_Fanily Planning Success Stories in Bangladesh and India_ _2_ The prevalence of modern contraceptives in another contiguous part of Matlab comprising 79 villages (population about 88,000 in 1981) designated as the Comparison Area, which did not receive the inputs, rose from about 8 percent in 1977 to 12 percent in 1985-a much less significant rise. The rise in the prevalence of modern contraceptives in the whole country during the period was from 6 percent in 1977 to 23 percent in 1985 and to 26 percent in 1989 (Mitra et al. 1990). Undoubtedly, the contraceptive prevalence in the Matlab Treatment Area increased at a significandy higher rate compared to other areas of Bangladesh.

The Matlab Project is a part of the ongoing research and services undertaken by the ICDDR,B. The original activities of the 1CDDR,B (previously known as Cholera Research Laboratory or CRL) was confined to research, training, and service provision related to cholera and other diarrhoeal diseases. Matlab was chosen as a field site for diarrhoeal disease research because it was poor, densely populated, riverine, and prone to cholera epidemics. During the last two decades the research agenda of the ICDDR,B has expanded to include broader areas of health including family planning.

# _Geness of Om Project_

The government of Pakistan (of which Bangladesh was a part of until 1971) recognized the necessity in the early 1960s to control population growth as a prerequisite for development and initiated a family planning program in 1965. The 1968 National Impact Survey indicated a wide gap-often called KAP-gap-between knowledge of contraception and expressed attitude towards birth control on the one hand, and actual practice of birth control on the other (Sirageldin et al. 1975). In order to probe the limit of contraceptive demand by minimizing monetary costs of using contraceptives and by applying experimental method for comparison, the ICDDR,B, in collaboration with the Bangladesh government's Ministry of Health and Population Control, started in July 1975 a project called Contraceptive Distribution Programme (CDP).

A continuous system of demographic and disease monitoring data collection in the area, known as the Demographic Surveillance system (DSS), was established by the ICDDR,B in 1963 for evaluating experimental cholera vaccines and has yielded what is believed to be one of the Third World's most extensive longitudinal data sets relating to demographic change. Since research had shown that the DSS data was complete and accurate, effects of experimental contraceptive distribution could be continuously evaluated by using the DSS data along with the data collected through a complete census of Matlab experimental area in 1974.

In the CDP nonclinical methods of contraception (oral pills and condoms) were distributed in 150 villages (designated as the Treatment Area) through 154 Lady Village Workers (LVWs) who were responsible for visiting households with women eligible for contraception and offer regular supplies as needed. These workers with little or no education were already engaged in other health-related activities in the same area and were given only minimal training in motivation and followup in accordance with the hypothesis that distribution alone would increase contraception use and reduce fertility. Another contiguous area comprising 83 villages of Matlab