title: Association of programmatic factors with low contraceptive prevalence rates in a rural area of Bangladesh.
abstract: OBJECTIVE
  The study was conducted to identify selected programmatic factors relating to low contraceptive-use in a low-performing rural sub-district in Sylhet division of Bangladesh.
  
  
  METHODS
  A cross-sectional survey was carried out among 6983 currently-married women of reproductive age (MWRA) (15-49 years). To estimate the association between current contraceptive-use and other selected factors, multivariate analyse were performed, estimating the crude and adjusted odds ratios (OR), including 95% confidence intervals (CI).
  
  
  RESULTS
  The use of health facility by the MWRA in the last three months, distance from the residence to the nearest health facility, and contact with field workers in the last six months was significantly associated with contraceptive prevalence rate (CPR). There were potential differences regarding CPR, sources of contraceptive supply and Family Welfare Assistant (FWA) visit between hard to reach and non-hard to reach unions of Nabiganj sub-district.
  
  
  CONCLUSIONS
  Strategies should be devised to increase the accessibility of MWRA to contraceptive methods by increased partnership with non-public sector and increased contacts with outreach workers through introducing community volunteers, and mobile phones help lines, by organizing frequent satellite clinics (SCs) and making community clinics (CCs) functional. Innovative strategies should be piloted for improving use of contraception in such hard to reach and low performing locality.
authors.affiliation: Centre for Equity and Health Systems, icddr,b, Mohakhali, Dhaka 1212, Bangladesh. humayun@icddrb.org
authors.forename: Humayun
authors.initials: H
authors.lastname: Kabir
authors.forename: Nirod Chandra
authors.initials: NC
authors.lastname: Saha
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Oliveras
authors.forename: Rukhsana
authors.initials: R
authors.lastname: Gazi
mesh_terms: D000293:Adolescent; D000328:Adult; D001459:Bangladesh; D003268:Contraception Behavior; D003430:Cross-Sectional Studies; D005193:Family Planning Services; D005260:Female; D006801:Humans; D008393:Marriage; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D012424:Rural Population; D012959:Socioeconomic Factors