Quality of family planning services in Gujarat State, India: an exploratory analysis
Visaria, L.; Visaria, P.
Managing quality of care in population programs: 113-140
1992
Document Number: 373925
It has been 40 years since India's initial adoption of a national policy to promote the practice of family planning in order to lower its birth rate and slow the pace of population growth. During that period India's population has grown from about 361 million to around 850 million. The major achievement of the family planning programme has been that the rate of natural increase has not shot up higher. In recent years, considerable emphasis has been put on improving the quality of health and family planning services. These improvements are expected to result in greater and sustained use of contraceptives. The article describes the availability and utilization of health and family planning services in India, using data from rural and urban areas of the country as a whole and from interviews conducted with a representative sample of 2400 rural and 1000 households in Gujarat State during 1989. The findings indicate that the availability of health services in rural India is limited, that a large army of health functionaries are involved in delivering family planning services, and that the majority of persons rely on the private sector for these services. Given the number of health workers involved and the variation in their background and training, assessing the quality of service they provide is a huge and complex task. In Gujarat State, over 93% of family planning users rely on sterilization. Here therefore, the main quality issue is the lack of method choice, as reflected by the reliance on and promotion of permanent methods.