Contraceptive users in rural Bangladesh: a time trend analysis

Abstract

An examination of the characteristics of contraceptive acceptors in a family planning program in rural Bangladesh revealed trends of declining age and number of living children among new acceptors. A time series analysis of the age-specific acceptance rates confirmed the observation, indicating that over time the program succeeded in attracting younger and low-parity women. The high use prevalence rates resulted in fertility levels that were 25 percent lower in the program area than in the comparison area. The decline in the fertility levels during the first program year was mainly due to a large decline in fertility among women over age 35, but in the second year, the contribution made by women 30-35 years old was substantial.

PIP: An examination of the characteristics of contraceptive acceptors in a family planning program in rural Bangladesh reveals trends of declining age and numbers of living children among new acceptors. A time series analysis of the age specific acceptance rates confirms the observation, indicating that over time the program succeeded in attracting younger and low parity women. The high use prevalence rates resulted in fertility levels that were 25% lower in the program area than in the comparison area. The decline in the fertility levels during the 1st program year was mainly due to a large decline in fertility among women over age 35, but in the 2nd year, the contribution made by women 30-35 years old was substantial. The family planning program was sponsored by the International Centre for Diarrhoeal Disease Research in 70 villages of Matlab Thana beginning in 1977. Data for the analysis is drawn from a survey of all married women of reproductive age (MWRA), 15-49 years, and from a longitudinal record keeping system maintained by female village workers who visited and recorded information on each MWRA fortnightly. In analyzing the data based on husband's occupation, the survey reveals that at the start of the program all had low contraceptive use levels; however, those in more skilled occupations and higher socioeconomic levels showed greater initial acceptance rates. But as the program developed, the use prevalence among the lower socioeconomic groups (boatmen, cottage industry workers, unemployed, agricultural laborers) increased substantially, indicating that the program was successful in catering to the needs of all socioeconomic groups. 75% made the injectable contraceptive (DMPA) their method of choice; 50% of the remainder chose the pill in the 1st year of the program. By the 2nd year, sterilization was chosen by many of the previous DMPA users to make a total acceptance rate of 20%. author's modified