Report on the study of interaction between clients and grass-root family planning workers: implications for programme performance.

In early 1990 the Institute of Population Studies interviewed 2378 currently married women 176 family planning (FP) workers and 28 medical/clinical staff to define the interaction process between FP workers and clients to Thailand. The study revealed no significant differences between low medium and high contraceptive prevalence areas of 3 northeastern provinces and 3 southern provinces and between various current contraceptive users ever users and never users. 52-67% of women believed people can change their fate but older women believed it less than younger women. Most said the wife should make decisions concerning familys health and contraceptive use. Most women knew much about contraceptives and the FP program despite contraceptive status. Indeed most knew their areas FP workers well and often invited them to visit their homes or to community parties. Thus interactions and relationships were good. FP workers tended to talk about side effects and symptoms rather than asking clients about their feelings towards FP methods. Most women used contraceptives to space births or to prevent anymore births. The relationship with FP workers did not affect a clients decision not to use contraceptives. 2 major client identified barriers included large family size norms and lack of a comprehensive service. Both FP workers and medical/clinical staff had a positive attitude towards their work. Indeed FP workers said they did not wish to leaver their jobs. They enjoyed the relationships with clients and found them friendly. Yet barriers did exist; rumors beliefs values cultural practices lack of support from supervisors heavy workloads and lack of appreciation. Medical/clinical staff also mentioned heavy workloads and lack of support from supervisors. Indepth interviews and observations of interaction between FP workers and clients supported the surveys findings.