How equitable is access to and use of reproductive health care and family planning services in Bangladesh? A review of the evidence

Simeen Mahmud, BRAC Development Institute, BRAC University

Compared to her South Asian neighbours Bangladesh is unique to have achieved considerable improvement in reproductive health outcomes without concomitant resource allocation or poverty reduction. However, aggregate gains hide large socio economic 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, which provides an opportunity to explore where policies and programmes have worked to expand access and utilization of RH/FP services and where these 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.