Strategic management of family planning programs

Program management has received insufficient attention among family planning leaders, possibly because of medical or demographic background of many leaders, a focus on other program priorities (such as sheer survival), the pressure to expand programs rapidly, and limited donor interest in the subject. As programs grow in complexity, the problems resulting from weak management systems become more obvious, and organizations are compelled to introduce rational systems. The more successful family planning programs have paid close attention to key aspects of management and have striven to continually improve their systems. According to the principles of strategic management, there is no single"best"solution to the various problems organizations face. Each organization must work out a response appropriate to a given situation. But managers should know more about possible options and their effectiveness in other settings. In family planning, a dearth of research on options - compounded by the fact that many programs do not collect basic information about program inputs and outputs - makes it difficult to analyze which programs work and why. Logistics management is the Achilles heel of family planning programs. Many programs experience depleted supplies of contraceptives in demand and oversupplies of others. Lack of contraceptives not only leads to pregnancies but erodes client trust in the service provider and undermines staff morale. Measures to improve logistics management are readily accessible. What is lacking is a commitment from high-level managers to introduce the needed changes. Staff development also merits more attention from managers, as high-caliber staff can make a big difference in program performance. Managers do not always have flexibility about staff recruitment, promotion, and retention, but they should strive for as much leverage as possible. Little research has been done on the impact of training, so managers should assess the relative effectiveness and costs of different approaches. The key factor seems to the relevance to the training content to the individual's job responsibilities.