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Lancet. 1995 Jul 29; 346(8970):301.The World Bank, in "India's Welfare Programme: Towards a Reproductive and Child Health Approach," a review done with the Ministry of Health and Family Welfare, makes the following recommendations: 1) eliminate method-specific contraceptive targets and incentives, and replace them with broad reproductive and child health goals and measures; 2) increase the emphasis on male contraceptive methods (which account currently for only 6% of contraceptive use); 3) improve access to reproductive and child health services; 4) increase the role of the private sector by revitalizing the social marketing program; and 5) encourage experimentation with an expanded role for the private sector in implementing publicly funded programs. Since the launch of the family planning program in 1951, mortality has fallen by two-thirds, and life expectancy at birth has almost doubled. However, the population has almost doubled since 1961. By 2025, it is expected to be 1.5-1.9 billion. By 1992, India had achieved 60% of its goal for replacement fertility (2.1 births per woman), decreasing from 6 births per woman in 1951-1961 to 3-4 births per woman. Meeting India's unmet need for family planning would allow the replacement fertility goal to be reached. Female education and employment would add to the demand for smaller families and assure continuing declines in fertility and population growth rate. The report also highlights problems in implementation of the program, including program accessibility and quality of care. The report cites National Family Health Survey data which shows that only 35% of children under 2 received all six vaccines in the program, while 30% received none. The bank's "1993 World Development Report" recommended spending $5.40 per head for maternal and child health and family welfare programs; India spends $0.60. Massive borrowing will be required.
Management information systems in maternal and child health / family planning programs: a multi-country analysis.
STUDIES IN FAMILY PLANNING. 1991 Jan-Feb; 22(1):19-30.Management and information systems (MIS) in maternal and child health were surveyed in 40 developing countries by trained consultants using a diagnostic instrument developed by UNFPA and the Pan American Health Organization (PAHO). The instrument covered indicators of input (physical infrastructure, personnel, training, finances, equipment, logistics), output (recipients of services, coverage, efficiency), quality, and impact, as well as frequency, timeliness and reliability of information. The consultants visited national and 2 provincial level administrative and service points of public and private agencies. Information on input was often lacking on numbers and locations of populations with access to services. In 15 countries data were lacking on personnel posts filled and training status. Logistics systems for equipment and supplies were inadequate in most areas except Asia, resulting in shortfalls of all types of materials and vehicles coinciding with idle supplies in warehouses. Financial reporting systems were present in only 13 countries. Service outputs were reported in terms of current users in 13 countries, but the proportion of couples covered was unknown in 25 countries. 2 countries had cost-effectiveness figures. Redundant forms duplicated efforts in half of the countries, while data were not broken down at the usable level of analysis for decision-making in most. Few African countries had either manual or computer capacity to handle all needed data. Family planning data especially was not available to draw the total picture. Often information was available too late to be useful, except in Portuguese speaking countries. Even when quality data existed, managers were frequently unaware of it. It is recommended that training and consultancies be provided for managers and that these types of surveys be repeated periodically.
A comprehensive review of the objectives, activities and performance of the family planning programs of the United Nations Fund for Population Activities.
[Unpublished] 1981. 97 p.Evaluative report on the progress of the United Nations Fund for Population Activities (UNFPA) in its family planning programs, the stated goal of which is to provide assistance to developing countries in the area of population control. Of particular interest is UNFPA's strategy for support of family planning programs which include substantial assistance for health related services. Several specific objectives of the review can be named: 1) identification of the major categories of family planning assistance supported by UNFPA; 2) specification of the nature of and rationale behind regional differences in UNFPA support for family planning programs; 3) description of and rationale behind UNFPA health programs which exclude family planning; and 4) analysis of UNFPA's strategy and practice for contraceptive procurement. The review was conducted between February and May of 1981 and drew on interviews with policy and technical staff, on-site visits, and review of a wide range of documents. Included in 2 appendices is a listing of personal contacts made and documents reviewed. Overall, the review indicated that UNFPA was carrying out its objectives and program activities adequately in all areas. It had established a system of voluntary incoming contributions, and an equitable system of disbursement to country and intercountry programs. Secondly, it had established resources and staff for the technical support and coordination of activities. The principal needs of the future are seen to be concerned with increased effectiveness of resource utilization and in even more forceful leadership in the population field.
In: The Population Debate: Dimensions and Perspectives, Vol. II. N.Y., U.N., 1975, pp. 506-513. (Population Studies, No. 57)Add to my documents.