The effects of outreach on perceived quality of care in two rural areas of Bangladesh

The 1994 Cairo Conference on Population and Development consensus called for actions that will make family planning programmes oriented to the needs and concerns of women that are served. This paper, based on data from Bangladesh, presents an illustrative analysis of how an outreach programme can be evaluated by this criterion. A scale for perceived service quality is developed from five indicators of desirable characteristics of services. Regression methods are used to assess the impact of outreach service encounters on the perceived quality scale. Econometric methods are used to adjust for endogeneity that arises from the selectivity of outreach encounters and the selective service exposure of contraceptive users. Results show that increasing contact with outreach workers increases client satisfaction with the overall quality of the Bangladesh family planning programme.     

The effect of birth interval on malnutrition in Bangladeshi infants and young children

This study was undertaken to investigate the independent effect of the length of birth interval on malnutrition in infants, and children aged 6-39 months. Data for this study were drawn from a post-flood survey conducted during October-December 1988 at Sirajganj of the Sirajgani district and at Gopalpur of the Tangail district in Bangladesh. The survey recorded the individual weights of 1887 children. Cross-tabulations and logistic regression procedures were applied to analyse the data. The proportion of children whose weight-for-age was below 70% (moderate-to-severely malnourished) and 60% (severely malnourished) of the NCHS median was tabulated against various durations of previous and subsequent birth intervals. The odds of being moderately or severely malnourished were computed for various birth intervals, controlling for: the number of older surviving siblings; maternal education and age; housing area (a proxy for wealth); age and sex of the index child; and the prevalence of diarrhoea in the previous 2 weeks for the index child. About one-third of infants and young children were moderately malnourished and 15% were severely malnourished. The proportion of children who were under 60% weight-for-age decreased with the increase in the length of the subsequent birth interval, maternal education and housing area. The proportion of malnourished children increased with the number of older surviving children. Children were at higher risk of malnutrition if they were female, their mothers were less educated, they had several siblings, and either previous or subsequent siblings were born within 24 months. This study indicates the potential importance of longer birth intervals in reducing malnutrition in children.