Family Planning in Bangladesh: An Unlikely Success Story

Abstract

The 1989 Contraceptive Prevalence Survey (CPS) was the most recent and most comprehensive of 5 national surveys conducted approximately biennially since 1979. The survey used a 2-stage probability sample design. 80 urban and 120 rural sample areas were randomly selected from areas with populations of 150-500 households. Interviews were completed with 11607 ever-married women younger than 50 between April 1989 and July 1989. The 1989 Bangladesh Fertility Survey (BFS) was designed to measure current fertility and its proximate determinants. Using a 2-stage probability sample design the 1989 BFS interviewed 11906 ever-married women in 100 urban and 175 rural areas from December 1988 through April 1989. Direct estimates from the 1989 BFS yielded TFRs of about 7 live births per woman in the late 1970s. According to the 1989 BFS the TFR declined sharply in the 1980s to below 5 births for the years immediately preceding the survey. The direct estimate of a TFR of 4.6 for the year prior to the BFS survey was low an adjustment inflated the rate to 5.4. The 1989 CPS tentatively suggested that the TFR for 1988-1989 was unlikely to be below 4.9 and might be somewhat higher. TFR of about 5.0 for Bangladesh was consistent with simple regressions predicting the TFR from national contraceptive prevalence rates. According to the 1989 CPS only the pill and tubal sterilization were recognized by almost all respondents. The 1989 CPS found that about 30% of contraceptive users relied on the pill and 43% of ever-users had adopted it as their first method. Most of the rise in current contraceptive use and ever-use between 1986 and 1989 resulted from an increase in pill use among rural women. This trend is likely to continue.