Coping with changing conditions: Alternative strategies for the delivery of maternal and child health and family planning services in Dhaka, Bangladesh

Subrata Routh, Shams El Arifeen, Shamim Ara Jahan, Anwara Begum, Aye Aye Thwin, Abdullah Hel Baqui

Research output: Contribution to journalArticlepeer-review

Abstract

The door-to-door distribution of contraceptives and information on maternal and child health and family planning (MCH-FP) services, through bimonthly visits to eligible couples by trained fieldworkers, has been instrumental in increasing the contraceptive prevalence rate and immunization coverage in Bangladesh. The doorstep delivery strategy, however, is labour-intensive and costly. More cost-effective service delivery strategies are needed, not only for family planning services but also for a broader package of reproductive and other essential health services. Against this backdrop, operations research was conducted by the Centre for Health and Population Research at the International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDR,B) from January 1996 to May 1997, in collaboration with government agencies and a leading national nongovernmental organization, with a view to developing and field-testing alternative approaches to the delivery of MCH-FP services in urban areas. Two alternative strategies featuring the withdrawal of home-based distribution and the delivery of basic health care from fixed-site facilities were tested in two areas of Dhaka. The clinic-based service delivery strategy was found to be a feasible alternative to the resource-intensive doorstep system in urban Dhaka. It did not adversely affect programme performance and it allowed the needs of clients to be addressed holistically through a package of essential health and family planning services.

Original languageEnglish (US)
Pages (from-to)142-149
Number of pages8
JournalBulletin of the World Health Organization
Volume79
Issue number2
StatePublished - Mar 14 2001
Externally publishedYes

Keywords

  • Bangladesh
  • Cluster analysis
  • Contraceptive agents, supply and distribution
  • Delivery of health care, methods
  • Family planning, supply and distribution
  • Maternal-child health centers, utilization

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health

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