ABSTRACT
Early use-effectiveness analyses showed that contraceptive use durations were significantly extended if the option to switch methods was available. This chapter analyses the contraceptive decision-making effects of a project aimed at improving the quality and intensity of contraceptive care in the Bangladesh public-sector program. It investigates whether changes in the quality of field work can be introduced into the Bangladesh program, and whether such changes are likely to affect the contraceptive choice behavior of program clients. The chapter discusses three sets of determinants of choice behavior: societal, organizational, and individual. Some critics of the Bangladesh program argue that administrative and institutional constraints hamper efforts to replicate the success of the sterilization program for reversible methods and constrain attempts to replicate the Matlab system for providing nonclinical methods. Many government personnel lack the technical skills to provide comprehensive services or the resources to cover service areas effectively.
