2. MethodMix

3. CPR & TFR Comparison Chart Source: BDHS 1999-2000 & MIS Report CPR (modern methods) TFR

4. Method Mix Changes Over Time

5. Trends in Sterilization Performance 1975 to 1999 Bangladesh Demographic and Health Survey, 1999-2000

6. Key findings from Review of Sterilization Services -2000 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

7. 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

8. 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

9. 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

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

11. Performance Comparisons Performance Comparisons 2 GOB Districts comparable in demographics Tubectomy-- 425 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-- 3132 NSV-- 5033 Total = 8165 October 2000 to Sept. 2001 October 2001 to Sept. 2002 14,181 =

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