Increasing the access to quality reproductive health and family planning (FP) services for the urban
slum population is a major concern for both demographic and programmatic reasons. Several nongovernmental
organizations (NGOs) are providing health and FP services in selected areas in cities
across the country. These urban health services aim at improving access to health care services, but
the thrust of these NGO clinics has been on maternal and child health. Urban slum populations do
not depend as much on NGO clinics for contraceptive methods as the private sector. A major
concern is that NGO clinics have not considered the quality of their FP services as a priority despite
the contraceptive prevalence rate of urban slums is higher than the national average. Effective
programs are yet to be implemented to address the imbalance in contraceptive method mix as the
majority of modern contraceptive method acceptors use pills even though more than half have
already completed their desired family size and/or state that they want no more children. It is
necessary to increase the use of more effective contraception, suggesting the need for improvement
in the quality of services the clients receive from NGO providers.
Efforts were made through this operations research project to improve the quality of FP and
reproductive tract infection (RTI) services provided by NGO clinics. Selected NGO clinics in slums
of three wards in Dhaka city received interventions. Capacity of these NGO clinics to offer high
quality services to slum neighborhoods was strengthened by training of service providers,
strengthening service delivery points, and improving counseling services.
The key intervention was to provide high quality counseling to ensure client satisfaction. The service
providers were trained to give particular attention to follow standard screening criteria and informed
counseling so that the client can select an appropriate contraceptive method. They were also
sensitized to counsel clients by using the ‘life cycle approach’ with emphasis on the long-term and
permanent methods for women who have completed their family size.