Worker-client exchanges and contraceptive use in rural Bangladesh
Phillips, J.F.; Hossain, M.B.; Simmons, R.; Koenig, M.A.
Studies in Family Planning 24(6 Pt 1): 329-342
1993
ISSN/ISBN: 0039-3665 PMID: 8153964 DOI: 10.2307/2939243Document Number: 319840
This article uses longitudinal data from rural Bangladesh to assess the impact of household visits from family planning workers on contraceptive use. A panel of women was interviewed in a demographic survey and re-interviewed every 90 days for six successive rounds. Regression methods were used to estimate the effect of these encounters on the odds that a women will use contraceptives. Statistical controls adjust for the potentially confounding effects of underlying demand for contraception. Findings suggest that both male and female worker-initiated exchanges have an effect, although the impact of outreach is more pronounced if the worker is female. Estimated effects are consistent with the hypothesis that the predominant impact of outreach is to crystallize existing latent demand for contraception. Results indicate the importance of female outreach workers as agents of social change rather than as mere purveyors of contraceptive supplies. Introducing reproductive change is difficult in a conservative traditional society such as Bangladesh. Where demand for family planning lacks strong institutional underpinnings, strategic planning, careful training, strong supervision and other elements of high quality care represent necessary attributes of successful family planning outreach.