Direct and judgmental measures of family planning program inputs.

Two different approaches were compared to measure the strength of family planning programs in Bangladesh and Kenya. The judgmental approach has been used in a number of studies in the past two decades: scores on the characteristics of family planning programs are derived from the responses given by knowledgeable persons to a series of questions. The direct approach obtains measures of key program inputs based on direct evidence. The sources for the two measures were leaders favorable statement use of the civil bureaucracy multiministry and agency involvement import law and regulations involvement of private sector agencies budgets and social marketing. Of the 16 feasible variables scores were obtained for 13 in Bangladesh and for all 16 in Kenya. In addition scores were also developed for 11 other variables in Bangladesh and 6 others in Kenya. In Bangladesh the total program effort score for 1993 for both the direct and the judgmental approaches was 72%; while in Kenya the scores differed substantially: 61% for the direct approach and 53% for the judgmental approach. In Bangladesh the 1993 direct score was 73% of the maximum above the judgmental score of 67%. In Kenya the direct score for the feasible variables was 64% above the judgmental score of 55%. There was a definite decline in effort in Bangladesh from 1989 to 1993 (75% to 67%) and a mild one in Kenya (59% to 55%). However the full set showed little change in Bangladesh (74% to 72%) and essentially no change in Kenya (54% to 53%). The family planning program in Bangladesh was pushed vigorously in the late 1980s; however the intensity lessened in the latter part of 1991 until 1993. The primary advantage of the judgmental approach is that scores can be obtained for a larger number of countries at much lower cost than by the direct approach.