Impact of an in-built monitoring system on family planning performance in rural Bangladesh

The interventions included development and testing of innovative solutions in service-delivery, provision of door-step injectables, and strengthening of the management information system (MIS). The impact of an in-built monitoring system on the overall performance was assessed during the period from June 1995 to December 1996, after the withdrawal of the interventions in 1992.The results of the assessment showed that Family Welfare Assistants (FWAs) increased household-visits within the last two months, and there was a higher use of service-delivery points even after the withdrawal of the interventions. The results of the cluster surveys, conducted in 1996, showed that the selected indicators of health and family-planning services were higher than those reported by the Bangladesh Demographic and Health Survey (BDHS) 1996–1997. During June 1995-December, 1996, the contraceptive prevalence rate (CPR) increased by 13 percentage points (i.e. from 40% to 53%). Compared to the national CPR (49%), this increase was statistically significant (p < 0.05).The in-built monitoring systems, including effective MIS, accompanied by rapid assessments and review of performance by the programme managers, have potentials to improve family planning performance in low-performing areas.Inadequate basic management skill among health teams at the implementation level is one of the main constraints in providing primary healthcare (PHC) in developing countries [1]. Literature on health reforms also emphasizes strengthening the capacity of the ministry of health at the central and district levels and improvement of supervision and administrative leadership [2-7]. An effective monitoring and tracking mechanism enables identification of low-reach catchments areas, operational problems in improving coverage, and corrective actions to enhance service-use [8]. In the Philippines, focus is placed on improving maternal and child health and meeting the reproductive intentions of women by improving the