Abstract

PIP:

The rapid increase in Bangladesh's contraceptive prevalence rate, from 8% in 1975 to 25% in 1985, is in part attributable to the introduction in 1978 of grassroots-level family planning workers, known as family welfare assistants (FWAs). FWAs cover a geographic cluster of about 4000 women and make home visits to discuss family planning every other month. To confirm the significance of FWAs, data from the 1989 Bangladesh Fertility Survey on 7764 rural women were analyzed. The presence in the respondent's area of a FWA was found to increase by 54% the probability that the woman would be a contraceptive user. This factor also accounted for more than a third of the inter-cluster variation in contraceptive use. The presence of a family welfare center in the area was not a significant factor, however. The presence of an FWA increased by 66% the probability of a couple accepting sterilization. Sterilization acceptors tended to be less religious, over 30 years old, and of low socioeconomic status. Part of the effectiveness of FWAs pertains to their willingness to make home visits in a culture that discourages women from leaving the home without their husband. To further increase the contraceptive prevalence rate, it is urged that FWAs be assigned to the many geographic clusters that have no worker and that caseloads be reduced to enable monthly home visits.