Fertility reduction and the quality of family planning services

Stud Fam Plann. 1989 Jan-Feb;20(1):1-16.


The purpose of this paper is to determine whether a focus on quality of family planning services is consistent with meeting demographic objectives. An analytical framework that links the six elements of quality with fertility is described. A review of existing literature and analysis suggest that improvements in quality of family planning services by enhancing the choice of contraceptive methods available in a country would increase the overall practice of contraception and thus would result in fertility reduction.

PIP: Because most family planning programs in developing countries focus on producing a quantitative effect on fertility, the qualitative aspect of fertility control may be overlooked. To achieve population stabilization and affect societal attitudes and acceptance, a fertility program must consider the individual's fertility needs. A program must also consider and incorporate the elements of quality such as offering a choice of contraceptive methods, presenting information to acceptors, providing competence and good client/provider relations, pursuing former clients with recontact and follow-up and by offering an appropriate constellation of services. If the quality of a program is increased, it is hypothesized that the fertility rate will decrease because attitudes toward contraception and a continuation of family planning will be positively affected. Conscientiously handling a smaller, more manageable number of acceptors into a planning program is also considered a beneficial measure as opposed to attempting to meet the needs of an overwhelming number of program acceptors neglecting the aspect of quality. Although the theory of increased acceptance and continuation has been proven in simulated models, it needs to be implemented and tested in larger programs and field projects where the impact of varying levels of quality in fertility programs can be directly assessed. It is also important to observe that the success of a family planning program is dependent on a couple's desire to regulate their fertility and this is often affected by the quality of a family planning program.

Publication types

  • Review

MeSH terms

  • Contraception / methods
  • Family Planning Services*
  • Fertility*
  • Humans
  • Quality of Health Care*