Controlling Fertility through Broad Health Interventions: Evidence from Bangladesh

Gustavo Angeles, University of North Carolina at Chapel Hill
Paul Hutchinson, Tulane University
Peter M. Lance, University of North Carolina at Chapel Hill

The family planning policies traditionally pursued in Bangladesh may have in certain respects reached the limits of their effectiveness as fertility reduction measures. Some argue that further reductions require broader approaches aimed at child health. We assess a program intended to reduce fertility in Bangladesh through interventions targeting the health of infants and small children. Our dataset provides information about fertility, family planning, reproductive health practices, health care utilization and child health for samples of households in communities where the program was implemented as well as those residing where it was not. It includes repeated cross sections from 1998 (the outset of the program) as well as 2003, permitting us to estimate difference-in-difference models for these outcomes. The program had a significant impact on demand for certain family planning and child health inputs and child morbidity as well as a small but significant immediate impact on child mortality and fertility.