title: Changes in the selected reproductive health indicators among married women of reproductive age in low performing areas of Bangladesh: findings from an evaluation study.
abstract: BACKGROUND
  Three-year duration Demand-Based Reproductive Commodity Project (DBRHCP) was launched in three low performing areas: rural Nabiganj (population 323,357), Raipur (population 260,983) and urban slum in Dhaka (population 141,912).
  
  
  OBJECTIVE
  Assessing changes in knowledge among married women of reproductive age on selected reproductive health issues and to explore their service utilization patterns over the project period in selected low performing areas of Bangladesh.
  
  
  METHODS
  The study adopted a pre- posts design. In the project areas, the entire chain of service provision were modified through the interventions under the DBRHCP, including training of the providers, enhanced behavioral change communication activities, follow-up and counseling, record keeping, reporting and monitoring, as well as improvement in logistics and supplies. Peer promoters were established as linkages between clients and service providers. All households were enlisted. Baseline and end line surveys were done using representative simple random sampling method, capturing changes over one year intervention period. Descriptive analysis was done using SPSS package, version 10. Proportional tests using Stata, version 8 were done to assess changes from baseline to end line.
  
  
  RESULTS
  The overall contraceptive prevalence was markedly different in the three study areas but significantly increased in both Dhaka urban slums and Nabiganj. In the rural areas, a higher proportion of the women in endline compared to baseline obtained contraceptive methods from the public sectors. Irrespective of study sites, significantly higher proportion of women received ANC (Antenatal Care) and PNC (Post natal care) in endline compared to baseline. In all study sites higher proportions of women were aware of maternal complications at endline. Services were obtained from qualified persons for reported symptoms of sexually transmitted infections by a higher proportion of women at endline compared to baseline. There were improvements in other RH indicators, such as use of skilled birth attendants and overall utilization of health care facilities by women.
  
  
  CONCLUSIONS
  The improvements in several important RH indicators in the intervention areas suggest that the interventions affected selected outcomes reported in the study. The study findings also suggest that investment in the reproductive health sector, particularly in existing government programs, improves RH outcomes.
authors.affiliation: Centre for Equity and Health Systems, icddr,b, Dhaka, Bangladesh. rukhsana@icddrb.org.
authors.forename: Rukhsana
authors.initials: R
authors.lastname: Gazi
authors.forename: Humayun
authors.initials: H
authors.lastname: Kabir
authors.forename: Nirod Chandra
authors.initials: NC
authors.lastname: Saha
mesh_terms: D000293:Adolescent; D000328:Adult; D001459:Bangladesh; D003268:Contraception Behavior / Q000706:statistics & numerical data*; D005191:Family Characteristics; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006305:Health Status Indicators; D006801:Humans; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D011204:Poverty Areas; D011247:Pregnancy; D011295:Prenatal Care; D060728:Reproductive Health / Q000193:education*; D016387:Women's Health