Integrating Health Services into an MCH-FP Program: Lessons from Matlab, Bangladesh

Abstract

Since 1977 the International Centre for Diarrhoeal Disease Research, Bangladesh, has conducted a field experiment in family planning and MCH in its Matlab research station. The project began with an emphasis on family planning and MCH services were added in stages. This paper uses time series regression methods to address the question of whether the addition of health services contributed to family planning efficacy in Matlab in a program launched with minimal MCH services. The results show that some MCH interventions increased contraceptive prevalence, some decreased it, and others had no effect. The broader significance of these findings for implementing integrated programs is discussed.

The Effect of Child Mortality on Fertility Regulation in Rural Bangladesh

“…The Matlab treatment area has received a series of carefully designed and closely supervised health and family planning interventions (Bhatia et al, 1980); (Phillips et al, 1982(Phillips et al, , 1984(Phillips et al, , and 1988. Briefly, family planning services have been provided on an intensive basis since 1977 through house-to-house delivery of contraceptives and information by trained village women, known as community health workers.…”

Staying for Benefits: The Effect of a Health and Family Planning Program on Out-Migration Patterns in Bangladesh

“…During these visits the female health workers also provided counseling on contraceptives, nutrition, hygiene, and breastfeeding, motivated women to continue using contraceptives, and instructed women how to prepare oral rehydration solution. These services were supported by well-developed follow-up and referral systems to ensure management of side effects and continued use of contraceptives (Phillips et al 1984, Fauveau et al 1994.…”

“…This program was especially valuable to the local population because it provided access to services that were difficult to obtain through government services, such as vaccines. Previous research shows this program was effective and valuable to the beneficiaries as it had important effects on a number of dimensions of human capital accumulation including reductions in child mortality and fertility (Phillips et al 1982(Phillips et al , 1984Koenig et al 1990Koenig et al , 1991, and longterm improvements in cognitive functioning, height, and education (Barham 2012, Joshi andSchulz 2013). The program was phased-in starting with family planning in late 1977, followed by child health interventions in 1982, with many of the health interventions becaming available in the comparison area after 1988.…”

Population Policy: Abortion and Modern Contraception are Substitutes

“…Most of the relative decline in abortion in treatment areas occurred around 1983 and thus is plausibly due to the end of abortion services. Antenatal and child health services were also bundled with the provision of modern contraceptives beginning in 1978 (Phillips et al 1984), making it difficult to disentangle the independent contribution of contraceptive supply from improvements in child survival.…”