Family planning field workers in Bangladesh as influence agents: some policy implications

Abstract

The family planning program in Bangladesh is one of the country’s success stories. However, in the quest to gain cost efficiencies, there are suggestions to scale back the role of the family planning field workers so that clients receive health and family planning services from fixed facilities established throughout the country. It is hoped, as a result, that clients will adopt more permanent methods of contraception. What are the implications of scaling back the role of the field worker? Over nearly three decades, they have helped shape the demographic transition underway in Bangladesh. As the most direct point of contact with their clients and devoting much of their time to building ongoing relationships, the social capital the filed workers have apparently built and the consequent influence they may have over fertility behavior is likely to be substantial. Under the circumstances, dissipation of this social capital would represent to the program the loss of an intangible asset of great magnitude. This study examines, from the fieldworkers' perspectives, the extent of influence they have over their clients and the factors that explain their influence. Policy implications are discussed in view of the findings.