in the 1930s. In 1963, in a governmental "Five-year Independence Plan", the state announced its intention to control population growth by encouraging emigration and the use of family planning services. By 1967 a National Family Planning Board was established to promote and deliver services. A later merge with the Ministry of Health in 1974 was acccmplished with mixed results. The responsibilities of each institution were not well defined and priority was given to primary health care by the Ministry of Health (30% of which is services for women-Segree, 1985). Consequent shortages in family planning physicians and staff may have ccmpromised the effectiveness and adequacy of family planning efforts (World Bank, 1987). Goals for family planning established in conjunction with the World Bank in 1983 include: population not to exceed 3 millioi by year 2000; attainment of a two-child family by 1990; access to high quality family planning for all men and women of reproductive age; continued inprovement in life expectancy to 75 by year 2000; and various econamic and social inprovements in the areas of employment, housing, etc. (World Bank, 1987). Health sector objectives have been modified to include goals of inproving service efficiency to maintain universal coverage of acceptable quality within the limits of the sector budget (World Bank, 1987). Sector efforts in Family Planning are described in more detail in the World Bank report; notably they include cost recovery efforts which involve patient copayments. The Ministry of Health served about 17% of the target population and the private sector served another 23% in 1982. Tlhe resultant contraceptive prevalence was only 40% of all women of reproductive age and 55% of wcmen in union (World Bank, 1987). The vast majority of wcmen (89%) seek family planning services for the first time after they have begun childbearing (Bailey & Powell, 1982). Rural wcmen are more likely to get pills and IUDs, and urban women are more likely to receive "other" contraceptive methods such as foam, diaphragms, and condoms (Bracken & Xasl, 1973). Rural women attending family planning clinics around 1972 tended to have more children than urban women (4.2 versus 3.4 per wcmian); the types of union and mean age was not different between the two groups. Studies on utilization of family planning services found that women most likely to drop out were either very young or very old, with few or a large number of living children, were more likely to be single, never had a miscarriage, and whose last pregnancy was not very recent. Religion, social class, and type of contraceptive method were not significant determinants of dropping out. Women were asked directly about their reasons for dropping out; 28% complained about the method, 17% described some aspect of clinic routine, 19% of the reasons involved pregnancy (one-third had been pregnant and didn't know it, about two-thirds had contraceptive failures, a minimum desired pregnancy and purposefully dropped out) (Bracken & Kasl, 1973). Of those that dropped out, 40% continued to use family planning since dropping out. These women were less likely to be from rural areas, were more likely to be married, and more likely to have been pregnant recently or more than three years previously. These women claimed they stopped coming to the family planning clinics because the time was inconvenient; they reported fewer side-effects fram the methods they had chosen. Women who continued to use contraception were more likely to use coitus dependent methods and used supplies left over from their last. visit, purchased from stores, or obtained from friends (Bracken, 1976). Another study on the use of contraceptives in Kingston (Bailey & Powell, 1982) found that drop out rates were associated 13