Impact of franchised family planning clinics in urban poor areas in Pakistan

Abstract

Family planning programmes are costly to implement, so it is critical to determine their effect. This study uses a quasi-experimental design to determine the impact of new family planning clinics on knowledge, contraceptive use and unmet need for family planning, amongst married women in urban poor areas of six secondary cities of Pakistan. Baseline (n=5,338) and end-line (n=5,502) population surveys were conducted in four study sites and two control sites. Client exit interviews identified the socio-demographic and geographic characteristics of clinic users. The results show that the clinics contributed to a 5% increase in overall knowledge of family planning methods, and an increase in knowledge of female sterilisation and the IUD of 15% and 7% respectively. There were distinct effects on contraceptive uptake, with an 8% increase in female sterilisation and 7% decline in condom use. Unmet need for family planning declined in two sites, while there were variable impacts on the other sites. Although the new clinics are located within urban poor communities, users of the services are not the urban poor themselves but select sub-groups of the local populatio