In 1985, there were three main private family planning organizations providing community-based family planning services in Lima, Peru, which did not communicate with one another. The three organizations served overlapping areas of the city. Each organization had a different service model with different contraceptive brands and prices, and the Information, Education, and Communication (IEC) messages of the three organizations provided conflicting information. As a result, existing and potential family planning users were confused. They didn't know which organization to believe and distrusted all three organizations.
The complex array of service models, contraceptive brands, and public information messages was largely due to the presence of multiple donor agencies, each with its own strategy for the region. Then in 1986, a donor provided funding for the creation of Proyecto de Apoyo al Sector Privado en Planificación Familiar (the Private Sector Family Planning Project), known as SPF. The objectives of the SPF were: to improve coordination among the Peruvian Family Planning Associations (FPAs); to contribute to a decrease in the annual rate of population growth; to strengthen and improve the capacity of the FPAs to increase the coverage of family planning services and increase contraceptive prevalence; and to strengthen the capacity of FPAs to influence population policies. In order to eliminate duplication of services, the SPF suggested that there would be an advantage to dividing the area into zones, including the three in Lima.
After several months of discussion and negotiation, the three principal family planning organizations in Lima agreed to provide services only within specified geographic areas. This arrangement brought the organizations a number of administrative benefits. It cost the organizations significantly less to deliver services in a delineated area near their headquarters than to provide services for a larger area, and supervision costs also decreased. It was then possible to provide better support for family planning promoters. Each of the three organizations involved reported a significant increase in the services provided and a marked improvement in cost-effectiveness. In addition, because the organizations no longer had to worry about expanding their programs to compete with the other organizations, they could concentrate on improving the quality of services instead.
There were also improvements in the area of Information, Education, and Communication (IEC). Up until this time, each organization had its own logo, advertising imagery, and strategy. During the monthly coordination meetings, the executive directors of the three organizations adopted a new logo to be used by all three organizations to identify family planning service locations, including health posts, family planning clinics, distribution outlets, and the homes of promoters. A uniform was also designed for all the promoters, regardless of their organization, identifying them within the community as family planning providers.
In a second stage of coordinated IEC efforts, the organizations agreed to develop a coordinated IEC strategy. They produced a single pamphlet and poster for each contraceptive method to be used by the whole private sector. Each organization could affix its address and hours of operation in a designated part of the pamphlet. The logo was eventually adopted nationally and was used in mass communications, television spots, and billboards.
The coordination effort also reaped political benefits. The three organizations began to see themselves as a team. For the first time, they joined together to respond with one voice to an attack on family planning, and they issued an official announcement of the group's opinion on a sterilization law that was being considered by the Peruvian congress.
An additional benefit of the coordination effort was that each organization learned about the skills and areas of specialization of the other organizations. It now became possible for each organization to concentrate on its areas of expertise (such as service delivery) and to seek the support of those organizations which were more skilled in its weak areas (such as training). The organizations began to see themselves as a family planning team that could work together to improve the coverage and quality of services.
Today, the organizations are interested in further coordination. They are focusing their coordination efforts on equalizing prices and maintaining the work of each agency within the assigned zones. They are also considering involving a fourth family planning agency in their coordination efforts. In the long term, they also hope to collaborate on such central services as a central logistics system, a press, a graphics production center, a library, and meeting and training facilities.
In the final analysis, it is not only the organizations that benefit from improved coordination, but the family planning clients as well. Reliable and consistent family planning information and services are more widely available now in Lima, and increased coordination has also led to improved quality of care.