Health and Family Planning Commission levels and the enhanced family planning service work at County and Township Health and Family Planning Commission levels achieved the organizational merger's main goal of separating planning and oversight from service provision. The interview evidence also indicated that the organizational merger cut bureaucracy, overlapping work practices and inefficiencies. Better organizational work practices were confirmed by the interview data, with less overlapping practices, better information flows and reduced bureaucratic processes and more staff time allocated to providing front-line family planning services.

While the financial restructurings promoted the two-child policy aims in Shandong province, different county and township local development conditions might challenge the capacity of county and township family planning programs in differ parts of China, especially for underdeveloped and more rural counties and cities,in China had more than two children. There were few social compensation fees to collect after 2015.

5. Conclusions {#sec5-ijerph-16-02121}
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To assess whether family planning organizations' management structures and funding levels and streams shift in response to the new two-child policy and whether the new management structures promoted the new family planning policy, we investigated the family planning funding and expenditure trends before and after the 2013 formation of the National Health and Family Planning Commission, and measured the reallocation of funding and expenditure to family planning work, reductions in overlapping work practices between departments, elimination of wasteful funding and streamlining of information flows and decision-making. We found that the organizational change reduced total family planning funding and saved resources, while increasing family planning services. Planning and oversight at province