The Impact of Family Planning Household Service Delivery on Women’s Status in Bangladesh

Since 1982, the Maternal and Child Health and Family Planning Extension Project in Bangladesh has compiled longitudinal panel data on rural women’s contact with household service providers who visit homes to discuss family planning and offer services to women on request. This study tests the hypothesis that home-based services reinforce customs of purdah (female seclusion) by sustaining the dependency and isolation of the women served by the program. Results show that household services improve women’s status. This effect is largely attributable to the impact of outreach on effective fertility regulation. Findings do not support the hypothesis that household service delivery is detrimental to women’s status in Bangladesh. Policy implications of this research are discussed. This material may not be reproduced in any form without written permission from the authors. For two decades, the government of Bangladesh has hired, trained, and deployed married women to visit rural households, consult with couples about family planning, and provide contraceptive services in their homes to those who adopt a method. Fully 28,000 of these workers, known as family welfare assistants (FWAs), are currently working in hamlets throughout Bangladesh. Research has established that FWA outreach fosters family planning awareness, contraceptive adoption, and continuity of use, suggesting that the FWA program has achieved many of its original objectives. Contraceptive knowledge is virtually universal throughout Bangladesh, nearly half of all women are contraceptive users, and FWA doorstep services constitute a major source of supply of all commodities in use. The onset and pace of the rapid demographic transition in Bangladesh has likely been influenced by this program. Despite the apparent demographic success of the FWA initiative, this program has recently become controversial on gender grounds. A widely cited ethnographic appraisal by Schuler et al. (1995) argues that the direct effects of the household FWA visitation regime may constrain rather than enhance women’s status by reinforcing the customs of patriarchy and purdah (female seclusion). By reinforcing patriarchal institutions, houseto-house outreach may keep women isolated and vulnerable. In this sense, FWA outreach is detrimental to women’s status. This paper re-examines this proposition with a statistical analysis testing the hypothesis that women’s status has been adversely affected by FWA home visits. Two cross-sectional women’s-status surveys conducted in two rural thanas (administrative districts which serve a population of about 300,000) are used, in conjunction with longitudinal data recording exposure, to assess the impact of FWA visits during the period from 1982 to 1993 on women’s status in 1988 and 1993. THE SCHULER ET AL. STUDY The investigation by Schuler and her colleagues is based on social survey data collected in six villages, three of which are in a district of northern Bangla-