Family Planning Programs in 2004: Efforts, Justifications, Influences,
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Author(s): Ross J, Stover J, Adelaja D
Context: Six study cycles from 1972 to 2004 were conducted to measure the intensity and types of effort exerted by national family planning programs. In 2004 a simpler questionnaire was used and new questions added to explore current issues.
Methods: Informants in each of 83 developing countries completed a standard questionnaire. The returns were analyzed centrally with immediate feedback provided to the countries.
Results: Family planning effort increased from 1999 to 2004 overall and within each region using unweighted country data; with weighted country data all regions except Asia rose. The 2004 effort profile across 30 indices is nearly identical to 1999. Countries beginning with low scores have improved more than countries beginning at high levels. Policy scores are more favorable than scores for actual services. Contraceptive access is uneven by method and limited in sub-Saharan Africa. Negative influences bearing on the programs especially concern changes in domestic and donor funding. The strongest justifications for the programs concern improved child and maternal health and avoiding unwanted births. Among groups of special interest unmarried youth and postabortion women receive the least emphasis.
Conclusions: Overall program effort rose again despite competition with HIV/AIDS programs and the post-Cairo broadening of attention, as well as decentralization of health programs, and reallocations of donor funding. Increased program effort is consistent with continuing increases in contraceptive practice. National justifications for the programs stress health and prevention of unplanned births more than economic development or fertility reduction. Unexplained questions concern the persistence of the same or better program effort ratings despite fragile contraceptive security, some losses in funding, and worsening institutional environments.
Acknowledgement: Support for this research was provided by USAID through the MEASURE Evaluation Project implemented by the University of North Carolina.
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