From research to action : how operations research is improving reproductive health services

(1) Quality of care. OR reveals clients" perspectives on their care, thus enabling program managers and service providers to understand the factors that affect both delivery and receipt of services. In many countries, OR studies have found that providers" attitudes and beliefs affect quality of care and influence a client"s choice of contraceptive method. When providers are retrained, client satisfaction improves, as does the continued use of their chosen contraceptive method. (2) Outreach to special populations. In Latin America and Africa, family life education courses have increased knowledge and use of FP among young people. Worldwide, studies show that working through traditionally male organizations and training male leaders in a gender-sensitive manner are effective strategies for reaching men. In Africa and Asia, specially trained paraprofessionals and community members have provided information and services to rural and indigenous groups. (3) Integration of FP and other RH services. OR provides useful information about service integration in different settings. Studies in Haiti and Honduras show that providing FP services along with postpartum care is popular and effective, even for women who deliver at home. Groundbreaking studies in Egypt, Mexico, and Kenya have demonstrated the demand for and cost-effectiveness of quality postabortion services that include FP. Studies in Uganda, Kenya, Botswana, and India show that integrating sexually transmitted infection services with FP is feasible, but requires changes in provider attitudes, training, and policies. (4) Sustainability. As the demand for FP and other RH services grows, program managers and policymakers are striving to make the best use of limited government and donor resources. Several OR studies show that programs can become more efficient by eliminating unnecessary procedures and making better use of staff without sacrificing quality of care. Studies also find that clients and private sector businesses are willing to pay for FP services, though how much they are willing to pay remains to be tested.