Comparing the productivity of family planning operations: an American experience.

This paper reports a comparison of the productivity of 77 public family planning programs in North Carolina. It combines an empirical statistical approach to identify differences with field studies of high and low performers based on our expanding knowledge of service organization performance and productivity. Its applicability in less developed countries is discussed in the context of existing productivity studies. After adjustment of performance for demographic and environmental factors, high performance was found in centers with flexible layouts and patient flows, flexibility in staffing patterns and schedules, creativity in circumventing manpower shortages, greater ingenuity in reaching target groups, especially teenagers, and more responsiveness to client demands. Poor performers were characterized by lack of the above and had more satisfied staffs. The key appears to be the role of the department director and board in setting more demanding standards for performance and in providing creativity, flexibility, and urgency in problem solving.