Acceptance of contraceptive by the poorest of the poor: the effect of an intensive Family Planning Programme

Abstract

Objective: Assess whether the impact of an intensive family planning service-delivery programme for the rich is similar to that for the poor. Methods: The site for this study was Matlab, a rural area of Bangladesh where ICDDR.B conducts health and family planning research and where BRAC has launched several social and economic interventions. In the Maternal and Child Health-Family Planning (MCH-FP) Project area, improved health and family planning services are provided; in the comparison area, normal government services are provided. Data for this study were collected through interviews in 60 villages in Matlab from July 1992 through November 1992 as part of the BRAC-ICDDR.B baseline survey. Eight thousand seven hundred and seventy-eight newly-married women of reproductive age were the respondents and units of analysis. Univariate and multivariate statistical analyses were performed, with acceptance of a modern contraceptive method as the main outcome measure. Results: Contraceptive acceptance was higher among women from households owning less than 50 decimal of land (0.4 hectare) and having at least one member who sells at least 100 days of manual labour a year (these households are BRAC's target group). However, the difference was observed only in the MCH-FP area. In addition, it was found that there was a difference in method use between the rich and the poor, and women from relatively richer households in both areas were more likely to use oral contraceptives. In the MCH-FP area, better off women were less likely to use injectable contraceptives. In the comparison area, female sterilization was more common among the women from poorer households. Conclusions: Contraceptive acceptance in Matlab is poverty-dependent. Differential acceptance of various methods by the rich and the poor needs to be studied further.