Figures & Tables
Figures
- FIGURE 1.
Percentage of Facilities Having BCC Materials/Products on LARCs/PMs at Endline, Mayer Hashi Provider Survey, 2013
Abbreviations: BCC, behavior change communication; LARCs, long‐acting reversible contraceptives; PMs, permanent methods.
- FIGURE 2.
Use of LARCs/PMs and Other Methods, by Program vs. Nonprogram Districts, 2010 and 2013, Mayer Hashi Evaluation
Abbreviations: LARCs, long‐acting reversible contraceptives; PMs, permanent methods.
Tables
Survey and Respondents Program Districtsa Nonprogram Districtsb Number Response Rate (%) Number Response Rate (%) Household survey of CMWRA Baseline – 2010 (BMMS) 22,145 93c 9,893 93c Endline – 2013 (MH Program) 3,894 95d 1,970 93d Provider survey, 2013 FWAs 118 100 62 100 FWVs 118 98 62 98 UFPOs 59 71 31 83 MOs–MCH 59 32 31 61 RMOs 53 79 28 79 OB/GYNs 53 34 28 36 All providers 460 77 242 82 Abbreviations: BMMS, Bangladesh Maternal Mortality Survey; CMWRA, currently married women of reproductive age; FWAs, family welfare assistants; FWVs, family welfare visitors; MH, Mayer Hashi; MOs–MCH, medical officers–maternal and child health; OB/GYNs, obstetrician/gynecologists; RMOs, resident medical officers; UFPOs, upazila (subdistrict) family planning officers.
↵a Barisal, Patuakhali, Comilla, Cox’s Bazaar, Moulvibazar, Sunamganj.
↵b Kishoreganj, Mymensingh, Narsingdi.
↵c 93% for program and nonprogram districts together.
↵d 94% for program and nonprogram districts together.
Program Districts Nonprogram Districts 2010 2013 2010 2013 Age, years, mean 30.6 31.4 30.3 31.5 No. of children, mean 2.6 2.7 2.5 2.6 No education, % 31.1 28.5 36.7 32.0 Lowest 2 quintiles, % 39.9 42.3 40.7 35.6 Non-Muslim, % 13.7 10.4 5.7 3.5 Urban, % 33.5 25.6 44.3 27.0 Source of data: 2010 baseline data are from the Bangladesh Maternal Mortality Survey; 2013 endline data are from the Mayer Hashi endline survey.
FWAs FWVs MOs–MCH Program Nonprogram Program Nonprogram Program Nonprogram (n = 118) (n = 62) (n = 116) (n = 61) (n = 19) (n = 19) Pre-counseling for implant clients Explain advantages and disadvantages 97 98 31 23 95 100 of implants Ensure informed choice 39 23 14 7 37 26 Mention probable side effects of implants Amenorrhea 64 81 22 20 68 100 Spotting 47 58 22 11 74 95 Post-counseling for IUD clients Provide the follow-up card 54 73 74 90 58 95 Determine that clients understand key 31 8 9 10 21 16 counseling points Post-counseling for female sterilization clients Provide the follow-up card 53 68 66 87 58 95 Determine that clients understand key 9 3 8 15 21 26 counseling points Abbreviations: FWAs, family welfare assistants; FWVs, family welfare visitors; IUD, intrauterine device; MOs–MCH, medical officers–maternal and child health.
- TABLE 4. Women’s Reports of Client–Provider Contact, Informed Choice, and Exposure to Information on LARCs/PMs, Mayer Hashi Household Survey, 2013
Percentage Sample Size P Value Program Nonprogram Program Nonprogram Provider contact with CMWRA (in last 3 months) Visited by family planning workers 13 23 3,194 1,637 <.001 Sought health care from government facilities 30 44 3,117 1,544 <.001 Sought health or family planning care from government facilities 44 55 3,117 1,544 <.001 Informed choice – Received family planning or LARC/PM information from providers or facilities (in last 3 months) Temporary method acceptors who were told about PMs 40 33 410 174 NS Injectable, IUD, and implant acceptors who were told about side effects 38 49 216 79 NS Injectable, IUD, and implant acceptors who were reminded about follow-up visits 31 48 216 79 <.05 CMWRA who sought health or family planning care and noticed BCC materials with LARC/PM messages 42 43 1,369 854 NS Exposure to LARC/PM Information – Heard, saw, or read messagesa (in last 3 months) about: IUDs 15 21 3,194 1,637 <.001 Implants 22 40 3,194 1,637 <.001 Tubectomy 29 35 3,194 1,637 <.001 No-scalpel vasectomy 17 13 3,194 1,637 <.001 LARCs/PMs 38 50 3,194 1,637 <.001 PMs 31 35 3,194 1,637 <.001 Abbreviations: BCC, behavior change communication; CMWRA, currently married women of reproductive age; IUD, intrauterine device; LARCs, long-acting reversible contraceptives; PMs, permanent method; NS, not significant.
↵a From TV, radio, newspaper/magazine, billboard/poster, folk song/theater, courtyard meeting, health/family planning worker, health facility, or friend/relative.
- TABLE 5. Change in LARC/PM Method Use Among CMWRA Between 2010 and 2013, Mayer Hashi Program
% Reporting Use 2010 2013 Change IUD Program 0.5 0.4 -0.1 Nonprogram 0.4 0.6 0.2 Implant Program 0.7 1.2 0.5 Nonprogram 0.8 1.9 1.1 Tubectomy Program 3.7 4.9 1.2 Nonprogram 3.2 5.7 2.5 NSV Program 0.4 1.0 0.6 Nonprogram 0.5 0.8 0.3 Any LARC/PM Program 5.3 7.5 2.1 Nonprogram 5.0 8.9 4.0 Abbreviations: CMWRA, currently married women of reproductive age; IUD, intrauterine device; LARC, long-acting reversible contraceptive; PM, permanent method; NSV, no-scalpel vasectomy.
- TABLE 6. Multinomial Logit Coefficient Estimates and Estimated Program (Interaction) Effect for LARC/PM Use and Other Method Use, Mayer Hashi Evaluation, 2013 (N = 37,902)
LARCs/PMs Other Methods Coefficient SE P Value Coefficient SE P Value Program (ref: nonprogram) –0.084 0.088 .34 –0.243 0.049 <.001 Year 2013 (ref: 2010) 0.616 0.157 <.001 0.145 0.070 .04 Program X Year –0.359 0.182 .05 –0.223 0.093 .02 Age, years (ref: 25–29) <20 –2.396 0.280 <.001 –0.812 0.072 <.001 20–24 –1.039 0.166 <.001 –0.283 0.056 <.001 30–34 0.691 0.122 <.001 0.247 0.072 .001 35–39 1.071 0.127 <.001 0.460 0.071 <.001 40–44 0.487 0.155 .002 –0.054 0.078 .49 45–49 0.169 0.157 .28 –1.269 0.081 <.001 Education (ref: no education) Primary incomplete 0.242 0.110 .03 0.189 0.057 .001 Primary complete –0.164 0.127 .20 0.273 0.053 <.001 Secondary incomplete –0.276 0.140 .05 0.231 0.061 <.001 Secondary complete or higher –0.589 0.197 .003 0.279 0.085 .001 Wealth quintile (ref: lowest) Second –0.207 0.115 .07 0.064 0.056 .25 Middle –0.285 0.124 .02 –0.139 0.061 .02 Fourth –0.263 0.135 .05 –0.221 0.072 .002 Highest –0.380 0.171 .03 –0.378 0.083 <.001 Religion (ref: Muslim) Non-Muslim 0.545 0.137 <.001 0.278 0.063 <.001 Sector (ref: rural) Urban 0.278 0.115 .02 0.286 0.054 <.001 Constant –1.988 0.129 <.001 0.380 0.073 <.001 Program effecta Interaction effect –0.017 0.011 .14 –0.038 0.021 .07 Abbreviations: LARC, long-acting reversible contraceptive; PM, permanent method; SE, standard error.
↵a Estimated from the predicted probabilities of LARC/PM use or other method use obtained from the model for each program area by survey year combination, in line with the difference-in-difference approach to estimate program impact, as described in the main body of the article.
- TABLE 7. Indicators of Regional Health System Strength and Increase in LARC/PM Use, Mayer Hashi, 2013
Program Districts Nonprogram Districts Eastern region South-central region North-central region Vacancy of UFPO, % 36 47 10 Vacancy of MO–MCH, % 56 38 19 CMWRA visited by FWA and other family planning worker,a % 13 12 23 CMWRA sought health/family planning care from facilities, % 41 49 55 CMWRA heard, saw, or read about LARCs/PMs, % 38 37 50 Increase in LARC/PM use between 2010 and 2013, percentage pointsb 1.6 3.3 4.0 Abbreviations: CMWRA, currently married women of reproductive age; FWA, family welfare assistant; LARC, long-acting reversible contraceptive; MO–MCH, medical officer–maternal and child health; PM, permanent method; UFPO, upazila (subdistrict) family planning officer.
↵a Although FWAs are supposed to make home visits every 2 months, in practice less than 20% of CMWRA reported that they were visited by a family planning worker in the 6 months prior to the 2011 Demographic and Health Survey.9
↵b It was not possible to match the program and nonprogram districts in the health system characteristics that may affect couples’ LARC/PM use.
