A Review of the Hhs Family Planning Program: Mission, Management, and Measurement of Results

by Butler, Adrienne Stith

• ISBN13: 9780309131179
• ISBN10: 0309131170
• Edition: 1st
• Format: Paperback
• Copyright: 2009-08-01
• Publisher: NATL ACADEMY OF SCIENCE

Summary

A Review of the HHS Family Planning Program provides a broad evaluation of the Title X family planning program since its establishment in 1970. The program successfully provides family planning services to its target audience of low-income individuals, but there is room for improvement. While the program's core goals are apparent, a secondary set of changing priorities has emerged without a clear, evidence-based strategic process. Also, funding for the program has increased in actual dollars, but has not kept pace with inflation or increased costs. Several aspects of the program's structure could be improved to increase the ability of Title X to meet the needs of its target population. At the same time, the extent to which the program meets those needs cannot be assessed without a greater capacity for long-term data collection. A Review of the HHS Family Planning Program recommends several specific steps to enhance the management and improve the quality of the program, as well as to demonstrate its direct contribution to important end results, such as reducing rates of unintended pregnancy, cervical cancer, and infertility. The book will guide the Office of Family Planning toward improving the effectiveness of the program. Other parties who will find the research and recommendations valuable include programs receiving Title X funding from the Office of Family Planning, policy makers, researchers, and professional organizations.

Table of Contents

Summary	p. 1
Study Charge	p. 2
Findings, Conclusions, and Recommendations	p. 4
Concluding Thoughts	p. 20
References	p. 20
Introduction	p. 23
Overview of the Title X Program	p. 23
Study Purpose and Charge to the Committee	p. 25
Study Approach	p. 27
Organization of the Report	p. 27
Overview Of Family Planning In The United States	p. 29
Why Family Planning Is Important	p. 30
Milestones in Family Planning	p. 37
The Use of Family Planning Services	p. 45
The Changing Context in Which Family Planning Services Are Provided	p. 48
Financing of Family Planning	p. 66
Conclusions	p. 70
Title X Goals, Priorities, And Accomplishments	p. 71
Original Goals and Amendments to the Law	p. 72
Shifts in Program Emphasis	p. 74
Fulfillment of the Program Mission and Goals	p. 83
Conclusions and Recommendations	p. 96
Program Management And Administration	p. 101
Central Office, Regional Offices, Grantees, and Delegates: Roles and Relationships	p. 102
Application Process	p. 105
Grantees and Delegates: Types and Distribution	p. 109
Services Provided by Grantees and Delegates	p. 113
Oversight of Grantees and Delegates	p. 115
Funding of Grantees and Delegates	p. 116
Assessment of the Program's Management and Administration	p. 123
Conclusions and Recommendations	p. 139
Collection Of Data To Measure Program Outcomes	p. 145
Part Process for Evaluating Title X	p. 145
Committee's Evaluation Questions	p. 146
Committee's Evaluation Framework	p. 146
Current Sources of Data for Program Assessment	p. 148
Applying the Committee's Framework to Assess OFP's Measures and Goals	p. 151
Adequacy of the Data Collection Infrastructure	p. 151
Conclusions and Recommendations	p. 166
Concluding Thoughts	p. 170
References	p. 171
Appendixes*
Data Sources and Methods	p. 183
Population Research and Voluntary Family Planning Programs	p. 191
Title X Family Planning Program Regulations	p. 197
Program Guidelines for Project Grants for Family Planning Services	p. 215
Family Planning Program Assessment Rating Tool	p. 251
Committee Site Visits	p. 267
Family Planning Annual Report Data Elements	p. 285
Summary of Previous Title X Evaluations and Reviews	p. 295
Title X- and OPA-Funded Research	p. 301
Organization, Funding, and Management of the Title X Program	p. 343
Measurement of Quality in the Title X Family Planning Program	p. 407
Committee and Staff Biographies	p. 459
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