Maternal-child health and family planning: user perspectives and service constraints in rural Bangladesh
Simmons, R.; Koenig, M.A.; Huque, A.A.
Studies in Family Planning 21(4): 187-196
1990
ISSN/ISBN: 0039-3665 PMID: 2219224 DOI: 10.2307/1966613Document Number: 387333
The article presents a microanalysis of interactions between female fieldworkers and women in rural Bangladesh, and a discussion of the broader organizational constraints that hamper service delivery. It is argued that the field worker, herself a rural woman, is faced with considerable demand for both maternal-child health (MCH) and reproductive health care services, but that operational constraints prevent her from realizing her potential in both these areas. Qualitative data show that, in the eyes of rural women, contraceptive use and health care are intricately intertwined, and that this association often raises a range of questions that the worker cannot address competently. A number of specific operational barriers: worker densities, staff motivation, supervision, technical competence, supplies, are identified. These barriers reflect a general institutional weakness in the Ministry of Health bureaucracy that prevents if from organizing itself to deliver user-oriented health and family planning services while maintaining adequate and appropriate standards of care.