Managing integrated services.

There is an emerging consensus that the integration of family planning services into maternal-child health, nutrition, women's reproductive health, adult literacy, and other health and development activities is both feasible and effective. In addition, more and more family planning programs are incorporating sexually transmitted diseases counseling, testing, and treatment into their activities. This issue of "The Family Planning Manager" provides guidelines for assessing integration at several different organizational levels and offers practical advice on how to enhance the effectiveness of integrated programs. Managers must be prepared to collaborate with providers, program managers, trainers, and senior-level managers to ensure that the quality of family planning services is not undermined in the process of integration. Guidelines for making integration work include the following: focus on developing an integrated plan and budget, make plans flexible, provide equal pay for jobs of equivalent responsibility, design programs so that form follows function, take the opportunity to reallocate staff to where they are needed, ensure staff have a clear understanding of their roles and how they fit into the overall program, develop a case-based training curriculum, limit the number of supervisors, integrate the logistics system only when services are operating at similar levels of efficiency, and offer many services to all clients.