Population Council Research that makes a difference

American Public Health Association (APHA) 138th Annual Meeting and Exposition
6–10 November 2010

Abstract

"Reaching underserved populations with reproductive health services: What works"

Ubaidur Rob and Md. Noorunabi Talukder

Although Bangladesh has a comprehensive service delivery structure in rural areas, the utilization of facilities for family planning, maternal health, and reproductive health services is alarmingly low. Several operations research studies were conducted to identify innovative, participatory, and effective service-delivery models for increased use of those services. Each of the studies used specific interventions, along with several generic interventions: strengthening health facilities; capacity building of service providers and field workers; conducting targeted BCC activities; involving the community in developing, implementing, and monitoring.

A voucher mechanism was tested to address demand-side barriers, by providing financial assistance in the form of vouchers to poor pregnant women for receiving lifesaving obstetric care. Introduction of the voucher scheme increased the utilization of trained providers during pregnancy and delivery by poor women. Another model investigated the feasibility of introducing male- and youth-friendly reproductive health services in female-focused service-delivery points by establishing male- and youth-friendly corners and ensuring the presence of male service providers in these facilities. Due to interventions, client flow to facilities increased remarkably, and use of modern family planning methods reported by married men increased. A service-delivery model was introduced to increase rational use of modern contraceptive methods according reproductive life cycle, which examined a combined involvement of field workers and community volunteers to create demand among eligible couples. This model yielded an increase in the utilization of long-term and permanent methods. Overall, tailored demand-based strategies are necessary to increase utilization of services provided that facilities are well-functioning.

Learning areas

• Program planning
• Public health or related research
  
  

Learning objectives

• Describe the factors that influence the utilization of maternal health, family planning, and other reproductive health services
• Identify the role of the community in increasing the demand for services and monitoring services for greater accountability
  

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