[Family planning centers].
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The effectiveness of ensuring quality of care in reproductive health/family planning (RH/FP) services and making services accessible to people in rural areas is being demonstrated in Laos, where community people are willingly paying nominal fees for services provided under JOICFP's project. The birth spacing project is being implemented by the Institute of Mother and Child Health (IMCH) under the UNFPA-supported regional "Capacity Building for Sustainable Community-based RH/FP Project Emphasizing Quality of Care (RAS/96/P09)." How to reinvest funds collected for services was one of the main topics of a project review and planning workshop held in Vientiane on July 18 and 19. The event was attended by 15 staff members directly involved in project implementation who focused on ways to effectively manage the funds. Specifically, the participants discussed establishing a revolving fund system. The participants noted that the project, which reaches out to remote villages with mobile teams of health care personnel, has been successful in creating awareness of RH/FP issues and motivating community people. In many areas, community people have voiced their desire to sustain services with their own support if outside funding is withdrawn. Neighboring villages to project communities have also expressed their interest in launching the project with their own funds. Interviews conducted as part of a small-scale survey of project areas in Laos clearly indicated a high level of awareness of FP. In response to this, the project personnel are now focusing on ways to build on this awareness and meet unmet needs with high-quality services and counseling.
"This analysis begins with a presentation of a summary of levels and trends of fertility. Selected factors affecting fertility are also addressed. Then data from the National Indonesia Contraceptive Prevalence Survey (NICPS) carried out as part of the Demographic and Health Surveys program in 1987 are used to investigate the extent of fertility planning among Indonesian women, and the extent to which the plan is being implemented. Differentials in fertility intentions are also studied." (SUMMARY IN ENG)
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"This article reviews the experience of two pilot projects in Bangladesh that have addressed the question of how [operations] research can be designed to foster its utilization. In a rural field experiment [begun in 1972] in Matlab subdistrict, research has demonstrated that contraceptive services, if carefully designed and properly implemented, can influence demographic dynamics even where social and economic circumstances are not conducive to fertility change. Despite the success that Matlab represents, the project was not systematically utilized for policy until a second study [begun in 1981] was launched to address government questions concerning its replicability in the public sector programme. Results suggest that pilot projects, if fielded in conjunction with research systems for testing their replicability, can foster organizational development in contexts that are not conducive to bureaucratic change."
The Indian family welfare program has offered financial incentives since the early 1960s to both family planning motivators and acceptors of sterilization and the IUD. This article reviews the available evidence regarding the impact of incentives on the quality and quantity of family planning services in India. Administrative concerns related to the implementation of incentive programs are discussed, and the current debate on disincentives, as well as the brief period when disincentives were used, is summarized. The studies reviewed, though few in number and varying in quality and methodology, indicate that incentives to acceptors help to increase the level of contraceptive acceptance, especially when they are part of a well designed strategy of service delivery and client motivation. Incentives do not appear to have an adverse effect on quality of services and acceptors, and they do not seem to influence method choice. Disincentives, if they are used, should not impinge on fundamental individual rights of either the parents or the child.
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