Family Planning

In 1978, JSI took on its first project: coordinating the Title X Family Planning Training Center in New England. Since then, JSI has upheld its reputation as a leader in family planning by expanding access to reproductive health services and education in both domestic and international communities. In the documents that follow, JSI shares its family planning research and project publications.

For JSI-authored articles in peer-reviewed journals please go to Journal Articles.

Please note the following are listed in chronological order starting with the most recent publication.

Assessing Policies and Practices That Affect Contraceptive Financing and Procurement: A Review Guide (PDF, 635 KB)

Contraceptive security exists when every person can choose, obtain, and use high-quality contraceptives and condoms whenever they are needed. The purpose of this guide is to help national governments, donors, and other stakeholders improve the policy environment for contraceptive security and, in particular, the operational policies and practices for procuring and financing contraceptive supplies. This guide focuses on the public sector, but much of it may also be applied to the private sector, as well as financing and procuring other health commodities. USAID | Health Policy Initiative and the JSI/ USAID | DELIVER PROJECT. April 2010.

Trend in Reproductive, Maternal, Neonatal and Child Health Indicators, The Ethiopia Last Ten Kilometers Project Areas, Southern Nations, Nationalities and People's Region 2005-2009 (PDF, 1.07 MB)

The report analyzes the trend in the reproductive, maternal, neonatal, and child health (RMNCH) care seeking behaviors and practices in 30 L10K Project woredas of the SNNP region of Ethiopia to assess the impact of the health extension program (HEP). For the report, data from the L10K baseline survey conducted between December 2008 and January 2009 and the 2005 Ethiopian Demographic and Health Survey is used. The study indicates that the HEP has demonstrated significant achievements in latrine construction and use, distribution of insecticide treated bed nets (ITNs), use of family planning, antenatal care services, and immunization coverage; however, the program is lagging behind in certain areas including the provisions for safe and clean delivery, postnatal and neonatal care services. The HEP needs to improve maternal and neonatal health service delivery strategies. JSI/Ethiopia L10K Project. 2009.

Building Bridges: Working with American Indian/Alaska Native Health Care Providers to Integrate Reproductive Health, STI, and HIV Prevention Services (PDF, 4.56 MB)

This toolkit brings together various tools, information and resources is intended to be used as a general resource for groups who are trying to partner with American Indian/Alaska Native communities to address HIV prevention integration in both urban and non-urban areas. JSI's work was concentrated within the Northern Plains tribal culture (tribes residing in Iowa, Minnesota, South Dakota, Wisconsin, Montana, North Dakota, and Wyoming) - work and lessons may look different within other regions and within other tribal communities and cultures.

It is intended to supplement the Roadmap to Integration: HIV Prevention Is Reproductive Health toolkit. The Roadmap toolkit is a technical assistance and training guide which may be used by Regional Training Center staff to facilitate integration of HIV services into reproductive health clinics and other settings. Assisted by the RTCs, clinics can discuss the desired level of HIV integration, assess the current level of integration, determine clinic proficiency at the current level, assess current clinic capacities, develop a training and technical assistance plan to build and enhance capacities and evaluation efforts in integrating HIV service into clinical practice. Yvonne Hamby, Christine Duclos, Mary McCrimmon. JSI Research & Training Institute, Inc. 2009.

Ethiopia L10K Baseline Household Health Survey Summary Report (PDF, 539 KB)

The Ethiopia Last Ten Kilometers (L10K) Project in collaboration with the Regional Health Bureaus of Amhara, Oromiya, SNNP and Tigray conducted a baseline household health and community survey to benchmark the reproductive, maternal, neonatal and child health (RMNCH) outcome indicators in its project areas. The survey which was conducted during the period December 2008 - January 2009 gathered information from 204 communities or kebeles and 6,277 women using a two-stage cluster sampling methodology. This report presents the survey results that describe the availability, perceived quality, awareness, knowledge, demand, access and utilization of RMNCH services in the L10K project areas. This report is the first-of-its-kind to describe the neonatal health care practices in rural Ethiopia. Implications of the survey findings for the health extension program of the Ethiopian Government are discussed. JSI/Ethiopia L10K. 2009.

The Long Wait: Reproductive Health Care in Haiti (PDF, 18.02 MB)

This report draws on findings from an assessment of Haiti's reproductive health response in crisis and beyond. The report highlights persistent gaps in family planning and adolescent sexual and reproductive health, particularly in remote areas. In spite of deteriorating infrastructure and short-term funding cycles, a number of local initiatives offer promising approaches to fill reproductive health gaps.

Please visit the JSI Astarte Project website for more information on JSI's work on reproductive health for refugees. JSI/Astarte Project. May 2009.

Improving Family Planning Pre-Service Education: Experience from the Eastern Europe and Eurasia Region (PDF, 1.92 MB)

The Europe and Eurasia (E&E) Regional Family Planning Activity was an initiative funded by the USAID and designed to leverage best practices in family planning to accelerate FP program implementation across the region, and ultimately to increase modern contraceptive use and decrease abortion rates. This document highlights the Regional Activity's core results, including the process of changing the culture of FP and RH medical education in several countries at varying points in post-Soviet medical education reform; applying the concept of evidence-based medicine to curriculum content and teaching in three countries; introducing curricular reforms to key faculty and medical school leadership emphasizing case-based teaching and more active, student-centered learning; and finalized new FP curriculum in modularized format for use across the region. John Snow, Inc. 2009.

The Europe and Eurasia (E&E) Regional Family Planning Activity Final Report (PDF, 1.36 MB)

The Europe and Eurasia (E&E) Regional Family Planning Activity was an initiative funded by the USAID E&E Bureau and designed to leverage best practices in family planning to accelerate FP program implementation across the region, and ultimately to increase modern contraceptive use and decrease abortion rates. Extensive and critically important regional knowledge sharing activities were undertaken across the entire E&E region. All activities undertaken by the Regional Activity shared an underlying operational principle: Activities were based on a strong commitment to evidence-based programming, using both worldwide and regional best practices and evidence. The Regional Activity's 'Final Technical Report' and 'Improving Family Planning Pre-Service Education: Experience from the Eastern Europe and Eurasia Region' document the major results of these efforts. John Snow, Inc. 2009.

Clear Communication: A Family Planning Provider's Guide for Developing Easy-to-Read Materials (PDF, 3.39 MB)

JSI's Region I Title X Family Planning Training Center has produced a toolkit developed for family planning providers who create educational materials for their clients. The toolkit helps providers assess the readability of existing client materials and assists them in developing high quality, low literacy materials to meet the needs of their clinic population. The toolkit provides an introduction to plain language, tools to assess the quality and reading level of existing materials, guidelines to develop new materials, examples of well written and easy-to-read family planning factsheets and brochures, and other relevant resources. JSI Research & Training Institute, Inc. 2008.

Ten Best Public and Private Sector Practices in Reproductive Health and Family Planning in the Europe and Eurasia Region (PDF, 1.73 MB)

This brief synthesizes best practices in achieving reproductive health and family planning (RH/FP) goals for the Europe and Eurasia region, and highlights the role of the private sector in meeting these goals. It is designed for policymakers, service providers, FP organizations, and other stakeholders with an interest in developing better public/private collaboration in achieving RH/FP goals. The report identifies best practices that helped maximize the quality, efficiency, and effectiveness of RH/FP interventions. The criteria used to identify these best practices included effectiveness in improving RH/FP services and outcomes, potential for sustainability and replication, innovation, and ability to address local needs. JSI Research & Training Institute, Inc. and PSP-One Project, September 2008.

Procurement Primer for Health and Family Planning Progr ams in Bangladesh (PDF, 4.47 MB)

This 100-page booklet provides a simple overview of goods and services procurement for health-sector projects in Bangladesh that have been financed wholly or in part by the World Bank and the International Development Association (IDA). JSI/DELIVER Project, 2008.

Eastern Europe Family Planning Situational Analysis (PDF, 154 KB)

JSI has conducted a series of country desk reviews to assess the environment for improving family planning (FP) programming in the region for the USAID-funded Europe and Eurasia Regional Family Planning Activity. Priority countries were chosen based on need, opportunity, and Mission interest in participating in the regional program. Each analysis reviewed progress against ten regional family planning best practices and made recommendations for potential action in focal areas to increase utilization of modern contraception and reduce reliance on induced abortion. To date, the Activity has completed reviews for Albania, Azerbaijan, Georgia, Kyrgyzstan, and Tajikistan. John Snow, Inc./Europe and Eurasia Regional Family Planning Activity, August 2007.

Russia: Integrating Family Planning Into the Health System. A Case Study of the Maternal and Child Health Initiative (PDF, 1.96 MB)

This case study looks specifically at the integration of family planning into the other Women and Infants' Health (WIN) and Maternal and Child Health Initiative (MCHI) project activities. The objectives were to provide a new evidence-based model for reproductive health care services and to increase access to, demand for, and quality of these services, as well as to increase the practice of preventive health behaviors among women in the community. As a result, access to client-centered counseling has increased, unplanned pregnancies have decreased, and the abortion rate has declined. Laurel Cappa, Natalia Vartapetova, Tatyana Makarova, Polina Flahive. JSI/DELIVER Project, 2007.

The Logistics Handbook: A Practical Guide for Supply Chain Managers in Family Planning and Health Programs (PDF, 6.83 MB)

The Logistics Handbook explains the major aspects of logistics management with an emphasis on contraceptive supplies. It is intended to help managers who work with supplies every day, as well as managers who assess and design logistics systems for entire programs. JSI/DELIVER Project, 2007.

Nepal: Scaling Up an Integrated Health Logistics System (PDF, 1.70 MB)

This case study, developed as part of JSI's Best Practices in Scaling Up series, explores the implementation of an effective and sustainable integrated health logistics system. The paper delineates the steps used to design the integrated system, the training process, coordination and resource generation, and implementation. The logistics system now enables health staff nationwide to monitor drugs and supplies at each service delivery point and throughout the system to ensure that resources are used efficiently. Also included are highlights of what JSI staff learned along the way as scale up processes were implemented. Also included in the series is an Introduction to scale up as well as case studies from Guatemala, Romania, Turkey, Uganda, Zambia, and the DELIVER Project. Janardin Lamichhane and Heem Shakya, John Snow, Inc., 2007.

Romania: Reaching the Poor- Scaling Up Integrated Family Planning Services (PDF, 1.04 MB)

This case study, developed as part of JSI's Best Practices in Scaling Up series, maps out how the Romanian Family Health Initiative (RFHI) has expanded family planning coverage nationwide to over 2000 rural communities. This case study highlights the process JSI's project used to integrate family planning into existing primary health services, including creating a favorable policy environment, training health care professionals, and implementing an effective logistics management system. Also included are highlights of what JSI staff learned along the way as scale-up processes were implemented. Also included in the series is an Introduction to scale up as well as case studies from Guatemala, Nepal, Turkey, Uganda, Zambia, and the DELIVER project. Merce Gasco, Diane Hedgecock and Christopher Wright, John Snow, Inc., 2007.

Turkey: Scaling Up Nationwide Access to Integrated Family Planning through the Turkish Social Insurance Organization (SSK) (PDF, 197 KB)

This case study, developed as part of JSI's Best Practices in Scaling Up series, reviews the successful introduction and expansion of family planning services through the Turkish government's social services agency, SSK. The paper maps out the results and sustainability of the program as well as the process used to introduce and scale up services, including contraceptive security, collaboration and quality assurance. Also included are highlights of what JSI staff learned along the way as scale up processes were implemented. Also included in the series is an Introduction to scale up as well as case studies from Guatemala, Nepal, Romania, Uganda, Zambia, and the DELIVER project. Nancy Pendarvis Harris, Nilgun Kircalioglu, Diane Hedgecock, John Snow, Inc., 2007.

Romania: Scaling Up Integrated Family Planning Services: A Case Study (PDF, 2.46 MB)

The Romanian Family Health Initiative (RFHI) rapidly expanded access to family planning services and supplies by integrating family planning into primary health care delivery. This case study identifies some of the successful strategies and key steps that can be taken to replicate the success and address some of the challenges that arose during program implementation that program managers and policymakers in Eastern Europe and Eurasia can use when facing similar challenges as they expand access to family planning. Gasco, Merce, Christopher Wright, Magdalena Pätruleasa, and Diane Hedgecock. JSI/DELIVER Project. November 2006.

DELIVER Project: Scaling up Logistics Management Information Systems in Health Commodity Supply Chains (PDF, 574 KB)

This case study, developed as part of JSI's Best Practices in Scaling Up series, examines the process that three country programs have used to scale up commodities supply chains to increase the number and types of products they provide. The case study highlights why commodity scale up is important, how logistics management information systems must be developed to support expended services, steps in the scale-up process and results from three country programs. Also included are highlights of what JSI staff learned along the way as scale up processes were implemented. Also included in the series is an Introduction to scale up as well as case studies from Guatemala, Nepal, Romania, Turkey, Uganda, and Zambia. Gregory Roche and Barbara Felling, John Snow, Inc., 2006.

Contraceptive Procurement Guide and Product Catalog 2006 (PDF, 1.47 MB)

The USAID Contraceptive Procurement Guide and Product Catalog 2006 is an annual publication of current contraceptive ordering procedures for Missions. It includes (1) USAID contraceptive ordering procedures (2) guidance on how to use logistics data and forecasts to calculate contraceptive requirements and (3) a catalog of contraceptives provided by USAID. JSI/DELIVER Project. 2006.

Prevention of Mother-to-Child Transmission of HIV and Family Planning Practices in HIV-Infected Women in Russia Facility Survey: Report of Main Findings (PDF, 1.07 MB)

This report presents the findings from a facility study of prevention of mother-to-child transmission of HIV (PMTCT) and family planning services provided to HIV positive women in Russia. The study was conducted in 8 Russian regions in facilities both participating and not participating in The JSI Russia Maternal and Child Health Initiative (MCHI) program interventions. The aim of the study was to provide a socio-demographic profile of HIV-positive women coming to facilities for abortion or delivery, to obtain quantitative information on current practices and knowledge that will allow the appropriate authorities to strengthen training programs, improve clinical services, and to provide a firm basis for policy discussions. Natalia Vartapetova, Anna Karpushkina, JSI/MCHI. 2006.

Republic of Georgia Contraceptive Availability Assessment: Final Report (PDF, 548 KB)

This assessment identifies contraceptive availability issues, such as public sector supplies, availability and affordability in the private sector, existing policies, and supply chain constraints for the Republic of Georgia. It also provides recommendations on contraceptive availability and analyses key issues such as forecasting and costs.
JSI Research & Training Institute, Inc./Healthy Women in Georgia (HWG) Program. November, 2004.

Contraceptive Forecasting Accuracy: Trends and Determinants (PDF, 934 KB)

This study examines the accuracy of the contraceptive forecasts contained in the Contraceptive Procurement Table (CPT) database, which is maintained by JSI/DELIVER to evaluate the quality of the forecasting process, to assess the utility of the forecasts in procurement planning, and to monitor and evaluate project progress. One-year-ahead contraceptive forecasts for 50 clients from 19 countries for 1995 to 2003 are analyzed. Among others, the results indicate that the forecast accuracy has been improving over time, which is partly attributable to the improvement of the client's logistics management information system and the use of the PipeLine software for preparing the CPTs. JSI/DELIVER, 2004.

Integrating HIV Prevention and Family Planning Services: Organizational Self-Assessment Manual (PDF, 2.74 MB)

This guide/manual was developed to help family planning clinic managers and staff strategically work through how to provide integrated HIV services in the context of the clinic's organizational structure and resources. The manual consists of several modules each addressing key aspects of HIV integration including: Guiding principles/Model of care, Providing HIV Risk Assessment and Prevention Counseling Services, Linkage to HIV Testing Services, and Developing Referral Networks and Procedures. The manual also includes an extensive Special Section on Cultural Competence. 2004.

Social Franchising Health Services: A Philippines Case Study and Review of Experience (PDF, 742 KB)

This monograph documents the work of the USAID-funded TANGO Project to establish a franchise of Well-Family Midwife Clinics throughout the Philippines. Included are lessons learned in developing a sustainable franchise, as well as examples of social franchising from other countries and programs. JSI/TANGO Project, 2004.

Asking the Hard Questions: A Reproductive Health Provider's Guide to Client-Centered HIV Risk Assessment (PDF, 461 KB)

This guide is deigned to help counselors, clinicians, health educators and other reproductive health care providers feel more confident about doing client-centered HIV sexual behavior and substance use risk assessment. A client-centered risk assessment is a conversation based on what the individual client reveals, and on their unique needs and circumstances. 2002.

Supporting Quality HIV Risk Assessment: A Guide for Reproductive Health Clinic Managers and Supervisors (PDF, 403 KB)

This Guide is designed as a companion to Asking the Hard Questions: A Reproductive Health Provider's Guide to Client-Centered HIV Risk Assessment. Its goal is to help clinic managers and supervisors assure that staff is equipped with the skills and knowledge necessary for providing quality care. This Guide offers tips on how to work with providers, using the Provider's Guide. 2002.

The Contraceptive Forecasting Handbook for Family Planning and HIV/AIDS Prevention Programs (PDF, 6.08 MB)

Contraceptive Forecasting Handbook for Family Planning and HIV/AIDS Prevention Programs is a reference book for forecasting commodity needs for family planning and HIV and AIDS prevention programs. Topics range from general methodological considerations to special considerations when forecasting for HIV and AIDS prevention programs. JSI/USAID DELIVER Project, 2000.

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Client perceptions of reproductive health services in Vladivostok and Novosibirsk, Russia (PDF, 3.69 MB)

The purpose of this study was to gather formative information on client perspectives concerning family planning, maternity care, breastfeeding, and contraception and to incorporate these findings into the training courses for service providers. Information was collected through focus groups with women on clients' preferences, role in decision making, expectations, and level of satisfaction with the quality of services in Novosibirsk Oblast, Vladivostok, and Primorsky Krai. Participants showed knowledge of reproductive health and general satisfaction with services. Recommendations center on improving provider-patient communications, developing consumer health education resources and communication channels, and increasing patient role in decision making. March, 1998.

Pocket guide to managing contraceptive supplies (PDF, 1.17 MB)

This guide is for the staff of family planning or health clinics who manage contraceptive supplies and for the supervisor who oversees these logistics activities. This booklet is not a complete logistics text; its purpose is to be a quick reference for logistics formulas and principles to help staff manage supplies (both contraceptives and other commodities) correctly and efficiently. JSI/DELIVER Project, 1998.

"We Want to Know Eeverything About It:" Albanian women speak about family planning (PDF, 64 KB)

Very little research had been done in Albania to understand knowledge, attitudes, and practices regarding contraceptive use. In 1996, SEATS Project staff collaborated with the Albanian Ministry of Health and Environment (MOH) and the Albania Family Planning Association (AFPA) to conduct focus group research with women of reproductive age. This research included separate discussions with married women, unmarried university students, postpartum women, and women who had recently received abortions in order to better appreciate the informational needs of these primary audiences for information, education, and communication (IEC) activities in the SEATS/Albania project.

Recommendations for programming include emphasizing messages on contraceptive safety and price, developing youth-friendly services that include counseling on STD/HIV protection, providing updated information, again emphasizing contraceptive safety, to service providers, including allied health personnel who can refer women to RH services, and producing print materials for women on FP and contraception. Enilda Gorishti, MD and Joan Haffey, MPH, SEATS Working Paper #1 1997.

Plan for Sustainability: Guidelines to Strengthening Institutions and Recovering Costs (PDF, 220 KB)

John Snow, Inc., SEATS Project. 1997.

Business management skills for private midwives: Curriculum and guide for trainers (PDF, 481 KB)

The Business Management Skills Guide aims to increase the sustainability of private-sector delivery points and emphasizes the relationship among continuing education, improvement in the quality and scope of reproductive health care (RHC) services, and business viability. Should be used with the Community Mobilization Curriculum and Guide. Originally designed for private sector midwives in Uganda but can be used throughout the developing world.

Community mobilization for private midwives: Curriculum and guide for trainers (PDF, 741 KB)

The Community Mobilization Curriculum and Guide aims to increase the effectiveness of private midwives by expanding their active involvement in the community. Should be used with the Business Management Skills for Private Midwives: Curriculum and Guide for Trainers. Originally designed for private sector midwives in Uganda but can be used throughout the developing world. November, 1997.

Integrating reproductive health into NGO programs -- 2nd edition (PDF, 1.36 MB)

Integrating elements of reproductive health into the work of nongovernmental organizations (NGOs) currently focused on other development sectors is a cost-effective and efficient method of increasing quantity, access, and quality of reproductive health services to underserved populations. This handbook focuses on interventions that can be implemented at the community level to complement and collaborate with existing public and private resources. It describe the essential steps to consider in the process of integration. These include 1) deciding whether to integrate family planning, 2) selecting a program strategy, 3) measuring program results, 4) identifying staff requirements, 5) developing a contraceptive supply system, and 6) managing the finances for an integrated program. 1997.

Contraceptive Logistics Guidelines For Refugee Settings (PDF, 1.11 MB)

The guidelines in this manual provide an outline of basic contraceptive logistics management principles and procedures used by program managers in camps for refugees or displaced persons. By using the steps outlined in the manual, program managers can design and implement a simple contraceptive logistics system in a camp where family planning programs are underway. Chapters cover estimating quantities of contraceptives needed, designing and developing contraceptive logistics management information systems, managing contraceptive inventories, and storing contraceptives.JSI/Family Planning Logistics Management (FPLM). 1996.

Family Planning Program Monitoring and Evaluation System (FPPMES): User's Manual and spreadsheet application (PDF, 121 KB)

Manual and Spreadsheet application, 1996.

Developing National Training Strategies in Family Planning Logistics: How Hard Can it Be? (PDF, 638 KB)

This paper, originally presented by JSI/DELIVER staff at the 121st Meeting of the American Public Health Association in October 1993, continues to be popular. It explains the different methods to train family planning personnel at all levels of the health care system in the area of contraceptive logistics. The paper illustrates training examples from cases around the world. JSI/DELIVER Project, 1993.