Evaluation report : FPMD [family planning management development] assistance in Bangladesh

Interim evaluation covers the period 1987-8/95. LIP's achievements have been impressive. The program has covered about one-quarter of all thanas (local administrative units) in the country, and host government support is high. The formation of local management teams, comprised of community leaders and program staff and providers, has strengthened local commitment and accountability to the national FP program. The lowest level of FP workers -- Family Welfare Assistants (FWAs), all of whom are women -- have seen their role enhanced from household distributor to supervisor through the introduction of a cadre of female village volunteers who have taken over distribution tasks. The vast majority of the FWAs surveyed felt that their skills in planning, supervision, data analysis, and reporting had improved through training and participation in LIP. LIP also appears to have had a life-changing impact on the status of the more than 25,000 women volunteers working with the program. The contraceptive prevalence rate in eight LIP areas averaged 64% compared with the national figure of 36%. About 89% of women in LIP areas reported visiting with program workers within the previous 3 months compared with the national figure of 38%. Further, 15.7% and 64.9% of women with no children and those with one or two children, respectively, use contraception in LIP areas; comparable national figures are 9% and 36.1%. Besides the exceptional advances in community participation fostered in LIP areas, all thanas are now required to make a contribution from local resources to support local FP activities. Policymakers are encouraging the national replication of LIP principles. Finally, the skills of the local subcontractor for LIP have been developed in several areas, such as monitoring and evaluation, use of data for decisionmaking, and serving as trainers in South-to-South exchanges. The Cooperative Agency (CA)/NGO project has had important impacts in three management areas. For example, the management development assessment (MDA) methodology has enabled the CAs to better identify the technical support needed for sustainability; its flexibility is especially appreciated. The Training Impact Evaluation (TIE) methodology has also proven helpful. The project has also worked with the CAs to develop a high-quality management information system (MIS) for collecting Quality, Expansion, Sustainability (QES) data. Lessons learned from LIP are as follows. (1) Developing local level FP management skills though training, TA, and small grants improves service delivery. (2) Despite their low literacy levels, female volunteers can be effectively used to supplement outreach efforts of paid government staff at reduced costs and with notable effects on local FP performance. (3) Demonstrated innovations at the local level, e.g., community contributions, can have a positive effect on the national program. It is too early to document lessons from the CA/NGO project.