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  • Title: Using situation analysis data to assess the functioning of family planning clinics in Nigeria, Tanzania, and Zimbabwe.
    Author: Mensch B, Fisher A, Askew I, Ajayi A.
    Journal: Stud Fam Plann; 1994; 25(1):18-31. PubMed ID: 8209392.
    Abstract:
    Situation analyses conducted in Nigeria. Tanzania, and Zimbabwe have revealed problems in the functioning of many of the subsystems of family planning service delivery, namely in supplies of commodities; in facilities and equipment; in staffing and training; in information, education, and communication; and in record keeping. Although a clear pattern of clinic use exists, in that only a few service-delivery points provide contraceptive services to the majority of new family planning acceptors in the three countries, an attempt to explain how clinics with more clients differ from those that are visited less frequently revealed only a weak association between subsystem functioning and use. Family planning specialists analyzed subsystem data and the pattern of clinic use from family planning clinics in Nigeria, Tanzania, and Zimbabwe to illustrate how situation analysis can help program managers identify service delivery problems, possible remedial actions, and needs in a clear manner and evaluate specific interventions to improve the quality of family planning services. The Nigerian study included service delivery points in only 6 states. The Tanzanian and Zimbabwean studies included service delivery points countrywide. The researchers examined the functioning of family planning subsystems. They found considerable problems in supplies of contraceptive methods, in facilities and equipment, in staffing and training, in IEC (information, education, and communication), and in record keeping. In Nigeria, just 37% of service delivery points had disposable gloves. Only 56% of facilities had adequate water available in the examination area. In Zimbabwe, 84% and 86% of service delivery points did not have IUDs and injectables, respectively, which limited contraceptive choice. Tanzania had the most problems with subsystem functioning. Few service delivery points in any country provided contraceptive services to most new clients. Thus, there is much room to expand family planning services in most facilities which have few clients. A weak positive association existed between subsystem functioning and use, so the researchers could not explain the variation in number of new acceptors by level of subsystem functioning. They suggested a return visit to a few service delivery points, for a longer stay, as a way to learn ways the active facilities differ from the inactive facilities.
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