THE LONG-TERM DEMOGRAPHIC ROLE OF COMMUNITY-BASED FAMILY-PLANNING IN RURAL BANGLADESH

Experimental studies demonstrating the effectiveness of nonclinical di stribution of contraceptives are typically conducted in settings where contraceptive use is low and unmet need is extensive. Determining the long-term role of active outreach programs after initial demand is me t represents an increasingly important policy issue in Asia, where con traceptive prevalence is high and fixed service points are convenientl y available. This article examines the long-term rationale for househo ld family planning in Bangladesh-where growing use of contraceptives, rapid fertility decline, and normative change in reproductive preferen ces are in progress, bringing into question the rationale for large-sc ale deployment of paid outreach workers. Longitudinal data are analyze d that record outreach encounters and contraceptive-use dynamics in a large rural population Findings demonstrate that outreach has a contin uing impact on program effectiveness, even after a decade of household visitation. The policy implications of this finding are reviewed.