Family planning success in two cities in Zaire

Both projects described here, Matadi and Kananga, helped health providers in those two cities offer clinical family planning services. But their approaches differed markedly. The family education program in Matadi concentrated on pioneering community-based distribution of contraceptives, with carefully supervised distributors. The Kanaga Project emphasized clinical supervision and pleasing the clients; introduced social marketing with loose supervision of retailers; and provided an information team skilled in face-to-face group meetings, plus a weekly radio program. Four factors common to both projects seemed to contribute to their success: The single-minded dedication of staff members to making family planning work. An uninterrupted supply of affordable contraceptive methods available through outlets at many locations. Enough organizational autonomy to be able to respond to problems as they arose. Such autonomy made project personnel identify more with project goals and feel responsible for achieving project objectives. Regular and supportive supervision of those responsible for service delivery. Both projects emphasized regular contact with clinic personnel - Matadi also included distributors. These contacts bolstered morale by showing that the project administration was closely following service providers'activities and by transmitting to providers the staff's enthusiam for project activities. Supervisory visits included administrative functions such as collecting service statistics and controlling inventory, but these activities were handled in a friendly, nonthreatening manner that encouraged service providers to perform their tasks well. The fourth factor is adequate funding. Both projects had special funding that allowed them to experiment with approaches for increasing contraceptive prevalence. That funding may partly explain their organizational autonomy and may have contributed to the sense of purpose and esprit de corps that developed among project staff. Larger-scale programs in Zaire have operated with significant financial constraints, so it would be unfair to compare them with these more successful projects. Special funding does not guarantee project success but may make it far more likely, conclude the authors.