This article is based on the ten-year experience of an operations research project in Bangladesh. It assesses how, and under what circumstances, research-based advice and results of pilot projects contribute to change in large-scale public programs.

In 1991, an article on the Maternity Care Program in Matlab, Bangladesh, reported a substantial decline in direct obstetric deaths in the intervention area, but not in the control area. The decline was attributed primarily to the posting of midwives at the village level.

An extensive literature exists on the determinants of fertility behavior in developing countries, and how these determinants may constrain demand for family planning services.

Bangladesh, the eighth most populous nation in the world is also one of the poorest with a per capita income of less than US200. Although it enjoys a tropical monsoon climate, it is a country with unique geographic peculiarities, which distinguish it from the rest of the sub-continent.

Bangladesh, the eighth most populous nation in the world is also one of the poorest with a per capita income of less than US200. Although it enjoys a tropical monsoon climate, it is a country with unique geographic peculiarities, which distinguish it from the rest of the sub-continent.

The necessity of controlling the growth of population in Bangladesh was seriously recognized as early as 1965 when a large-scale national family planning program was initiated in erstwhile Pakistan A.

Despite an early and strong commitment by the government to the family planning programme, Bangladesh has achieved modest success in increasing the level of contraceptive prevalence. For instance, the use of contraception has increased from 12.7 percent in 1979 to over 25 percent in 1985 [1].