An integrated approach to operations research for strengthening family planning programs: a case example in kenya

The Africa Operations Research/Technical Assistance Project developed an integrated approach to introducing and institutionalizing family planning in Kenya. This approach consisted of: 1) the development of the Situation Analysis methodology to diagnose problems; 2) the development of a computer simulation model for choosing operations research (OR) strategies; 3) an OR training workshop; 4) the implementation of three OR field studies testing educational approaches to several program problems; 5) a conference to review the findings and implications from the three studies. Technical assistance was provided in all phases. Results from the field studies indicated that all of the tested educational interventions had at least some short-term impact. Health talks with waiting maternal and child health (MCH) clients doubled the proportion adopting family planning; a simple educational package for clinic supervisors, along with a day of training, raised the proportion of family planning clients receiving education and referral for voluntary surgical sterilization (VSC) and increased the number of tubal ligations at a referral hospital. Waiting time was reduced. The Division of Family Health of the Ministry of Health has submitted plans to introduce these interventions into several districts of the country in the near future. Full institutionalization of OR requires additional cycles of program activities.