From the home to the clinic: The next chapter in Bangladesh\u27s family planning success story rural sites

This study reports on Bangladesh’s new program model for reproductive health service delivery and people\u27s reactions to it. NGOs in Bangladesh have discontinued door-to-door contraceptive distribution in response to the government’s integrated, clinic-focused approach. The findings from this study strongly support these policy changes: 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. As the NGOs and the Bangladesh government proceed with implementation of the integrated, essential health services model, additional strategies will be needed to erode the paternalistic service delivery culture that evolved in the context of a vertical family planning program. As the government moves forward with its own transition, much can be learned from the NGOs’ experiences in dealing with the complex challenges of pursuing simultaneously goals of access, quality, integrated service delivery, as well as cost recovery