Trends in family size preferences and contraceptive use in Matlab, Bangladesh

Abstract

In the nearly ten years of its existence, the Matlab Family Planning and Health Services Project has been characterized by a remarkable rise in contraceptive use and a corresponding decline in fertility. This study examines available evidence on trends in family size preferences in the Matlab area from 1977 to 1984 and their relationship to contraceptive use. Within the Matlab treatment area, the most significant factor behind the increase in contraceptive use has been a sharp rise in the practice of contraception for spacing births. There also appears to have been a more modest increase in the proportion of women wanting no additional children. Family size preferences in the treatment and comparison areas were roughly comparable, suggesting--to the extent that such preferences have changed over time--change may have occurred throughout the Matlab study area. The findings are evaluated in terms of their implications for the current debate on the contribution of family planning programs to fertility decline in developing countries. PIP:

In the nearly 10 years of its existence, the Matlab Family Planning and Health Services Project has been characterized by a remarkable rise in contraceptive use and a corresponding decline in fertility. This study examines available evidence on trends in family size preferences in the Matlab area from 1977 to 1984 and their relationship to contraceptive use. Within the Matlab treatment area, the most significant factor behind the increase in contraceptive use has been a sharp rise in the practice of contraception for spacing births. There also appears to have been a more modest increase in the proportion of women wanting no additional children. Family size preferences in the treatment and comparison areas were roughly comparable, suggesting--to the extent that such preferences have changed over time--change may have occurred throughout the Matlab study area. The findings are evaluated in terms of their implications for the current debate on the contribution of family planning programs to fertility decline in developing countries. The Matlab service program has conclusively demonstrated that substantial demand for family planning exists even within a setting such as rural Bangladesh. Important questions remain, however, about the cost-effectiveness of the Matlab project, given its special nature and the unusual resources that have been provided