The Quality of Family Welfare Services in Rural Maharashtra: Insights from a Client Survey

Abstract

For the last three decades, India's Family Welfare Programme has pursued the goal of reducing fertility as rapidly as possible. Until recently the means used to achieve this goal were method-specific contraceptive targets and cash incentives for acceptors. The Indian government has recognized that this approach has failed to produce the desired reduction in fertility because it has emphasized targets and incentives to the detriment of quality. To remedy the situation, the government has adopted a reproductive health approach for delivering family welfare services and has taken the critical step of removing method-specific contraceptive targets. In addition, the government has decided that the Family Welfare Programme should focus on quality of care, client satisfaction, and service coverage. This chapter presents results from a survey designed to assess the quality of care of, and client satisfaction with, the Family Welfare Programme in a district in rural Maharashtra. The study also identifies specific program elements deemed to be detrimental and client characteristics that influence program quality and client satisfaction.