With contraceptive prevalence currently around 50 percent, Bangladesh has achieved remarkable success in family planning by offering free doorstep delivery of family planning services. In late 1997, doorstep services were replaced by clinical services at fixed sites, known as the essential services package (ESP). These fixed site services include family planning (FP), reproductive health (RH), and child health (CH) services. Services are provided under the Rural Service Delivery Program (RSDP) through a three-tiered service delivery structure that includes village depotholders, paramedics at satellite clinics, and static clinics that provide ESP services for a nominal fee. RSDP operates in 171 of Bangladesh’s 409 rural thanas.
The present study examined survey data from 1998–99 and service statistics from 1997–1999 to determine whether the transition from doorstep to fixed site services had affected contraceptive use. Statistics show that there was not much improvement in the use of FP, RH, and CH services during the first year (1997-1998). The major reasons cited by clients for not using of services were “not aware of service sites” and “not aware of the benefit of RH and CH services.” However, the data show an increase of 84–180 percent in contraceptive method distribution for the second year (1998-99). The client volume for RH services has doubled, and volume has more than doubled for CH services. These preliminary results suggest that the transition from doorstep to fixed site services is likely to sustain the pace of demographic transition in Bangladesh. Another client survey will be conducted in mid-2000.
Learning Objectives: At the conclusion of the session, the participant (learner) in this session will be able to: 1) Identify lessons learned and strategies for continued improvement of RSDP activities. 2) Discuss the policy implications of study findings and the transition from community-based to fixed site services
Keywords: Sustainability, Family Planning
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.