A strategic approach to reproductive health programme development

Many countries are transforming their efforts to meet their population’s reproductive health needs by refocusing maternal and child health and family planning activities into more comprehensive reproductive health programmes. Clearly, the specific directions and magnitude of the changes involved should depend on the socio-economic context and local epidemiology of reproductive health problems, as well as on the current programmatic situation. In seeking to innovate and expand reproductive health services, programme managers and policy makers are generally advised to follow an approach that is (a) public health based - addressing key reproductive health problems, (b) pragmatic - adding interventions and services in an incremental manner and building on what already exists, and (c) participatory - recognizing what different actors can feasibly do (Fathalla, 1996). The need to identify appropriate service delivery models and subsequently scale-up successful efforts is acute.