The report by University of North Carolina at Chapel Hill researchers could affect U.S. international assistance for family planning programs in developing countries, especially as the federal government tightens its foreign aid purse strings, the researchers say.
"Cutbacks in U.S. spending on family planning increase the need to use resources where they make the most difference," said Dr. Amy O. Tsui, director of the EVALUATION Project at UNC-CH's Carolina Population Center.
"The Rockefeller Foundation recently reported that the largest generation in history is about to reach child-bearing age," said Tsui, also associate professor of maternal and child health at the School of Public Health. "Contraceptive demand is increasing, but resources are not. Scientific research can inform policy so we can find ways to stretch family planning dollars."
The EVALUATION Project sponsored a group of nearly 60 scholars including health specialists, economists, demographers, biostatisticians, geographers and physicians to conduct the research. The U.S. Agency for International Development (USAID) funded the work, which assessed programs in Bangladesh, Brazil, Ecuador, India, Indonesia, Kenya, Morocco, Peru, the Philippines, Nigeria, Tanzania and Thailand.
Findings from 41 studies are summarized in the report, "Understanding How Family Planning Programs Work: Findings from Five Years of Evaluation Research."
The report documents how the composition of family planning service providers has broadened over the years. In some countries, programs are subsidized by the state, but delivered by private health care providers or integrated into other health services.
For example, in Bangladesh, health-care workers visit homes to disseminate family planning information and services. A community-based outreach program accounted for a tripling in contraceptive use by couples in that country. The program, which offers continuous personal contact, also prevented 65 percent of couples from stopping contraception.
Since government-sponsored, national family planning programs were begun in the 1950s and 1960s, evaluations have been used to determine the extent to which those effort have lowered birth rates.
"Evaluation is critical to family planning programs," Tsui said. "It is key to building successful programs that enable managers to identify which components are linked to what they are trying to accomplish. Objective evidence gathered by such evaluation allows decision-makers to channel resources into those programs with the greatest likelihood of success.
"By empirically demonstrating the effects of family planning programs, decision-makers can make informed choices about where to use scarce funds for the best results," she said.
Note: Tsui can be reached at (919) 966-7482
Carolina Population Center Contact: Allison Adams, (919) 489-1521
News Services Contacts: David Williamson, Juliet Dickey