Bangladesh · Matlab · See the Bangladesh profile
Evidence: Quasi-experimental Top 36% 78/100 · Ask Evidence Copilot about this practice
Since 1977, icddr,b's family planning programme in Matlab, Bangladesh has been rigorously studied, cutting fertility ~25% — but 35-year follow-up finds no gain, and some decline, in women's own long-term health and decision-making power.
Since October 1977, icddr,b (International Centre for Diarrhoeal Disease Research, Bangladesh) has run a door-to-door family planning and basic maternal/child health programme covering roughly 100,000 people in half of Matlab sub-district's villages, with the other half of villages left as a non-randomised comparison area.
Door-to-door contraceptive counselling and supply of pills, condoms, IUDs, sterilisation and injectables, alongside basic maternal and child health services.
The original 1982 evaluation found an ~25% fertility decline in treatment villages, with about a third of eligible couples adopting contraception. The 35-year PNAS follow-up found children of programme mothers were about 1cm taller by ages 8–14, with higher survival rates and better cognitive test scores and schooling than children in comparison villages; Bangladesh's national life expectancy rose from 47 to 72 years over the same period, with family planning cited as one contributing factor among several.
The 35-year follow-up found no improvement — and in some measures a slight decline — in enrolled women's own personal health, household wealth and decision-making power, even as their children's outcomes improved markedly, indicating benefits accrued more to the next generation than to the women themselves.
Implementation detail (cost, timeline, staffing, conditions for success) is not yet available for this practice.
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