Levels, Trends, and Determinants of Unwanted Pregnancies in Rural Bangladesh: Evidence from the ICDDR,B FHRP Areas

 Funded by: USAID

The reduction in unwanted pregnancy represents a central objective of the Essential Services Package (ESP) in the Bangladesh program. Yet, to date, little remains known about levels of unwanted childbearing in Bangladesh, nor the extent to which the program has led to reductions in levels of unwanted childbearing overtime. Moreover, in light of the fact that the total fertility rate has stagnated at around 3.3 births during the period of 1993-99, it is of central policy and programmatic significance to determine whether this reflects a floor given current family size preferences, or whether significant scope for further reductions in fertility levels could be achieved by reducing levels of unwanted childbearing.

As contraceptive use becomes increasingly widespread within Bangladesh, levels of unwanted childbearing will assume increasing importance as an indicator of success within the program. The study will provide some of the first concrete evidence on levels of unwanted childbearing among Bangladeshi couples, as well as the extent to which more intensive the experimental family planning services in the former ORP areas can contribute to reductions in unwanted births over time. An additional contribution of the project will be the identification of subgroup(s) of women/couples who are likely to be particularly at risk for repeated unwanted childbearing.

The study will generate preliminary evidence on the potential health and mortality risks associated with unwanted childbearing. These results will be important both in illuminating a largely unexplored pathway through which the Bangladesh family planning program may have contributed to improved infant and child health and survival, and as such, may provide important support for the continued emphasis upon family planning services as a means for improving the well being of Bangladeshi children and families.

The study will also identify a new program performance measure level of unwanted childbearing that may serve as a primary indicator of overall family planning performance in the future for the family planning managers. A technical interest group comprised of key researchers and policy makers involved in the family planning program policy and implementation in Bangladesh are likely to use the findings of this study in their respective work areas/positions.