Evaluation of the operations research in family planning and maternal - child health for Latin America and the Caribbean (INOPAL II) project

Interim evaluation covers the period 9/89-5/93. Having completed 3.5 years, the project has developed 42 subprojects (SPs) in 11 countries, thus fulfilling its major contract requirement. It has demonstrated flexibility in developing different types of SPs and applying different research approaches. The majority of the SPs involve field testing solutions to service delivery problems, ranging from increasing access to FP in rural areas to developing postpartum programs in large urban hospitals. About a third of the SPs are primarily TA efforts, and these range from conducting a seminar or workshop to refining a model for a postpartum adolescent program. The remaining SPs are diagnostic studies, including a comprehensive situation analysis. Although most of the SPs are still underway, considerable progress has been achieved. The project is testing new ways to increase access to an expanded range of FP methods in rural areas by working through PVO networks and ministry of heath units. It has led a successful effort to introduce FP in postpartum hospital programs and has spurred replication in various countries in the region and by other A.I.D. cooperating agencies. It has also incorporated cost-effectiveness analysis and pricing strategies into efforts of private sector FP agencies, and is working to put into practice a theoretical framework for quality of care in a number of programs. The project has contributed to a widening awareness of OR concepts and its value to FP service delivery, although institutionalization of OR capacity is found only in selected agencies in a few countries. The project has also provided broad and effective support for reproductive health as an approach to the delivery of FP services.