PIP: The Africa OR/TA Project assisted the Nairobi City Commission (NCC) in conducting a situation analysis of its 46 family planning clinics. An important element in Kenya's national family planning program, NCC provides more than 1/2 of all family planning services in Nairobi and accounts for more than 1/3 of all family planning acceptors in Kenya. In order to upgrade NCC services, researchers conducted staff and client interviews and observed provider-client interactions. In addition to quality of care, the study evaluated the functioning of each major family planning subsystem; logistics/supplies, facilities, staffing, training, supervision, IEC, and record keeping. The study found that record keeping and logistics were functioning relatively well, and that IEC activities compared favorably with the national family planning program. Significant problems, however, were noted in training, supervision, and equipment. Only 15% of nurses had undergone refresher training, about 1/2 of the staff reported receiving no external supervision, and essential equipment was either missing or not working in many clinics (39% of clinics lacked working sterilizers). Concerning quality of care, clients were receiving information on a range of contraceptive methods, and clients provider-client relations were generally good. But waiting times were long, service hours were curtailed unnecessarily, and often, clients received inadequate information on how to manage side-effects. More significantly, the study found low provider competence (only 49% of clients received aseptic services). As a result, NCC clinics scored low on quality of care.