Family Planning Operations Research: A Book of Readings

For as long as there have been family planning programs, there has been family planning research. At the theoretical level, researchers examine the effect of fertility on health and socioeconomic development and study the determinants of fertility for individuals and populations. At the policy level, studies explore the role of family planning programs in modifying fertility and health. The development of new contraceptives is accompanied by clinical and pre-introductory trials in program settings. Surveys measure changes in contraceptive use and fertility, and the results are used to make decisions affecting programs. Finally, programs themselves carry out operations research (OR) to improve service delivery. This book provides an overview of how OR is used by family planning programs. The readings illustrate many of the major issues and topics that have benefited from OR, as well as many of the research designs encountered among OR studies. The book also provides information about the problems that programs and researchers encounter in carrying out OR and the challenges faced in translating research findings into changes in day-to-day program operations

Technical assistance to the Institute of Reproductive Health, Georgetown University in researching introduction strategies for the Standard Days contraceptive method (SDM)

The Institute of Reproductive Health (IRH), Georgetown University tested the impact of introducing the standard days contraceptive method (SDM) with the technical assistance (TA) of Population Council staff. FRONTIERS technical assistance had the immediate effect of allowing IRH to carry out evaluations of the SDM in Asia and Latin America. The IRH studies also produced important lessons learned on strategies for the introduction of natural methods. IRH staff responsible for the India and Ecuador projects learned specific skills in cost-analysis and research instrument design

Increasing access to family planning (FP) and reproductive health (RH) services through task-sharing between community health workers (CHWs) and community mid-level professionals in large-scale public-sector programs: A literature review to help guide case studies

This literature review covers case studies related to community-based distribution of family planning programs, and community health worker (CHW) programs that included family planning and other reproductive health services. It offers essential processes and implications for additional operations research which look at constraints and factors critical to introducing new program procedures or strengthening existing ones

FRONTIERS capacity building: An overview

The Population Council’s Frontiers in Reproductive Health Program is a cooperative agreement with USAID to improve family planning and reproductive health service delivery through operations research (OR). Frontiers builds on more than 20 years of research to improve family planning service delivery programs. A major goal of Frontiers is to transfer skills in OR so that public and private agencies in developing countries can conduct OR and apply research findings to reproductive health programs and policies. OR addresses problems in operational effectiveness, access, quality, and efficiency by investigating facets of programs that managers can control and change. As concluded in this overview report, Frontiers seeks to institutionalize capacity building by increasing the number of service delivery organizations that use OR and increasing the number of research organizations capable of conducting and teaching OR. Investment in capacity building will ensure that OR will make a continuing, significant contribution to reproductive health and family planning programs and policies

Building capacity to utilize operations research: Strategies and lessons learned

The effectiveness of development assistance depends on good decision-making. Many donors and international health agencies such as USAID, DFID, and WHO are placing more emphasis on the utilization of research results for policy and program development. Yet, while there is a long tradition of training researchers to produce research, there are few lessons on how to teach managers to request and use research results for making program decisions. Addressing this gap has been a major strategy of the Population Council’s Frontiers in Reproductive Health Program (FRONTIERS). Since its inception in 1998, FRONTIERS has complemented its support for operations research (OR) with an evolving range of capacity-building activities. This capacity building increases the number of program managers and researchers who can understand and conduct OR and utilize the resulting findings. As of 2005, over 700 program managers and researchers from 54 countries had participated in FRONTIERS capacity-building activities, including courses, training of trainers, infrastructure development efforts, and costing studies. This program brief presents lessons learned through FRONTIERS capacity-building work in fostering the increased use of OR by family planning and reproductive health programs

Using systematic screening to integrate health services in India and Senegal: Pilot study versus scale-up results

This study examines the effectiveness of using systematic screening to integrate health services in India and Senegal. First, a pilot study of relatively small-scale experiments was undertaken to determine if systematic screening for unmet needs for health services could increase the number of preventive care services clients receive at healthcare visits. FRONTIERS then participated in the scale-up to test the effect of different supervision and training strategies on the frequency of provider screening. Results show that systematic screening may have the potential to produce important increases in the number of services provided in many developing country settings at the pilot level; however, at the program level, the frequency of screening can vary greatly. The factors influencing implementation at the program level need to be better understood

Willingness to Pay Surveys for Setting Prices for Reproductive Health Products and Services: A User\u27s Manual

Social programs need to balance volume (coverage) and revenue (sustainability). The law of demand says that we cannot get both coverage and sustainability at the same time—as prices go up, demand will come down. Client loss with increasing prices is inevitable, except in those cases where starting prices are so low or demand is so high that demand is insensitive to price changes. Willingness to pay surveys allow program managers to simulate price-related changes in demand without actually changing prices, giving them a way to make pricing decisions based on empirical information. In making pricing decisions, managers of social programs face an equity dilemma—the problem of balancing the need for program sustainability with the social goal of making services available to low-income clients. Raising prices too high will deny services to poor clients. However, maintaining needlessly low prices will perpetuate reliance on external donors. Until recently, managers had to make pricing decisions without a reliable methodology for predicting the effect of price changes on program revenues or use. This user’s manual describes a simple survey technique to estimate client willingness to pay for goods and services, thus allowing managers to make rational pricing decisions

Postabortion family planning benefits clients and providers

A woman’s fertility can return quickly following an abortion or miscarriage, yet recent data show high levels of unmet need for family planning (FP) among women who have been treated for incomplete abortion. This leaves many women at risk of another unintended pregnancy and in some cases subsequent repeated abortions and abortion-related complications. It is thus vital for programs to provide a comprehensive package of postabortion care (PAC) services that includes medical treatment, FP counseling and services, and other reproductive health services such as evaluation and treatment for sexually transmitted infections, HIV counseling and/or testing, and community support and mobilization. Providing FP services within PAC benefits clients and programs. Facilities that can effectively treat women with incomplete abortions can also provide contraceptive services, including counseling and appropriate methods. As stated in this brief, any provider who can treat incomplete abortion can also provide selected FP methods. Clients, providers, and programs benefit when FP methods are provided to postabortion clients at the time of treatment

Encuestas de voluntad de pago para fijar precios de productos y servicios de salud reproductiva: Manual de usuarios

Social programs need to balance volume (coverage) and income (sustainability). The law of supply and demand states that we can not obtain coverage and support at the same time, because when prices rise, demand decreases. This manual presents willingness-to-pay (WTP) surveys that allow program managers to simulate changes in demand related to price, without actually changing prices. The Population Council with The Futures Group International developed these surveys that can be used for existing and new products and services, collect responses from clients with no formal education with sensitivity to their individual characteristics, and provide conservative estimates that accurately predict most reactions to price changes

Systematic screening: A strategy for determining and meeting clients\u27 reproductive health needs

Systematic screening is a strategy to integrate reproductive health services at the provider level. Integration is the proactive provision of multiple reproductive health services in the same facility at the same time. Systematic screening is a simple intervention to increase the number of services received at a single client visit. In this strategy, providers use a checklist or questionnaire to identify each client’s needs and desires for reproductive health services. They then provide these services during the same visit, through an appointment at the same clinic, or through referral to another facility. The Population Council’s Frontiers in Reproductive Health Program (FRONTIERS) conducted an interregional test of systematic screening in four countries in sub-Saharan Africa, Asia, and Latin America. This brief discusses the results of these four FRONTIERS OR studies on systematic screening in Bolivia, Honduras, India, and Senegal. The objectives were: to determine the effectiveness of screening in different regions and service delivery points, where the measure of success was the number of health services per client visit; identify major barriers to screening; and test the effectiveness of different screening materials and techniques