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Articles 241 - 270 of 277
Full-Text Articles in International Public Health
Integrating Sti And Mch/Fp Services, Population Council
Integrating Sti And Mch/Fp Services, Population Council
Reproductive Health
The integration of STI and HIV/AIDS information and services into existing MCH/FP programs has been strongly supported in recent years, following recommendations from the 1994 Cairo ICPD. Moreover, it is now widely accepted that early detection and management of STIs can reduce the incidence of HIV infection. Thus, there are powerful incentives to increase efforts to broaden the capacity of MCH/FP programs to provide STI prevention and management information and services for their clients, both as a comprehensive reproductive health service and as a preventive measure for reducing the transmission of HIV. As described in this brief, the Africa OR/TA …
Quality Of Care And Utilisation Of Mch And Fp Services At Kenyan Health Facilities, Lewis Ndhlovu
Quality Of Care And Utilisation Of Mch And Fp Services At Kenyan Health Facilities, Lewis Ndhlovu
Reproductive Health
Quality of services is playing an increasingly important role in many family planning (FP) programs. In 1995, a national Situation Analysis Study of 254 health facilities was conducted in Kenya to assess the status and quality of FP services in the country. An in-depth survey of a subsample of 28 health facilities was conducted the following year. From these facilities, 1,834 women were interviewed about their experiences with services at facilities when they sought antenatal, child health, and FP services. The goal of the survey was to examine the links between quality of care in FP services and contraceptive behavior. …
Strengthening Reproductive Health Services In Africa Through Operations Research, Population Council
Strengthening Reproductive Health Services In Africa Through Operations Research, Population Council
Reproductive Health
The health status of women, men, and children in sub-Saharan Africa remains the poorest in the world. Moreover, virtually every country in the region is suffering mediocre economic growth or economic decline, thereby reducing the ability of their health care systems to respond adequately, and increasing dependence on external donor assistance. In terms of reproductive health (RH), the region is faced with high levels of unwanted fertility; high levels of maternal, child, and infant morbidity and mortality; and an almost exponential growth in HIV prevalence. Access to and quality of RH services remains poor in most countries, thereby maintaining unmet …
Demand For And Cost-Effectiveness Of Integrating Rti/Hiv Services With Clinic-Based Family Planning Services In Zimbabwe, Baker Ndugga Maggwa, Ian Askew, Caroline S. Marangwanda, Sithokozille Simba, Hazel M.B. Dube, Rick Homan, Barbara Janowitz, Ahmed Latif, Peter R. Mason
Demand For And Cost-Effectiveness Of Integrating Rti/Hiv Services With Clinic-Based Family Planning Services In Zimbabwe, Baker Ndugga Maggwa, Ian Askew, Caroline S. Marangwanda, Sithokozille Simba, Hazel M.B. Dube, Rick Homan, Barbara Janowitz, Ahmed Latif, Peter R. Mason
Reproductive Health
The current spread of HIV/AIDS poses a major threat to individual lives and national economies in many sub-Saharan African countries. The region also has some of the highest levels of other reproductive tract infections (RTIs) in the world. Some of these RTIs increase the risk of sexual transmission of HIV infection. Thus, the control of RTIs is seen not only as an important reproductive health care strategy to alleviate symptoms of infection and long-term gynecological, obstetric, and neonatal complications, but also as a key strategy in reducing the spread of HIV/AIDS. As a result, all national health care programs in …
Implementing A Reproductive Health Agenda In India: The Beginning, Saroj Pachauri
Implementing A Reproductive Health Agenda In India: The Beginning, Saroj Pachauri
Reproductive Health
At the International Conference on Population and Development (ICPD) in 1994, the nations of the world agreed to give special attention to girls’ education, women’s health, infant survival, and women’s empowerment, and to provide comprehensive reproductive health (RH) services to enable couples to achieve their reproductive goals. The government of India launched a reproductive and child health program in October 1997. This book begins a review of the processes underway to operationalize the program. It brings together several important initiatives at various stages of development and examines key policy and program issues based on empirical research and field experience. The …
Integrating Sti/Hiv Services Into Existing Mch/Fp Programs, Baker Ndugga, Ian Askew
Integrating Sti/Hiv Services Into Existing Mch/Fp Programs, Baker Ndugga, Ian Askew
Reproductive Health
The presence of certain STIs increases the risk of the sexual transmission of HIV. Thus, controlling STIs can reduce the incidence of HIV. Almost all women in the East and Southern African regions attend MCH/FP clinics regularly, and recent surveys have shown that the prevalence levels of many STIs, including HIV, can be high for women seeking FP and antenatal services, even though they are frequently asymptomatic. MCH/FP services are provided by medically trained staff with many of the same skills needed for managing STIs. Consequently, several MCH/FP programs have started looking for ways to integrate STI management strategies, such …
An Assessment Of The Zimbabwe Family Planning Programme: Results From The 1996 Situation Analysis Study, Lewis Ndhlovu, Hazel M.B. Dube, Caroline S. Marangwanda
An Assessment Of The Zimbabwe Family Planning Programme: Results From The 1996 Situation Analysis Study, Lewis Ndhlovu, Hazel M.B. Dube, Caroline S. Marangwanda
Reproductive Health
Within the past ten years, the Zimbabwe National Family Planning Council (ZNFPC) has conducted two major studies for assessing the availability and quality of reproductive health services. The two studies, generally referred to as Situation Analysis studies, were conducted in 1991 and 1996. The 1996 survey collected data from 192 health facilities spread throughout Zimbabwe. During this exercise, an inventory of physical facilities, equipment, and educational materials was taken. In addition, 758 provider–client interactions of new and revisit clients were observed. Exit interviews were conducted with service providers, and with family planning and maternal and child health clients. In this …
Ethnicity And Child Mortality In Sub-Saharan Africa, Martin Brockerhoff, Paul C. Hewett
Ethnicity And Child Mortality In Sub-Saharan Africa, Martin Brockerhoff, Paul C. Hewett
Poverty, Gender, and Youth
Analysis of recent survey data reveals large differentials in child mortality among ethnic groups in countries throughout sub-Saharan Africa. These disparities correspond with the prominence of specific ethnic groups in the national political economy. In many countries where heads of state since independence have come from one or two ethnic groups-as in Côte d’Ivoire, Kenya, and Niger-these groups have experienced levels of early child mortality at least one-third lower than those of other groups. In other countries where there have been several transitions in state control, as in Ghana and Uganda, descendants of precolonial kingdoms such as Ashanti and Buganda …
The Impact Of Family Planning Household Service Delivery On Women's Status In Bangladesh, James F. Phillips, Mian Bazle Hossain
The Impact Of Family Planning Household Service Delivery On Women's Status In Bangladesh, James F. Phillips, Mian Bazle Hossain
Poverty, Gender, and Youth
Since 1982, the Maternal and Child Health and Family Planning Extension Project has compiled longitudinal panel data on rural women’s contact with household service providers who visit homes to discuss family planning and offer services to women on request. This study tests the hypothesis that home-based services reinforce customs of purdah (female seclusion) by sustaining the dependency and isolation of the women served by the program. Results show that household services improve women’s status. This effect is largely attributable to the impact of outreach on effective fertility regulation. Findings do not support the hypothesis that household service delivery is detrimental …
Strengthening Rti/Std Services: Lessons Learned From A Pilot Project, Ismat Bhuiya, Ubaidur Rob
Strengthening Rti/Std Services: Lessons Learned From A Pilot Project, Ismat Bhuiya, Ubaidur Rob
Reproductive Health
The national family planning and maternal child health (FP-MCH) program in Bangladesh has raised FP acceptance among couples of reproductive age significantly. A major challenge still facing the program, however, is strengthening its reproductive health (RH) component. The Population Council launched a pilot project to examine the feasibility of strengthening comprehensive reproductive tract infection (RTI) and sexually transmitted disease (STD) services at the Health and Family Welfare Center level. The project had three phases. First, a needs assessment was conducted. Then the components of the intervention were identified, designed, and implemented. And at the third phase, an evaluation was carried …
Workshop Report: Launching Of The Revised Reproductive Health Policy Guidelines And Standards, Division Of Primary Health Care, Kenya Ministry Of Health
Workshop Report: Launching Of The Revised Reproductive Health Policy Guidelines And Standards, Division Of Primary Health Care, Kenya Ministry Of Health
Reproductive Health
The Government of Kenya recently revised its Policy Guidelines and Standards for family planning (FP) and other reproductive health (RH) services to encourage service providers to undertake a more comprehensive approach to service delivery. Some of the recommendations, especially those relating to the integration of STI/HIV/AIDS services into MCH/FP services, and to safe motherhood, include new practices and procedures. A number of research studies have been conducted in Kenya and elsewhere that provide data pertinent to many of these recommendations, and the Division of Primary Health Care (DPHC) used the results to provide a framework within which the guidelines were …
Ensuring Community Participation In Mch/Fp Activities: Lessons Learned From A Pilot Project, Abbas Bhuiya, Ubaidur Rob, Maruf Rabban Quaderi
Ensuring Community Participation In Mch/Fp Activities: Lessons Learned From A Pilot Project, Abbas Bhuiya, Ubaidur Rob, Maruf Rabban Quaderi
Reproductive Health
Family planning (FP) and maternal and child health (MCH) in Bangladesh have achieved commendable success in the recent past, mostly through a large-scale government service-delivery system supported by donors and nongovernmental organizations. Although encouraged by this success, there was concern about programmatic, financial, and social sustainability of the program, including quality of services. It is now believed that most of these concerns will be taken care of if effective community participation can be ensured. A pilot project was initiated in 1997 in Anowara, a low-FP-performing area in rural Chittagong, with assistance from the Population Council. The main objective of the …
Technical Assistance To Enhance The Institutionalization Of Operations Research Within The Philippines Family Planning Program, Population Council
Technical Assistance To Enhance The Institutionalization Of Operations Research Within The Philippines Family Planning Program, Population Council
Reproductive Health
This technical assistance project supports the goal of the Asia Near East Operations Research and Technical Assistance (ANE OR/TA) project of helping strengthen family planning (FP)/reproductive health (RH) operations research (OR) capabilities in the Philippines. During the extension period of the ANE OR/TA project, four OR studies were implemented in the Philippines dealing with cross-cutting issues, including a study to assess the feasibility of integrating RTI management within FP/MCH programs; an intervention study dealing with improving quality of care via expanded FP counseling; an intervention to address high unmet need in Pangasinan Province; and an intervention study to increase male …
Male Involvement Through Reproductive Health Awareness In Bukidnon Province, The Philippines: An Intervention Study, Lita Palma-Sealza, Marilou P. Costello, Chona R. Echavez
Male Involvement Through Reproductive Health Awareness In Bukidnon Province, The Philippines: An Intervention Study, Lita Palma-Sealza, Marilou P. Costello, Chona R. Echavez
Reproductive Health
Recent years have been characterized by an increasing consensus that, in order to support women's goals and aspirations, health programs directed to the improvement of women's and children's health must consider men's perspectives. Although family planning (FP) is often viewed as the woman's responsibility, men have an important role in decisions of whether FP will be practiced and which method will be used. Even though gender relations in the Philippines are often characterized as being relatively egalitarian, there are several reasons for believing that male involvement in FP is highly relevant for this country. Studies indicate that not only are …
Dual Protection In An Integrated Community-Based Program: A Case Study Of Tanzania Family Health/Ministry Of Health Project In Mbeya, Grace Mbekem, Jane Chege
Dual Protection In An Integrated Community-Based Program: A Case Study Of Tanzania Family Health/Ministry Of Health Project In Mbeya, Grace Mbekem, Jane Chege
Reproductive Health
One of the most pressing challenges for health programs in most sub-Saharan African countries is effectively addressing the increasing prevalence of HIV/AIDS. Recent evidence suggests that controlling sexually transmitted diseases (STDs) through undertaking preventive measures, early diagnosis, and treatment significantly slows the spread of HIV/AIDS. In regard to STI/HIV, Maternal and Child Health (MCH) and Family Planning (FP) clients are described as “low risk” groups. However, in a number of sub-Saharan African countries, the reported levels of STDs are significantly high enough to justify use of limited resources to target this group for STD services. MCH/FP programs have begun to …
Situation Analysis Of Lgu Health Centers For Integrating Rti Management Within The Philippines Fp/Mch Program, Jesus Encena, Carmeli Marie Chaves, Marilou P. Costello, Chona R. Echavez
Situation Analysis Of Lgu Health Centers For Integrating Rti Management Within The Philippines Fp/Mch Program, Jesus Encena, Carmeli Marie Chaves, Marilou P. Costello, Chona R. Echavez
Reproductive Health
A Situation Analysis (SA) was conducted in seven local government health centers as part of a larger project studying the feasibility of integrating RTI services within the existing Family Planning/Reproductive Health Program of the Department of Health (DOH). The SA was part of a series of baseline activities conducted by the Family Planning Operations Research and Training Project as part of its study on Integrating RTI Management in Local Government Unit Health Centers. It was conducted by Population Council, Manila, for the DOH. Participating health centers were located in a large and highly urbanized community, a medium-sized city, and two …
Study Of Adolescents: Dynamics Of Perception, Attitude, Knowledge And Use Of Reproductive Health Care, Syed Jahangeer Haider, Shamsun Nehar Saleh, Nahid Kamal, Alan Gray
Study Of Adolescents: Dynamics Of Perception, Attitude, Knowledge And Use Of Reproductive Health Care, Syed Jahangeer Haider, Shamsun Nehar Saleh, Nahid Kamal, Alan Gray
Poverty, Gender, and Youth
Knowledge, perceptions, and behavior related to reproductive health (RH) and sexual matters underlie all the conditions that family planning/maternal and child health (FP/MCH) programs address, thus these are important issues for FP researchers, population policymakers, and service providers. To achieve significant levels of fertility or mortality declines, participation of adolescents in reproductive health programs, including FP/MCH, is essential. Studies focusing on sexuality and attitudes of adolescents on RH, and the interacting influences of family, community, and the social sector developmental programs (health, FP/MCH, education, women’s development) would give useful revelations. This report presents findings from a study that was designed …
Integrating Sti/Hiv Management Strategies Into Existing Mch/Fp Programs: Lessons From Case Studies In East And Southern Africa, Baker Ndugga Maggwa, Ian Askew
Integrating Sti/Hiv Management Strategies Into Existing Mch/Fp Programs: Lessons From Case Studies In East And Southern Africa, Baker Ndugga Maggwa, Ian Askew
Reproductive Health
Sub-Saharan Africa is confronting an HIV/AIDS epidemic and virtually all health programs in the region are seeking ways of preventing and reducing the spread of this virus. To compound the problem, the presence of certain sexually transmitted infections (STIs) is known to increase risk of the sexual transmission of HIV. The sub-Saharan region is believed to have some of the highest levels of STIs in the world, thus controlling STIs is not only an important reproductive health care strategy in itself but also a key strategy in reducing the spread of HIV. The strongest evidence to support this has come …
Integration Of Sti And Hiv/Aids With Mch-Fp Services: A Case Study Of The Nakuru Municipal Council's Project On Strengthening Std/Aids Control, James Kariba Wabaru, Bedan Kiare Kariuki, Baker Ndugga Maggwa
Integration Of Sti And Hiv/Aids With Mch-Fp Services: A Case Study Of The Nakuru Municipal Council's Project On Strengthening Std/Aids Control, James Kariba Wabaru, Bedan Kiare Kariuki, Baker Ndugga Maggwa
Reproductive Health
Kenya’s Nakuru Municipal Council (NMC) operates five clinics located primarily in residential areas with high concentrations of people. The clinics provide basic antenatal, child welfare, STI, and other curative services, and family planning services are available at four of the clinics. One provincial referral hospital operated by the Ministry of Health also provides MCH-FP and HIV/STI services in a special STI treatment clinic. The seven public health facilities in Nakuru Municipality are participating in a collaborative project with the Department of Community Health at the University of Nairobi, the University of Manitoba in Canada, and the Nairobi Municipal City Council. …
Integration Of Sti And Hiv/Aids With Mch-Fp Services: A Case Study Of The Busoga Diocese Family Life Education Program, Uganda, Joy Mukaire, Florence Kalikwani, Baker Ndugga Maggwa
Integration Of Sti And Hiv/Aids With Mch-Fp Services: A Case Study Of The Busoga Diocese Family Life Education Program, Uganda, Joy Mukaire, Florence Kalikwani, Baker Ndugga Maggwa
Reproductive Health
The Family Life Education Project (FLEP) was started in 1986 by the Busoga Diocese of the Anglican Church of Uganda with assistance from Pathfinder International. The project provides integrated MCH, FP, STD, and HIV/AIDS services to more than 500,000 individuals through 48 clinics and 162 trained village health workers (VHWs). Each clinic serves an estimated 11,000 people living in a sub-Parish. Each sub-Parish has a health subcommittee selected by the community that is responsible for hiring clinic staff, identifying VHWs, and mobilizing resources for clinic staff salaries. Data suggest that the program is reaching a large number of clients through …
Integrating Rti Services In Primary Health Care System: Observations From An Operations Research In Uttar Pradesh, India, M.E. Khan, Saumya Ramarao, R.B. Gupta, Bella C. Patel, Leila Caleb-Varkey, Jayanti Tuladhar, Sanjeev Kumar, John Townsend
Integrating Rti Services In Primary Health Care System: Observations From An Operations Research In Uttar Pradesh, India, M.E. Khan, Saumya Ramarao, R.B. Gupta, Bella C. Patel, Leila Caleb-Varkey, Jayanti Tuladhar, Sanjeev Kumar, John Townsend
Reproductive Health
Evidence from community studies indicates that significant proportions of Indian women (30 percent) may have reproductive tract infections (RTIs). Given that women are in general asymptomatic and that even symptomatic women may not seek care, the estimates are the minimum levels of prevalence. Most women do not seek treatment for RTIs for such reasons as lack of awareness, acceptance that RTIs are part of women's lives, and lack of treatment facilities. On the supply side, in the public sector the treatment for RTIs is limited with most services provided through STD clinics in urban areas. Seeking treatment at STD clinics …
Iron Supplementation: Knowledge, Perceptions, And Usage Among Pregnant Women In Rural India, Jayanti Tuladhar, John Townsend, Nazir Haider, Leila Caleb-Varkey
Iron Supplementation: Knowledge, Perceptions, And Usage Among Pregnant Women In Rural India, Jayanti Tuladhar, John Townsend, Nazir Haider, Leila Caleb-Varkey
Reproductive Health
In India, severe anemia has been one of the causes of high maternal mortality and death of newborns and infants due to low birthweight. The prevalence of anemia among women ages 15–44 is extremely high. The Government of India has provided iron and folic acid tablets (IFA) as a prophylaxis against nutritional anemia among pregnant women as part of the Child Survival and Safe Motherhood program and will continue to do so in the Reproductive and Child Health package. This paper presents findings of both qualitative and quantitative research conducted among pregnant women to investigate the extent of distribution and …
A Situation Analysis Of The Maternal And Child Health/Family Planning (Mch/Fp) Program In Botswana, Benjamin Baakile, Lucy Sejo Maribe, Baker Ndugga Maggwa, Robert A. Miller
A Situation Analysis Of The Maternal And Child Health/Family Planning (Mch/Fp) Program In Botswana, Benjamin Baakile, Lucy Sejo Maribe, Baker Ndugga Maggwa, Robert A. Miller
Reproductive Health
Botswana has a rapid annual population growth rate and a high total fertility rate. It also has one of the highest levels of contraceptive use in sub-Saharan Africa. Infant and under-5 mortality rates have fallen, yet maternal mortality remains high. The Government of Botswana has developed an extensive network of health care facilities that provide services through an integrated approach. Family planning (FP) services are available at all three levels of the MOH system (hospitals, clinics, health posts). Services for managing sexually transmitted diseases (STDS) have recently undergone a substantial change with the introduction of the Syndromic Approach to STD …
Prospective Population Growth And Policy Options For India, 1991–2101, Leela Visaria, Pravin Visaria
Prospective Population Growth And Policy Options For India, 1991–2101, Leela Visaria, Pravin Visaria
Reproductive Health
India, the second most populous country in the world, experienced an accelerated decline in fertility during the 1980s. As a result, India’s total fertility rate (TFR) in 1993, 3.5 births per woman, is below the level presumed in the population projections of the United Nations and the World Bank. This favorable development has occurred as India is attempting to reorient its family planning program to focus on the reproductive health of women and the health and welfare of children. The method-specific targets for contraceptive acceptors assigned to every grassroots health worker were abandoned in April 1996. Against this backdrop, this …
Community Participation In Health, Family Planning And Development Activities: A Review Of International Experiences, Abbas Bhuiya, Fatima Yasmin, Farida Begum, Ubaidur Rob
Community Participation In Health, Family Planning And Development Activities: A Review Of International Experiences, Abbas Bhuiya, Fatima Yasmin, Farida Begum, Ubaidur Rob
Reproductive Health
The family planning (FP)/maternal and child health (MCH) program in Bangladesh has achieved success in the recent past, mostly through a large-scale government service-delivery system with support and cooperation from donors and nongovernmental organizations. There is concern about the financial and social sustainability of the program. Other issues include achievement of replacement-level fertility within a stipulated period and improvement of MCH-FP service quality. It is widely believed that most of the concerns will be taken care of with effective community participation. Before activating community initiatives, it is worth carrying out action research. A literature review was completed from July to …
Integration Of Sti And Hiv/Aids Services With Mch/Fp Services: A Case Study Of The Mkomani Clinic Society In Mombasa, Kenya, Amina Twahir, Baker Ndugga Maggwa, Ian Askew
Integration Of Sti And Hiv/Aids Services With Mch/Fp Services: A Case Study Of The Mkomani Clinic Society In Mombasa, Kenya, Amina Twahir, Baker Ndugga Maggwa, Ian Askew
Reproductive Health
Most national MCH-FP programs in sub-Saharan Africa are shifting their programmatic strategies toward a broader reproductive health service approach that includes integrating STI and HIV/AIDS services into existing MCH-FP programs. This is based on the belief that integration will lead to more cost-effective and better-quality service, and maximize use of existing resources. There is an assumption that the basic infrastructure for the MCH-FP programs can absorb the extra demands of the STI/HIV/AIDS services with minimal additional inputs and that staff providing MCH-FP services require only minimal training to be able to provide STI/HIV/AIDS services. There is a further assumption that …
A Model Of Costs Of Rti Case Management Services In Uttar Pradesh, Saumya Ramarao, John Townsend, M.E. Khan
A Model Of Costs Of Rti Case Management Services In Uttar Pradesh, Saumya Ramarao, John Townsend, M.E. Khan
Reproductive Health
The Government of India has adopted a Reproductive and Child Health (RCH) approach as the basis of its new family welfare policy. One component of RCH is management of reproductive tract infections (RTIs). The Population Council's Asia and the Near East Operations Research and Technical Assistance (ANE OR/TA) Project, in collaboration with the State of Uttar Pradesh, Ministry of Health and Family Welfare, is conducting a study on the feasibility and cost of providing RTI case management at the primary-care level. The estimated annual cost of RTI case management at the district level would be about US$64,000. From the analysis, …
Addressing Women's Reproductive Health Needs: Priorities For The Family Welfare Programme, Shireen J. Jejeebhoy
Addressing Women's Reproductive Health Needs: Priorities For The Family Welfare Programme, Shireen J. Jejeebhoy
Reproductive Health
India's national family welfare program has two objectives—to address the needs of families, notably women and children, and to reduce population growth rates. In reality, the program has been disproportionately focused on achieving demographic targets by increasing contraceptive prevalence. In this process, women's needs have been overlooked, in terms of poor reproductive health (RH). There is a need to reorient program priorities to focus more holistically on RH needs and on woman-based services that respond to health needs in ways sensitive to the sociocultural constraints women and adolescent girls face in acquiring services and expressing health needs. This report presents …
Doing More With Less: The Marie Stopes Clinics In Sierra Leone, Nahid Toubia, Grace Ebun Delano
Doing More With Less: The Marie Stopes Clinics In Sierra Leone, Nahid Toubia, Grace Ebun Delano
Poverty, Gender, and Youth
This edition of Quality/Calidad/Qualité reports on the Marie Stopes Sierra Leone (MSSL) organization which pursues its goals with compassion and ambition, despite seemingly insurmountable economic hardships. MSSL has established a service model that many programs in richer countries should try to imitate. Several particularly important lessons emerged, including: creative, skillful management, well-organized and flexible financial administration, and human motivation and perseverance can enable an organization to overcome financial difficulties; family planning is an integral part of people's reproductive and general health concerns and can dovetail with concern for development in useful and practical ways; men appreciate being involved in the …
A Qualitative Study Of Quality Of Care In Rural Karnataka, P.H. Reddy
A Qualitative Study Of Quality Of Care In Rural Karnataka, P.H. Reddy
Reproductive Health
The Third Five-Year Plan (1961–66) aimed at reducing the crude birth rate in India to 25 per 1,000 population by 1973, however this goal has not been achieved. Several other demographic goals were set later, to be achieved by specified years, but they were deferred or revised. One major reason for the failure to achieve these goals was thought to be the lack of adequate infrastructural facilities for the family welfare program, thus it was decided to improve the institution–population ratio. The primary objective of this study is to assess the quality of interaction between clients and providers, and the …