One of the great privileges of my life has been to know bold leaders in family planning and reproductive health. As I listen to the current debates about “task shifting” and “task sharing,” I am reminded of the pioneering work of Mechai Viravaidya and Allan Rosenfield in Thailand dating back to the 1960s. Along with Chitt Hemachudha, they introduced innovative approaches to family planning that can inform our current efforts to improve the health of women and their families.
The situation in Thailand at that time was similar to that faced today by many countries with a health workforce crisis. The number of doctors was quite low and they were very inequitably distributed; this meant that in large swaths of the country the doctor-patient ratio was on the order of one doctor per hundred thousand people. The Thai government had become committed to reducing the rate of population growth and improving maternal and child health. This led to the obvious conclusion that a diverse set of providers would be needed to make family planning widely available. Read more »