Addressing Informed Choice and Quality of Care in Family Planning
through Community Based Monitoring 

CHSJ has been at the forefront of raising issues of quality of care and informed choice in family planning programme. In partnership with nine civil society organisations CHSJ undertook community based monitoring of family planning services in 50 villages in 10 districts of Uttar Pradesh and Bihar. The exercise included discussions with women who are intended as well as actual beneficiaries of the family planning programme. Interviews were conducted with ASHAs, medical officers and auxiliary nurse midwives (ANMs) and health facilities were observed. Hundred focus group discussions (FGDs) were conducted (two in each village), and 340 women users, 50 ASHAs and 10 medical officers were interviewed and 10 PHCs observed. Score cards were prepared to assess the performance of each district.
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The major findings were:

M A J O R    F I N D I N G S

• Lack of counselling and information-sharing was a recurring problem in which all districts reported  'poor' performance
• Very few women were told about all the available family planning methods; providers generally only provided information about sterilisation
• Medical officers as well as ASHAs reported being given targets for sterilisation The ASHAs pressurised women to undergo sterilisation operations by making repeated visits to them
• The consent form was not read out to the women and no assistance was provided to help them understand it
• The PHCs/ Community Health Centres (CHCs) were not well equipped to provide family planning services, with 6 out of 10 districts scoring ‘poor’ in terms of quality of clinical services for family planning and the remaining four scoring ‘average’

​The findings have been widely shared through district level public dialogues in the 10 districts and also through two state level dialogues in Patna and Lucknow.

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