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Bangladesh is one of many countries struggling to narrow the gap between policy and implementation of the expanded approach to reproductive health agreed to at the International Conference on Population and Development (ICPD). Many of the ICPD goals are embodied in the government’s Health and Population Sector Strategy and a number of USAID-supported NGOs are moving ahead to implement these changes. In line with government and donor priorities of the past these NGOs previously had programs focusing on door-to-door family planning. Now that they have adopted the government’s ESP approach the NGOs have discontinued door-to-door contraceptive distribution. Services are being offered through clinics and satellite clinics with village depots available for re-supplying contraceptives in rural areas. The NGOs are employing a variety of measures to improve the quality of services to make the services more responsive to clients and to increase their sustainability. The new NGO program is important as a test case of the new strategies because of both the nature of the changes made and the speed with which they have been introduced. The findings from this study strongly support the policy changes reflected in the government’s integrated clinic-focused approach and the new USAID NGO program. Clients and communities are responding favorably to many aspects of the new model and there do not seem to be intractable social barriers to service utilization. (excerpt)

From the home to the clinic: The next chapter in Bangladesh's family planning success story rural sites