How Equitable Is Access to and Use of Reproductive Health Care and Family Planning Services in Bangladesh? A Review of the Evidence

Simeen Mahmud, Bangladesh Institute of Development Studies (BIDS)

Compared to her South Asian neighbors Bangladesh is unique in to have achieving considerable improvement in reproductive health outcomes without concomitant resource allocation or poverty reduction. However, aggregate gains hide large socioeconomic inequalities. The persistence and systematic nature of these differences raise the question of inequitable access to and consumption of health care and family planning services. This paper reviews evidence on the Bangladesh experience, providing an opportunity to explore which policies and programs have worked to expand access and utilization of Reproductive Health (RH)/Family Planning (FP) services and which have failed to reach the underserved. The paper finds that even free or subsidized services are not necessarily equitable, since these are not used by all groups of women equally. Moreover, use of RH care is not uniform across all components. Hence, achieving equity in RH outcomes requires service provision to be sensitive to both income and social constraints to demand.