**_7_**

**_7he Madab_** _Project_

# _Sodoeconomk_ **_S.Wag_**

The Matlab Project was desi2ned to test the hypothesis that a high quality family planning program oriented to fulfil the needs of potential consumers can increase the contraceptive prevalence substantially even under socioeconomic circumstances not favorable to small family norm. The experimental situation built into the Project by making provision for special family planning and MCH inputs in the Treatment Area and for collection of systematic demographic data in both the Treatment and Comparison Areas is not as perfect as in controlled comparison of biological sciences but is as close to the perfect as possible in social sciences. Since contraceptive prevalence and fertility are affected by family planning program as well as by socioeconomic factors, the socioeconomic settings in Bangladesh as well as in the Project area will be outlined below.

Bangladesh, the eighth most populous country in the world, is well-known for its poverty and a much faster population growth (2.8 percent per annum during 1980-87) than what is optimum for its development. With 87 percent of its 106 million people (mid-1987 estimate) living in villages and less than 0.10 hectare lad per head, it is the most densely populated rural country in the world. Its per capita GNP of US $180 (1987 estimate) is among the lowest.

Despite the inception of a national family planning program more than three decades ago, the national fertility level is still quite high. For example, the estimated crude birth rates and total fertility rates in 1990 were 35 and 4.6 respectively (World Bank 1992). The major bulk of the population in Bangladesh are Muslims. In 1981, they constituted 87 percent of the population; 12 percent were Hindus and majority of the rest were Buddhists. Islamic opposition to family planning was a serious constraint on its acceptance until recently. As in other southern Asian countries, the social structure in Bangladesh is patriarchal with male dominance over females in almost all spheres of life. In a recent worldwide comparative study of 99 countries on the basis of indices related to health, marriage and children, education, employment, social equality, and gender gap, Bangladesh has been assessed to have the lowest ranking in status of women (Population Crisis Committee 1988). Female education, one of the variables known to be highly associated with rise in contraceptive prevalence and decline in fertility, is still at a very low level. For example, adult female literacy was only 12 percent in 1970 and 22 percent in 1990. Only 64 percent of primary school age girls and 19 percent of secondary school age girls were enrolled in schools in 1986-89 (Grant 1992). Infant mortality, another variable highly associated with contraceptive acceptance and fertility decline, is also still very high in Bangladesh. For example, the infant mortality rates per 1000 births were 144 in 1965 and 105 in 1990. Hence socioeconomic setting in Bangladesh can be considered to be highly unfavorable for widespread practice of family planning and low fertility level.

Various drawbacks in the national family planning program of Bangladesh have been analyzed by many investigators (e.g., Choudhury and Akhter 1990; Duza 1990). The inadequacy of its inputs relative to those in the Treatment Vrea of the Matlab Project has been pointed in the previous two sections. Yet the family planning program effort level-as measured by various indices related to policy and stage-setting, service, record-keeping and evaluation, and accessibility-has been assessed to be moderate (among the four categories of strong, moderate, weak, and very weak or none) and ranked 11th among 100 developing countries (Lapham and Mauldin 1985). In this respect it **r3nks** somewhat lower than India but considerably higher than