MethodMix

CPR & TFR Comparison Chart Source: BDHS & MIS Report CPR (modern methods) TFR

Method Mix Changes Over Time

Trends in Sterilization Performance 1975 to 1999 Bangladesh Demographic and Health Survey,

Key findings from Review of Sterilization Services There is significant unmet demand  There is significant unmet demand  Infrastructure is adequate  Low performance factors:  Lack of communication and information  Need for more trained personnel  Inadequate leadership and management  Poor quality of care

Strengthening Long Term Clinical Family Planning Services in Bangladesh A Field Support Project implemented by EngenderHealth Providing Technical Assistance to the Government of Bangladesh and NGOs

Key Project Activities June 2001 – September 2002  District and sub-district workshops to provide information and plan for services Topics: Topics:  Contraceptive Update  Introduction of NSV techniques  Addressing misconceptions  BCC techniques  Organization and planning of sterilization services Example: August -- 3 Districts 52 workshops 52 workshops 3095 participants 3095 participants

Key Project Activities June 2001 – September 2002  Close collaboration with Government  Roving technical persons do training and provide services as needed Ex: August : 51 tubectomies and 32 NSVs performed as training, demonstration, or request for services  Expand private sector services  Research and BCC activities

Results Change in Sterilization Performance Change in Sterilization Performance Jan to Sept 2001 Vs. Jan to Sept 2002 District 1 (Jhenaidah) District 2 (Nilpharmari)

Performance Comparisons Performance Comparisons 2 GOB Districts comparable in demographics Tubectomy NSV-- 69 Total = 494 Total sterilization performance in all assisted Districts: Before and after/during project support Total sterilization performance in all assisted Districts: Before and after/during project support = 5,209 Control vs. Project: Performance July 2001 to June 2002 Project Districts 1 & 2 Tubectomy NSV Total = 8165 October 2000 to Sept October 2001 to Sept ,181 =

Challenges Ahead  Insuring informed choice and volunteerism  Broadening Scope  Quality of care  Replicating success for rapid expansion of impact