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Abstract
The Bangladeshi married, nonpregnant women of reproductive age who made up the data used in this dissertation were clients of a family planning program funded by USAID and implemented by three private agencies in 1990. A theoretical model was developed in which, in the absence of variation in supply, the three proximate determinants of contraceptive use were desire for no more children, attitude toward contraceptive methods, and proxies for unmeasured fecundity, sexual exposure and motivation to space births. Underlying these proximate determinants were client/program interactions, program and fieldworker characteristics and demographic and social characteristics of women. A new methodological approach tested and controlled for endogeneity and correlated error structures. The contribution of program and nonprogram factors to four different outcomes was assessed. The results cast doubt on a frequently made claim that differences in family planning program design, personnel or service delivery are a significant demand side force. These factors did not have much influence on desire for more children which in turn dominated the prediction of use. Program factors did affect attitude toward methods but attitude had no impact on use. The contribution of the program to contraceptive use seems to be due to supply side effects--reliable home delivery of popular methods--and not to other differences in demand for children or method attitude.
