Population Council Research that makes a difference

In urban slum areas of Bangladesh, nongovernmental organization (NGO) clinics provide family planning services, but these clinics often have focused only on the fulfillment of quantitative targets and not the quality of the services they provide. According to the 2007 Bangladesh Demographic and Health Survey, half of method acceptors use pills, one-quarter use injectables, and almost one in fifteen clients adopts sterilization. Effective programs to address the imbalance in the use of contraceptive methods chosen by clients have not been implemented.

To enhance the quality of family planning services provided by these NGO clinics, Population Council researchers conducted an operations research study that lasted for six months and used a separate sample pretest/post-test design. Results indicate that the ability of service providers to use counseling tools effectively was enhanced, and service delivery points were strengthened.

Results indicate a remarkable improvement in the competence of service providers in screening related to clients' fears and misconceptions about contraceptive methods: 97 percent of clients were asked to provide this information after the intervention, compared to only 34 percent before the intervention. There has been a three-fold increase in the number of clients who were asked about previous symptoms, signs, and/or treatment for reproductive tract infections. In the pre-intervention period only 28 percent of clients were given accurate and complete information on the methods they accepted; this number increased to 81 percent after the intervention. Results also indicate improvement in providers' interpersonal interactions with clients. The intervention improved providers' competence in using behavior change communication (BCC) materials during counseling and distribution of these materials. The proportion of cases in which service providers used BCC materials increased from 13 percent to 51 percent.  

The intervention helped service providers identify unmet need for family planning services and subsequently provide required services to their clients on a regular basis. Approximately 80 percent of the clients whose unmet needs had been identified were provided services immediately, given an appointment, and/or referred. Finally, satisfaction has increased among clients with the services provided.

Related projects:

• Demand-based Reproductive Health Commodity Project
  • Voucher Scheme for Poor, Rural Women to Utilize Pregnancy Care
  • Creating a Space for Men and Youth at Health and Family Welfare Centers
  • Increasing Rational Use of Modern Contraceptive Methods during the Reproductive Life Cycle