Decentralization And Performance Of Family Planning Program: An Institutional Analysis Of Population Welfare Department, Punjab

Abstract

Introduction: The family planning program was decentralized to the provinces to enhance the quality of family planning services and meet the needs at the grassroots level by engaging local contexts. The decentralization of the family planning program in Punjab has produced mixed outcomes.

Objective: The objective of the study was to assess the performance of the Family Planning Program in the context of decentralization by conducting an institutional analysis of the Population Welfare Department, Punjab.

Material and Methods: An explanatory sequential research design was applied. The target population included ever-married women of reproductive age (1549) in Punjab, with data extracted from four waves for the quantitative part from the four waves of PDHS 1990-91(8,939), 2006-07 (16,303), 2012-13 (3,800) and 2017-18 (10,825), covering pre and[1] post decentralization period. Descriptive analysis was conducted to assess the performance of family planning indicators in Punjab. In-depth interviews were conducted with key informants for institutional analysis of the Population Welfare Department, Punjab and conducted thematic analysis.

Results: The average number of children decreased in the era of post-decentralization from 5.19 to 4.34 per woman. Similarly, the percentage of current contraceptive use also increased from 19.5% to 48.5%. The use of modern contraceptive methods was improved from 14.9% to 35.5%. The unmet need for spacing also decreased from 80.0% to 40.3%. The results revealed that the indicators of family planning improved in Punjab from 1990-91 to 2017-18. However, institutional analysis revealed that limited human resources, inadequate budget allocation, compromised service quality, weak monitoring mechanisms, and lack of collaboration with development partners have impacted performance post-decentralization.

Conclusion: The decentralization has brought both opportunities and challenges for the family planning program in Punjab. Despite the institutional challenges, family planning indicators improved from 1990-91 to 2017-18. The government should allocate adequate resources, including human resources and budget, and establish a robust monitoring mechanism to ensure quality services.