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Throughout the world, family planning organizations devote a significant portion of their funds and staff time to training, with the expectation of improving the effectiveness and efficiency of their programs. But it is often not clear whether the training has made any difference, or whether specific performance problems can be solved through training.

Managers are increasingly focusing on bringing reproductive health services to hard to reach, underserved populations that are geographically, culturally, and economically isolated. By serving the reproductive health needs of these populations, managers will not only increase the use of family planning but also improve the health of mothers and increase child survival rates.

This issue concludes Volumes I through IV of The Family Planning Manager.

Increasingly health and family planning programs are decentralizing managerial responsibilities. As a result, managers at the local and district level need to make strategic decisions so that their programs will continue to meet the health needs of the communities they serve.

In recent years, some ministries of health around the world have embarked on a process of decentralization.

How can health programs and organizations achieve results under increasingly complex and changing conditions? How can health managers focus their organizations on tackling complicated problems, such as HIV/AIDS or organizational restructuring?

Customer service is a powerful tool that helps managers focus their services on what customers, or clients, want and need.

Partnerships between two or more organizations can be effective vehicles for achieving important public health goals.

Tuberculosis (TB) is a highly contagious disease that people catch after inhaling a very small number of TB germs and becoming infected. One-third of the world’s population is currently infected with the TB bacillus, and five to ten percent of these people will become sick or infectious at some time during their life. Nearly one third of people with HIV are also infected with TB.

Community participation has long been recognized as an effective means of helping rural and urban people focus energy and mobilize resources to solve their health, environmental, and economic problems.

Strategic thinking is a powerful skill that clinic managers and supervisors can use in creating clinic or program plans designed to meet future goals and effectively use available resources. In the past, formulating strategy has been reserved for senior managers and policy makers of large organizations.

When the demand for services increases or a program expands the range of health and reproductive health services it offers, the staff of a health facility can quickly become overwhelmed.

Family planning managers are frequently being asked to add or integrate family planning services into maternal and child health (MCH), nutrition, women's reproductive health, adult literacy, and other health and development activities. Consequently, managers are asking questions about exactly when, where, and how family planning services can be integrated with these other activities.

Gender is one of the most important factors to consider in designing, managing, and delivering reproductive health services. Yet gender may also be the least understood characteristic in terms of how women’s and men’s health needs differ and how those differences can best be addressed.

Health organizations are increasingly functioning in a marketplace where other health organizations offer similar services to overlapping populations. As a result of such competition for users, more and more organizations are turning to marketing to help them both to identify and better serve their target populations’ needs and to increase and sustain demand for their services.

Local resources can significantly contribute to national governments’ and external donors’ efforts to maintain and extend health programs.

No leader of an organization can last forever, but staff often behave as if their leader were immortal. Understandably, the staff may not want to spotlight the need to plan for a transition if their current leader is effective, or if the leader is ineffective but powerful and well connected.

The ability to assess an organization’s management capabilities is rapidly becoming a critical skill for health and family planning managers. As policy makers, national program planners, and donors take an increasingly critical look at program priorities and the use of available resources, their attention is drawn to how well organizations and programs operate.

The topic for this issue, "Reducing Client Waiting Time," addresses a common problem for managers of family planning programs. Long waits in clinic waiting areas can create barriers that prevent your services from reaching family planning clients.

Anyone who has ever worked in a family planning program will be all too aware that efforts to attract and recruit new clients will be only partially successful if the program fails to keep those new clients. How can the universally troubling problem of discontinuers best be addressed by program managers?

For over twenty years, managers of health programs have relied on many types of research to help answer strategic and programmatic questions. Demographic surveys, rapid assessments, operations research, and sociological and economic studies contribute significantly to The Manager’s ability to formulate appropriate goals, determine strategies, and assess the achievement of program goals.

Many program managers consider financial management a complex, uninteresting, or even frightening topic. They may prefer to leave the responsibility for financial management in the hands of accountants, bookkeepers, and finance officers. Today, however, organizations rely on all their managers to help allocate and monitor resources in order to achieve programmatic goals.

Pick up any popular magazine or newsletter these days and you will probably find an article about some aspect of communications technology. Whether the article is about how to hook up to the World Wide Web, how to search and receive information electronically, or how to avoid telephone charges by using e-mail to communicate with friends and colleagues, these technologies have a strong presence.

The experience of community based family planning programs in Indonesia and Bangladesh, demonstrates that simple geographical maps can serve as useful information tools in helping family planning workers or volunteers to understand their community and its contraceptive needs.

Linking the payment of funds with the results of service activities is a powerful strategy that funding organizations can use to make the service-providing organizations accountable for achieving program goals. This new strategy offers financial incentives and holds great promise for improving performance of health services.