Elements of Family Planning Success

The interaction between clients and providers lies at the heart of any service delivery system. In reproductive health programs, the quality of the client-provider interaction (CPI) is known to have a strong influence on initial adoption, effective use, and continuation of family planning methods, as well as on word-of-mouth publicity about family planning and other reproductive health services. As such, the quality of CPI should be a priority concern of all reproductive health organizations.
In their 1997 review of the research on CPI, Murphy and Steele emphasize that training in CPI is essential not just for counseling and clinical staff members, but for the entire organization. A 1998 issue of Population Reports also calls for organization-wide involvement: it emphasizes the importance of improving the quality of services through improved CPI and a client-centered approach at all levels of the organization. The challenge is how to create such an organizational culture.
To help meet this challenge, this paper proposes a conceptual framework that can guide the analysis of the organizational context in which services occur. Based on a widely recognized model, the framework uses a systems approach to identify the organizational elements that create the context for CPI. The framework provides sample questions for assessing each element within the service delivery setting, suggests issues the organization’s leadership can address in order to strengthen CPI, and discusses environmental trends that may affect service quality. It places particular emphasis on organizational leadership as the central factor linking together the various organizational and environmental elements.