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  • Title: Delivering reproductive health promises.
    Author: Hardee K.
    Journal: China Popul Today; 1995 Dec; 12(5-6):18-9. PubMed ID: 12346900.
    Abstract:
    This article briefly covers some issues involved in implementing the reproductive health agenda of the Fourth World Conference on Women, held in Beijing in 1995. A more detailed discussion is presented by the author in a Family Health International Working Paper (No. WP95-01). The reproductive health goals of the Beijing's women's conference were a ratification of the Plan of Action from the 1994 International Conference on Population and Development, Cairo. Women's empowerment is viewed as possible with a comprehensive, client-centered view of reproductive health services integrated with family planning. There remain many policy and service delivery challenges to integrated programs. The two main objectives of integrated services are to better meet client's needs and to improve efficiency and effectiveness of these services. There was some conference agreement on 16 broad groups and 76 specific services, which would be included in integrated programs. A service structure alone did not assure integrated services. The presence of established vertical programs and weak administrative capacity were obstacles, which had a more marked impact on integrated programs. Service delivery was viewed as enhanced by effective donor collaboration. A unified set of priorities between different donors must be agreed upon. Donors must also reach agreement on resource sharing, assumptions of joint responsibility for success and failure, and balancing of local priorities with agency priorities. The National Policy Development process must include a range of constituent groups, such as women's groups, policy makers, grassroots organizers, service providers, and client representatives. Service gaps could be identified by operations research efforts. A greater health impact could be achieved by programs with limited scope but clearly identified priorities than overextended comprehensive programs. Logistics and services delivery systems could adjust better when service components were phased in. Vertical government ministry organization, even with consistent national policy, was an obstacle to integration. Integration is costly, and funding needs must be secured. Implementation of integrated programs could be enhanced by use of the lessons learned already.
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