Evaluation of Family Planning/Reproductive Health policy

For reproductive health services, evaluation usually assesses the impact of a project seeking to increase service supply. However, as a result of recent legislative initiatives passed in Texas to curtail the availability of abortion through a two-thirds reduction in public funding for family planning, the subject of the evaluation described here is just the opposite—to assess the impact of measures intended to drastically reduce the supply of these services. We describe the 2011 Texas legislature’s initiatives, the key components of our comprehensive three-year evaluation that will attempt to assess the impact of this legislation on family planning and abortion services, unintended pregnancies, abortions and births, and highlight some of our initial findings. In the first of two waves of interviews with leaders of organizations that provided publicly funded reproductive health services, we found that 22% of the 240 clinics were closed after the funding cuts and an additional 16% of clinics reduced hours. Women in focus groups across Texas stated that it was difficult for them to pay newly instated fees for services, which exacerbated pre-exiting barriers to obtaining reproductive health care. We also review some of the main challenges we face in carrying out this evaluation.

The study explored the origin, architecture and role of political will in increasing contraceptive use in three sub-Saharan African countries - Ethiopia, Malawi, and Rwanda – that have stood out for phenomenal increases in contraceptive use between 2000 and 2012.

We assessed factors that have propelled changes in the attitudes of some political leaders to champion family planning; how such political will has manifested in different contexts; and how political will impacts the policy and program environment.

We use mixed methods, including desk review of policy and program documents and stakeholder interviews. The study findings demonstrate that political will for family planning evolved due to increased availability of evidence that demonstrated that family planning is central to achieving the MDGs, and that high population growth undermines efforts to transform the economies of developing countries.

We postulate that lessons from this study will help galvanize efforts to improve access to family planning services in other African countries where little progress is being made.

This paper is based on the results of the study “Evaluation the implementation of reproductive health care (RHC) policies for ethnic minorities in Vietnam” that was implemented in 2008 by the Institute for Population and Social Studies – NEU required by UNFPA. This study used a combination of three research methods (desk-study, quantitative survey, and qualitative survey). The report indicated that the strength of RHC policies is to clearly express the orientation of incentive RHC for ethnic minorities by setting up specific objectives and solutions towards better condition of human resources, natural and financial resources in the mountainous areas. However, there are some weaknesses: inconsistence and vagueness in terms for subjects of the policies, loopholes in policies, some infeasible objectives, illogicality, contradiction among policies, general criteria, overlapping, and some problems in policymaking procedure. The gaps of policy implementation related to issuing guidance for policy implementation, the dissemination of RHC policies to people, RHC models, human resources, essential health equipment and medicines, regular income-expense for the commune medical centers, are also found out. This paper gave some recommendations to enhance the quality of RHC services for ethnic minorities.

Policy is integral to the success of any health program, including sexual and reproductive health programs. Yet, most policy literature focuses on policy development. Literature on program implementation rarely focuses on the role of policy. Based on a review of academic and programmatic/applied literature, we have developed a conceptual framework linking health policies to health systems and outcomes. The strength of this conceptual framework is the articulation of the importance of the space between the development of a policy and the implementation of a program. Using examples from the field, we identify the challenges in policy implementation that affect programs and health outcomes. Our analysis also identifies gaps in the literature pertaining to the areas of sexual and reproductive health policy implementation, and monitoring and evaluation. We also recommend the initiation of evaluation studies examining the complete policy process linking health policies to health systems and to health outcomes.