Evidence-Based Family Planning Programming

Evidence-based family planning programming uses research to understand the needs of intended clientele, monitors progress toward program objectives, and evaluates the program's accomplishments.

Research Helps Tailor Programs to Their Context

Program planners and managers can draw on existing research and evaluations of other programs to inform design of their own family planning programs. Sometimes, it is necessary for programs to conduct their own research to learn more about the local context.

  • Formative research—research conducted beforehand to design and implement a new activity—informs program planners and managers about the local context and the intended clientele. For example, in Kenya, researchers conducted a formative assessment to find out why IUDs were unpopular before implementing a program. They found providers were not confident in their IUD insertion and removal skills, and many potential clients did not have accurate information about the IUD or where to access services. The initiative then developed provider training programs and a communication campaign to address client concerns.
  • Operations research tests what works in the local context. Before launching a full-scale activity, some programs start with operations research to test various approaches, often in the form of pilot projects with the assumption that if effective, they will be scaled up. For example, in northern Ghana, the Navrongo Community Health and Family Planning Project conducted a series of pilots in the mid-1990s to find out how to launch and sustain community health services. The most effective pilot staffing consisted of a community nurse paired with volunteer outreach worker, which contributed to increased contraceptive use and to a 15% reduction in fertility levels between 1997 and 2003. The Ghana Ministry of Health adopted this staffing pattern as the nationwide model.

Monitoring and Evaluation Informs and Strengthens Planning and Management

Monitoring and evaluation is a continual process of collecting and analyzing information about a program and its effects. It helps managers:

  • Make informed decisions about current program design and operations
  • Ensure the most effective and efficient use of resources
  • Assess impact

In general, a mature program might spend 10% of its budget on monitoring and evaluation.

Monitoring measures progress toward objectives. For examples, it can track the use of resources, the delivery of services, and the satisfaction of clients. It can detect changes in program performance and cost-effectiveness and help explain the reasons. Monitoring should be conducted throughout the life of a program, and data should be used to make mid-course corrections, if necessary, to improve program performance.

Evaluation measures a program’s accomplishments and costs. At the end of a program or at a significant turning point, evaluation can determine if the program achieved its original objectives and whether it achieved its long-term outcomes. While evaluations usually take place at the end of programs, it is important to plan for them at the start. Data for evaluation must be continuously collected so that comparisons over time can be made.