With special reference to India.

Using data from the 1980 Malaysian census, this paper reports on a project that tests methodology for measuring the impact of family planning programs on fertility. It also develops an efficiency measure that could be used by program administrators for adjusting program management. In the 1st phase of the project, subnational aggregate data are analyzed using a multivariate areal analysis technic. Based on the regression results an efficiency index was constructed for each sub-unit, the lowest administrative program unit. Sub-units were than ranked in order from the most efficient to the least. A sample from the 2 extreme quartiles was used to analyze differential performance using clinical and other selected data. A multivariate analysis of program and non-program inputs decomposed the relative contribution of socioeconomic development and family planning inputs on fertility. The study concludes that a strong cultural factor affects fertility; social mobility is essential in promoting fertility decline. Family planning efforts directly affect fertility and need to be strengthened. Policies to improve living conditions and educational status will raise contraceptive prevalence. In-depth case studies could help to characterize the least efficient units. Efforts should be made to develop simple statistical estimation technics for multivariate areal analysis to overcome unequal areal sizes, as current regression analysis tends to have biased estimates without appropriate weighting.

As resources for family planning programs become more scarce, measurement of program efficiency is rapidly becoming one of the top priorities of family planning program evaluators. This study of Thailand is part of the continuing effort to evaluate the efficiency and impact of program inputs on family planning achievement and fertility. Analysis is restricted to 70 of Thailand's provinces as they existed from 1975-1979. Data falls into 4 categories: 1. data on government family planning inputs, 2. 1970 census data on the environmental or socioeconomic conditions, 3. data on family planning achievement that came fron the National Family Planning Program (NFPP) service statistics report for December 1978, and 4. 1980 census fertility data. Composite variables were created to improve sensitivity, correlation matrices were run to select the most important variables, and multiple regression and path analysis were used define the effects of the main independent variables on the dependent variables. The study concludes that: 1. Thailand's NFPP has an observable effect on family planning use which, in turn, has had a strong impact on reducing fertility. 2. This impact is the result of interaction between the modernization of the environment and the availability of health personnel and their services. Either factor alone has only a moderate effect on family planning use and fertility. However, when the 2 factors increase together in the same area, there is a marked impact on fertility after several years. These findings may enable the NFPP to define optimal amount of inputs for a given socioeconomic setting, resulting in more efficient use of decreasing resources.

The main objectives of the ESCAP project: Study on the Impact and Efficiency of Family Planning Programs, are to test the methodology for measuring the impact of family planning programs, and develop a measure of efficiency which could be used by program administrators for quick adjustments in program management. This report concludes that the number of workers, doctors, family welfare visitors, and family welfare centers are going to be the important predictors for areal variation in family planning program performances regardless of the socioecomic factors in Bangladesh. Until the late 1970s, the number of doctors available and % of female literacy could significantly explain the macro level areal variation in total fertility rate much more than the other types of family planning program and non-program factors. The study shows the limitations of input-output ratios as the appropriate measure of program performance. The efficiency-index proposed in this study appears to have worked better as it takes into account socioeconomic and other factors that may create the areal variation in program inputs.