Family-Planning Services in a Low-Performing Rural Area of Bangladesh: Insights from Field Observations (Survey‪)‬

INTRODUCTION Bangladesh is often cited as one of the most successful examples in popularizing its family-planning programme (1). The contraceptive prevalence rate (CPR) of 45% among the eligible couples in 1993-1994 is considered a commendable success despite the existing poor level of socioeconomic development in the country (2). The family-planning programme has been equipped with 35,000 service outlets, most of which are organized at the district level and below. The activities are most intense at the union level, with 3,000 Family Welfare Centres (FWCs), 1,275 rural dispensaries, and 23 Mother and Child Welfare Centres (MCWCs). At the village level, basic maternal and child health and family-planning (MCH-FP) services are provided, free of charge, by the staff of FWCs at the satellite clinics at the rate of 30,000 clinic-days per month. Besides, 23,500 Family Welfare Assistants (FWAs) provide additional free doorstep services (3). The methods of contraception include pill, IUD, condom, and sterilization. Although injectables are available to women on a limited scale for a decade, their use has soared since 1990 (2). IUDs are inserted at the FWCs and satellite clinics, and sterilizations are performed at the Upazila Health Complexes (UHCs).