Planning for service delivery at health centres: an experiment.

PIP: An experiment was conducted in 1983-84 in a district of Rajasthan State to verify the feasibility of developing and institutionalizing a planning system at the primary health center (PHC) level as a means of improving the performance of maternal and child health (MCH) and family planning service delivery. As a 1st step, an analysis of PHC performance was carried out in the selected district with the help of medical officers' responses to a questionnaire. Based on this analysis, 2 PHCs were selected for experimentation. The 2 differed in terms of environment and organization related factors and in terms of perceived constraints on performance as identified by the medical officers in charge of each. Different planning strategies appropriate to the particular configuration of factors affecting PHC performance were required. In this context 3 different foci were indicated: ensuring needed inputs, planning for workers' performance and activity planning based on clients' needs. The institutionalization of client-oriented planning systems in PHCs require the improvement of client record keeping, flexibility of PHC medical officers in providing required inputs as dictated by client needs, and organizational support from higher levels. Implementation of a planning system to systematize PHC operations requires commitment on the part of the state, district and PHC officials and their continuing involvement during implementation.^ieng