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## **_Concusior_**

In the case of Matadi, the clinic-based facilities were complemented by the network of some 25 CBD posts and a number of private pharmacies; in Kananga, contraceptives were available at the two IMCK clinics, 9 other health centers and at some 50 retail outlets which sold social marketing products. In both cases, a variety of contraceptives was continuously available to the population at numerous locations in the city and at affordable prices.

# The organizational autonomy necessary to respond to problems as they arise.

In both cities the projects were administered locally, and action could be taken promptly to address the problems which constituted barriers to service delivery. For example, in Kananga the Project eventually established a regional depot for contraceptive supplies as a result of the problems with contraceptive procurement which they had previously experienced. In both cities, this organizational autonomy gave the project personnel a greater sense of identification with project goals and responsibility in achieving project objectives.

# Regular and supportive supervision of those responsible for service delivery.

Both projects put great importance on maintaining regular contact with clinic personnel, as well as distributors (in the case of Matadi). These contacts bolstered morale, not only by indicating that the project administration was closely following the activities of specific individuals in the system, but also by transmitting to these service providers the same enthusiasm fbr project activities as was felt by the staff themselves. While the supervisory visits included administrative functions such as collecting service statistics and controlling inventory, they were handled in a friendly, non-threatening manner which served to encourage the service providers **to** perform their tasks well.

# Available resources to support project activities.

Both Matadi and Kananga were operations research projects which received special funding to experiment with approaches for increasing contraceptive prevalence. This in part explains their organizational autonomy, and may well have contributed to the sense of purpose and esprit de corps which developed among project staff. In contrast to the larger scale programs of the PSND and AZBEF, which in recent years have operated with significant financial constraints, these two projects had funds available to cover the activities planned, and their staff could program events with the confidence that monies would be available to carry them out. In this sense it would be somewhat unfair to compare the success of Matadi and Kananga with other cities in Zaire where the inputs have been less concentrated. In sum, special funding does not insure an increase in contraceptive prevalence, but it may indeed contribute significantly to the likelihood of its happening.

By the same token, it would be incorrect to assume that only a pilot project could hope to achieve the results found in Matadi and Kananga, or that these conclusions have little bearing on the larger family planning programs in Zaire. The factors outlined above-developing a strong sense of mission among staff members, ensuring an uninterrupted supply of contraceptives through multiple outlets, and establishing a system of regular, supportive supervision-can be applied to large scale programs as well. Even the issue of organizational autonomy can be partially addressed by decentralization, with greater decision-making conferred on those responsible for programs at the regional level. Indeed, the findings from these two case studies