Evaluation of village family planning program, USAID Indonesia project : 497-0327, 1983-1986

External evaluation covered the period 1983-86 and was based on document review, questionnaire surveys during site visits, and interviews with officials. On the whole, the project is highly successful: access to contraceptive services has increased, as have new acceptors and continuing users. Even with a rapid growth of fertile age couples, contraceptive prevalence increased by 38% between 1983 and 1986. The quality of services has improved, and management improvements were made at all levels. However, despite much effort on the part of BKKBN (Indonesia"s National FP Coordinating Board) to improve its service statistics, some troubling anomalies require attention. Information, education, and communication (IEC) programs of a consciousness raising/motivational nature were increased, but there was no matching increase in information about various contraceptives. Although good progress was made in extending the Posyandu (integrated mother/child health and FP services), more could be done to ensure effective integration and prepare BKKBN field workers for their changing roles. And, although non-clinical contraceptive distribution is significant at the village level, with shifts toward longer-acting contraceptives, hospitals and health centers are becoming even more important to backstop village programs and provide clinical methods; the physical conditions of many of the health centers require further attention. The evaluation team found impressive institutional involvement of the community at the village level, and that the use of private doctors and midwives is growing slowly at the village level. In most areas, the VFP program will continue to grow even without further U.S. assistance. The evaluation recommendations are based on the assumption that the Indonesian government will continue its strong support for FP, as will USAID/I, through amendments to this project (plans now call for an extension to 1992) and through the new private sector/urban project. Specific recommendations include expanding the scope of the surgical program to include all clinical methods, assisting the training of field workers for new roles with Posyandu, assisting with review of the statistical base, ensuring adequate attention to explaining contraceptive methods in the IEC program, supporting operations research on village group cost recovery and other activities, expanding contraceptive social marketing, providing limited continuing assistance to two outer island provinces, ensuring that "integrated programs" are fully integrated, and assisting with review of income generation activities. (Author abstract, modified)