0 in 1960 to 2.7 in 1978, a 55% decline. The age specific fertility rate also declined except for women between 25-29 years of age. Program costs during the last 18 years totaled about $126.7 million; 80% of these funds came from the government and the rest from foreign assistance. 3811 full time employees were engaged in the program in 1979; 4.9% at the central level, 8.1% at the provincial level, and 87% at the urban and county level. 69% are considered family planning workers. Between 1962-79, 6.1 million cumulative acceptors have received contraceptive services. The IUD was the principal method of contraception until 1976 when female sterilization services were introduced. The contraceptive practice rate has increased from 9-49% between 1964-78. Organization of the program is structured on a national, provincial, and local basis. Assessment of the program indicates that there has been success but the following problems still remain in the, 1) rural oriented program structure, 2) high discontinuation rates of contraceptive usage and inadequate follow-up, 3) high turnover of field workers, 4) difficulties in using local civil administration services, 5) poor quality research, 6) weak management training, and 7) poor relationships among special projects. Other program management problems exist in planning, resource allocation, training, use of private clinics, coordination, interagency coordination, program supervision, recording systems, and overall program evaluation. Emphasis is placed on the operational and managerial capacity of the program managers to successfully implement family planning programs. Improvements in the current managerial system and the role of international agencies are discussed.
Bangkok, Thailand, Ministry of Public Health, 1976. 52 p.Add to my documents.