The Egyptian family planning program has been successful in that it has rapidly improved its service delivery system. In 1993 the Ministry of Health (MOH) had 3492 facilities providing family planning services in 21 governorates, and 10,714 physicians and 12,638 nurses took part in the program. As a result, 716,000 clients obtained family planning services from the MOH facilities, 15% more than in 1992. The achievements have been brought about by the System Development Project (SDP) that was started in 1987 which has upgraded the MOH family planning service delivery system in 21 out of 26 governorates. The initial goal of the SDP was to reduce the birth rate from 38/1000 population in 1986 to 35/1000 in 1993. The birth rate in 1994 is estimated to have dropped to 30/1000. New and improved IEC materials were designed and distributed. The clinics were reequipped for improved services. Training was conducted for doctors and nurses. Technical guidelines were developed in order to provide high quality service. Because injectables contain a hormone that causes amenorrhea in 80 to 85% of women, they might not be as popular as the IUD. In the end injectables and Norplant will be more popular in Upper Egypt than in Lower Egypt. Condoms are available throughout the country. Pills are available in clinics and also can be bought at any of around 18,000 pharmacies. At the impact of the family planning program the fertility level has been falling. The total fertility rate was 5.3 in 1979-1980. By 1994 it had dropped to 3.7 (2.9 in the urban areas and 4.9 in the rural areas). Infant mortality decreased by half between 1972 and 1992. More young women are using contraception for spacing rather than for limiting the number of children after having obtained the desired family size. Nevertheless, according to the Egypt Demographic and Health Survey 1992, the current family planning services have not reached one in five married women wishing to use family planning.