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...hole is likely to bring sharper fertility decline in the Treatment Area but since fertility is also affected by other proximate variables such as age at marriage, fecundability, and induced abortion (=-=Bongaarts 1978-=-), the fertility differentials between the Treatment Area and others may not exactly correspond to those of contraceptive prevalence. The mean yearly fertility levels, as measured by general fertility...

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... evaluation, and accessibility-has been assessed to be moderate (among the four categories of strong, moderate, weak, and very weak or none) and ranked 11th among 100 developing countries (Lapham and =-=Mauldin 1985-=-). In this respect it r3nks somewhat lower than India but considerably higher than 8 Fandly Planning Succes Stories i.n Bangladesh and India Paidstan-two countries which are not very different from Ba...

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...ioeconomic and cultural situation of Bangladesh there could be no such demand unless there was a policy-induced basic change in societal and administrative structure, particularly at the local level (=-=Arthur and McNicoll 1978-=-; Demeny 1975). Hardly any demographer could predict during the 1970s that the contraceptive prevalence in a rural population of about 100,000 in Bangladesh could possibly approach up to the levels of...

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...many difficulties to involve community members in these activities. Moreover, empowerment of communities perhaps require technical skill which the FPAI and government field staff usually do not have (=-=Askew 1989-=-). One other important limitation of the Kundam Project is the lack of females among its staff members. Only female staff member is the auxiliary nurse midwife. Perhaps the nonThe Rundun Projea 33 ava...

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...use and reduce fertility. Another contiguous area comprising 83 villages of Matlab The Matlab Project 3 served only by the regular Bangladesh government program was designated as the Comparison Area (=-=Stinson et al. 1982-=-).1 The 1974 baseline survey of eligible women in 233 CDP villages showed that only one percent were current contraceptive users but another 32 percent expressed a desire to cease childbearing and to ...

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...ntinuation rates low at the initial stage, because it served those whose demand was most prominent: high parity women, women with closely spaced births or many sons, and the relatively well-educated (=-=Bhatia 1981-=-, 1983). As the Project progressed, adoption rates were not so high and discontinuation rates increased. Such a pattern of adoption and continuation has been found in other countries also (Ross et al....

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... Treatment and Comparison Areas indicate that the population in the Project area were more or less similar to rural Bangladesh in educational attainment, occupational structure and housing condition (=-=Chowdhury and Phillips 1985-=-). The selection of villages for allocation in the Treatment and Comparison Areas was not made on a random basis. It was made by administrative criteria intended to control costs such as relative acce...

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...nt Area and 31 villages of the CDP Comparison Area; 79 villages of the Matlab Project Comparison Area is comprised of 54 villages of the CDP Treatment Area and 25 villages of the CDP Comparison Area (=-=Phillips et al. 1982-=-). The Treatment Area is divided into four blocks for project operation purposes. Basic domiciliary services for pill, condom, foam tablet, and injectable (depo-provera) and clinical services for IUD,...

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...hip with those able to assist them, identify problems and needs and increasingly assume responsibility themselves to plan, manage, control and assess the collective actions that are proved necessary (=-=Askew et al. 1986-=-:5). The Kundam Project appears to have succeeded reasonably to encourage community participation in activities for raising awareness regarding family planning and crystallizing the existing fragile d...

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...uctw of the Bangldesh National Program The family planning wing of the Ministry of Health and Family Planning (MOHFP) provides family planning and MCH services throughout the country (for details see =-=Balk 1986-=- and Balk et al. 1988). The union-level health and family welfare centers (one H&FWC for approximately 20,000 people) constitute the institutional cornerstone of the rural family planning and MCH outr...

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...ing effect of other proximate variables. A lower fertility level in the Treatment Area, however, has been sustained over time. Annual fertility trends are somewhat masked by seasonality in fertility (=-=Becker and Sardar 1980-=-). The rise of fertility level from 1978 to 1980 in both the Treatment and Comparison Areas even with sharp increase of contraceptive prevalence in the Treatment Area during the period, as reflected i...

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...unfavorable for widespread practice of family planning and low fertility level. Various drawbacks in the national family planning program of Bangladesh have been analyzed by many investigators (e.g., =-=Choudhury and Akhter 1990-=-; Duza 1990). The inadequacy of its inputs relative to those in the Treatment Vrea of the Matlab Project has been pointed in the previous two sections. Yet the family planning program effort level-as ...

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...tuation of Bangladesh there could be no such demand unless there was a policy-induced basic change in societal and administrative structure, particularly at the local level (Arthur and McNicoll 1978; =-=Demeny 1975-=-). Hardly any demographer could predict during the 1970s that the contraceptive prevalence in a rural population of about 100,000 in Bangladesh could possibly approach up to the levels of 45 percent b...

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...practice of family planning and low fertility level. Various drawbacks in the national family planning program of Bangladesh have been analyzed by many investigators (e.g., Choudhury and Akhter 1990; =-=Duza 1990-=-). The inadequacy of its inputs relative to those in the Treatment Vrea of the Matlab Project has been pointed in the previous two sections. Yet the family planning program effort level-as measured by...

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...adult female literacy was only 12 percent in 1970 and 22 percent in 1990. Only 64 percent of primary school age girls and 19 percent of secondary school age girls were enrolled in schools in 1986-89 (=-=Grant 1992-=-). Infant mortality, another variable highly associated with contraceptive acceptance and fertility decline, is also still very high in Bangladesh. For example, the infant mortality rates per 1000 bir...

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... The following analysis of the Kundam Project's performance in terms of its objectives is based on a report produced by the Operations Research Group using the survey data collected by it in 1986-87 (=-=Khan and Gupta 1988-=-). Implementadon Process and Serice Stnrudw of the Project As an initial step, a Liaison Committee comprising the president of the FPAI's Jabalpur Branch as chairman and six other members selected fro...

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...nd the factors responsible for the change, if any. A significant decline in the desired number of children in the Treatment Area was evident in the findings of two surveys conducted in 1977 and 1984 (=-=Koenig et al. 1987-=-). For example, in 1977, 43 percent of all currently married women in reproductive age wanted no additional children; the corresponding figure for 1984 was 55 percent. The difference was sharper among...

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...ruit new users after the first intensive round in late 1975. The prevalence rates in the Comparison Area held at about 3 to 4 percent throughout the program period (see Langsten and Chakraborty 1978, =-=Osteria et al. 1978-=-; Rahman et al. 1980). The CDP findings suggested that ubiquitous availability of contraceptive supplies alone was not a solution to high birth rate in Bangladesh, but they also indicated that there m...

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...ot Ara and 'Comparisn Area" of the MCH-PP Project. 4 Famdly Planning Success Stories in Banglah and India The service package of the Matlab Project, described in detail elsewhere (Bhatia et al. 1980; =-=Phillips et al. 1984-=-; Rahman 1986; Balk et al. 1988) includes the contraceptive methods mentioned above, immunization for children and pregnant mothers, treatment of diarrhoeal diseases, and provision of medicines for co...

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...ot Ara and 'Comparisn Area" of the MCH-PP Project. 4 Famdly Planning Success Stories in Banglah and India The service package of the Matlab Project, described in detail elsewhere (Bhatia et al. 1980; =-=Phillips et al. 1984-=-; Rahman 1986; Balk et al. 1988) includes the contraceptive methods mentioned above, immunization for children and pregnant mothers, treatment of diarrhoeal diseases, and provision of medicines for co...

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...ity rates in the Treatment Area were lower than in the Comparison Area. The regression analysis also shows that impact of the Project on child survival varies considerably by the child's age and sex (=-=Phillips et al. 1987-=-). The Project appears to have a negligible effect on neonatal mortality and reduced the postnatal mortality risks by only about 10 percent. The toddler and late child mortality in the Treatment Area ...

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...of 50 percent by the end of the 1980s. The patterns of adoption and continuation of modern contraceptives in the Treatment Area reveal a close relationship between the phenomena of supply and demand (=-=Phillips et al. 1988-=-). Adoption rates for all methods included in the Project were high and discontinuation rates low at the initial stage, because it served those whose demand was most prominent: high parity women, wome...

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...Area" of the MCH-PP Project. 4 Famdly Planning Success Stories in Banglah and India The service package of the Matlab Project, described in detail elsewhere (Bhatia et al. 1980; Phillips et al. 1984; =-=Rahman 1986-=-; Balk et al. 1988) includes the contraceptive methods mentioned above, immunization for children and pregnant mothers, treatment of diarrhoeal diseases, and provision of medicines for contraceptive s...

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...ct Survey indicated a wide gap-often called KAP-gap-between knowledge of contraception and expressed attitude towards birth control on the one hand, and actual practice of birth control on the other (=-=Sirageldin et al. 1975-=-). In order to probe the limit of contraceptive demand by minimizing monetary costs of using contraceptives and by applying experimental method for comparison, the ICDDR,B, in collaboration with the B...