Evaluating an Integrated Family Planning and Mother/Child Health Program The National Service Delivery Program in Bangladesh
The Traditional Approach to Fertility Reduction in Bangladesh <ul><li>The preferred Government of Bangladesh model; </li><...
The Challenge: A Fertility Plateau Evident by the mid-1990s Symposium 2008 www.cpc.unc.edu/measure Sources:  Bangladesh DH...
The National Service Delivery Program <ul><li>USAID-funded effort (begun 1998) to achieve further progress in lowering fer...
The National Service Delivery Program (NSDP) <ul><li>Delivery of FP and the ESP through a network of NGOs operating centra...
Monitoring and Impact Evaluation of the NSDP <ul><li>Random samples of women age 15-49 selected and interviewed in program...
Monitoring Symposium2008 www.cpc.unc.edu/measure Modern Contraceptive Use Rates, Married Women in Rural Areas
Impact Evaluation: Difference-In-Difference <ul><li>Basic Idea of Difference-in-Difference Tool: </li></ul><ul><li>See if ...
Some Examples of Difference-in-Difference Results Symposium2008 www.cpc.unc.edu/measure * Indicates statistical significan...
Further Results: The Effect of the Health Communication Component Symposium2008 www.cpc.unc.edu/measure * Indicates statis...
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Evaluating an Integrated Family Planning and Mother/Child Health Program

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The national service delivery program in Bangladesh.

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Evaluating an Integrated Family Planning and Mother/Child Health Program

  1. 1. Evaluating an Integrated Family Planning and Mother/Child Health Program The National Service Delivery Program in Bangladesh
  2. 2. The Traditional Approach to Fertility Reduction in Bangladesh <ul><li>The preferred Government of Bangladesh model; </li></ul><ul><li>Based on door-to-door delivery of contraception; </li></ul><ul><li>Family planning/reproductive health services not explicitly linked to maternal and child health services; </li></ul>Symposium2008 www.cpc.unc.edu/measure
  3. 3. The Challenge: A Fertility Plateau Evident by the mid-1990s Symposium 2008 www.cpc.unc.edu/measure Sources: Bangladesh DHS (1993, 1996,1999, 2004), Bangladesh Fertility Survey (1975,1989) , Contraceptive Prevalence Survey (1991).
  4. 4. The National Service Delivery Program <ul><li>USAID-funded effort (begun 1998) to achieve further progress in lowering fertility; </li></ul><ul><li>Recognized a potential link between persistently high fertility and persistently high infant and maternal mortality; </li></ul><ul><li>Integrated delivery of family planning (FP) and an essential services package (ESP) of reproductive and mother and child health services. </li></ul>Symposium2008 www.cpc.unc.edu/measure
  5. 5. The National Service Delivery Program (NSDP) <ul><li>Delivery of FP and the ESP through a network of NGOs operating central health centers (static clinics), smaller mobile facilities (satellite clinics) and village- and neighborhood-level providers of FP (depotholders); </li></ul><ul><li>Integrated approach which abandons door-to-door FP delivery mechanism in favor of “one-stop” model; </li></ul><ul><li>Significant health communication component aimed at both brand recognition and improved health behaviors; </li></ul>Symposium2008 www.cpc.unc.edu/measure
  6. 6. Monitoring and Impact Evaluation of the NSDP <ul><li>Random samples of women age 15-49 selected and interviewed in program and non-program areas; </li></ul><ul><li>Women asked a rich battery of questions related to their background and ESP-related outcomes, behaviors and attitudes. </li></ul><ul><li>Timeline: </li></ul>Symposium2008 www.cpc.unc.edu/measure 1998 1999 2000 2001 2002 2003 2004 2005 (Program Begins) Baseline Round 1 st Follow-Up 2 nd Follow-Up 3 rd Follow-Up
  7. 7. Monitoring Symposium2008 www.cpc.unc.edu/measure Modern Contraceptive Use Rates, Married Women in Rural Areas
  8. 8. Impact Evaluation: Difference-In-Difference <ul><li>Basic Idea of Difference-in-Difference Tool: </li></ul><ul><li>See if those in program areas experienced more progress over time than those in non-program areas. </li></ul><ul><li>Example: If the change in an indicator between 1998 and 2005 is greater in NSDP areas than non-NSDP areas, the program performed well and clearly had a positive impact compared with the likely alternative. </li></ul>Symposium2008 www.cpc.unc.edu/measure
  9. 9. Some Examples of Difference-in-Difference Results Symposium2008 www.cpc.unc.edu/measure * Indicates statistical significance Behavior Program Impact Modern Contraception .007 Currently Pregnant -.013* Vitamin A .103* Polio 3 -.046 ANC .114
  10. 10. Further Results: The Effect of the Health Communication Component Symposium2008 www.cpc.unc.edu/measure * Indicates statistical significance Behavior Program Impact ANC .184* DPT3 .131* Measles .146

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