Community needs assessment approach to family planning in India

  • Previously, the achievements of family welfare programs were assessed in terms of targets provided by the central planning authorities
  • There were many demerits to this approach. They were:
    • The actual needs of the local community was not taken into consideration
    • The emphasis was on the quantity of the services rather than quantity
    • Because of the existence of pre allotted targets and cash benefits, contraceptive methods were provided without first assessing whether the recipients were  good candidates for the same (for example, Intrauterine Contraceptive Devices were introduced without first checking for presence of any reproductive tract infections) – This resulted in low acceptance and high discontinuity rate
    • The health workers were tempted to falsify the reports so as to gain benefits
  • Because of these defects, the targets were replaced by community needs assessment approach
  • In this approach, at the beginning of the year, the Axillary Nurse Midwife (ANM) will consult the different families in her allotted area for assessing their needs for that year
  • Based on the needs assessment, the workload for that year is calculated
  • The sum total of the workload for the different ANM’s will become the workload for a PHC
  • The requirements of the district can be calculated by combining the workload of the different PHC’s
  • Thus instead of a top to bottom manner, the planning is based on the community needs and hence is more successful