Topical investigation and analysis of promoting family planning through health services

It is speculated that combining FP and general HS programs can have two principal advantages: making FP services more accessible and cost-effective can increase the number of FP recipients; and decreases in infant mortality can reduce desired and actual family size over the long run. This report presents the results of a study of 11 hypotheses on the use of HS as a tool for promoting FP after the hypotheses were tested in three different models: a health effects model describing the effects of improved health on fertility behavior; a delivery systems model determining the best allocation of FP funds among potential HS programs; and a decision model representing the optimal sequence of decisions to be made relative to the budget allocation among several programs. The hypotheses tested included: that there is an important relationship between increased HS expenditures and decreased mortality; that HS clients are effective contraceptors; that the anonymity provided by an HS program enhances the adoption of contraceptive techniques; and that favourable attitudes toward FP result from its inclusion in an HS program. The major test conclusion drawn was that the data for the health effects model were more complete and appropriate than for the second and third models, for which these data were inadequate to generate any absolute conclusions. Recommendations based on these conclusions are: to conduct a complete information search for the health effects model in those areas not previously examined; to develop the decision model (but not the delivery systems model) utilizing professional opinion to augment the available data; and to conduct a series of experiments using the decision model, data, and professional opinion to determine the sensitivity of this model to data variation and the optimal sequences of decisions for various environmental conditions. A 191-reference bibliography (1955-70), a 100-item list of footnotes, and a structural model and objective function are attached.