Community participation in national family planning programs: some organizational issues

Increasing the involvement of communities in implementing national family planning programs has been advocated as a means of increasing the acceptability, availability, and sustainability of services provided. This article reviews the nature and extent of community participation in the national programs of Bangladesh, China, the Republic of Korea, the Philippines, and Thailand by analyzing the structures and processes through which participation is organized. Across all five countries a similar pattern of participation has emerged in which a community-based delivery system is supported by the involvement of community leaders in activities that promote family planning. Active participation in planning and management functions is, however, virtually nonexistent. This limited form of participation is attributed to the bureaucratic organization of national family planning programs that seek to implement policies with explicit demographic goals. Given these goals and organizational structures, however, the pattern of organizing participation observed is probably the most appropriate. Consequently, policymakers should be wary of expecting greater involvement by community members in program implementation activities or in contributing resources unless consideration is given to reorienting the goals and organizing programs that meet needs that are directly relevant to families and communities.