Bangladesh 1993-1994 Demographic and Health ... - Measure DHS

nearby area. Field workers supply both pills and condoms. In part to increase the accessibility of other, moreclinical methods, the government implemented a system of satellite clinics. Under this system, staff from thehealth centers at the union headquarters visit selected villages at prescheduled times to set up a temporaryclinic, The clinics include basic health services, such as health and nutrition education, antenatal care,screening for high-risk pregnancies, and family planning advice and supplies. A key staff person in thissystem is the Family Welfare Visitor (FWV), who is able to give contraceptive injections and to insert IUDs.In order to assess the extent of coverage of both field workers and satellite clinics, the BDHS includedquestions about both services. Although "satellite clinic" is a simple term in English, there is no equivalentterm in Bangla, and interviewers, therefore, had to describe the clinic. Thus, the data depend on the abilityof respondents to understand the definition.Table 4.30 shows the proportion of currently married women who said that they had been visited bya field worker in the six months prior to the survey. The data are shown by whether the visit was to talk aboutfamily planning (or to give a method) and whether the respondent received family planning supplies. Thirtyeightpercent of women said that in the previous six months someone had visited them in their house to talkabout family planning or to give them a family planning method. An additional 5 percent of women said thata family planning field worker had visited them for another reason. The mean number of field worker visitswas three. Of those visited, about one-third received family planning supplies.There has been a slight increase in field worker coverage since 1991, when 36 percent of marriedwomen reported having been visited (Mitra et al., 1993:75). However, the fact that only slightly more thanone-third of married women are being visited by field workers is cause for concem, since virtually all partsof the country are now covered by field workers (see Table 10.3). Moreover, studies have shown thatfrequent home visits to all eligible couples, irrespective of their current status, are associated with higherfamily planning program performance (Bernhart and Kamal, 1994; Phillips et al., 1994).Some women are more likely than others to tlave been visited by a field worker. Younger and olderwomen are less likely to have been visited, presumably because they are either more likely to want to getpregnant or more likely to be infecund or sterilized. Urban women are slightly more likely than rural womento have been visited in the previous six months. As for differences by division, women in Chittagong andDhaka Divisions are less likely, and those in Khulna Division more likely, to have been visited by a fieldworker. A smaUer proportion of uneducated women and those with no children reported that they had beenvisited by a family planning field worker in the six months before the survey. As might be expected, womenwho were using contraception were substantially more likely than nonusers to be visited by a field worker.Although field workers are instructed to visit all the households in their assigned area, it is likely that manynonusers are either pregnant, attempting to get pregnant, opposed to family planning, or menopausal, andthus, do not present as urgent a need as others. Among users, coverage is higher for users of the pill,injection, and condoms, while it is understandably low for those who have been sterilized. Among womenwho were visited by a field worker, there are minimal differences in either the mean number of visits overthe six months prior to the survey or in the proportion who received family planning supplies, except thatwomen in Rajshahi Division are more likely to receive supplies than women in other divisions, as are womenwho are using supply methods such as the pill and condoms.68