This interactive graphic summarizes some of the many different areas of family life that research on the Matlab program showed were affected by a couple’s family planning use. These include mothers' health, increased family assets, increased home value, improved pregnancy and newborn health, health and education benefits for boys and for girls, improved water sources, and agricultural investments.
Women who used family planning were healthier than those in comparison villages. They weighed up to five pounds more, and their body mass indexes were above the critical threshold of 17.5, which is believed to be associated with a significant reduction in mortality risk from undernutrition. Since women using family planning had on average one fewer child, they had a lower risk of pregnancy-related death and disability. Healthier women are better able to support the health of themselves and their families through activities like working and preparing better food.
Women in the program area also earned more money than in the control group. They earned 450 taka more, or about six months of added salary, compared to women of similar education not using family planning. The higher income enabled women and their families to increase investment in their homes, livelihoods, and families.
Families in the program area were able to accumulate more forms of savings and assets than non-program areas. In fact, households in the program area had total assets that exceeded those of households in the comparison area by as much as 43 percent. This includes assets like jewelry that may be more profitable than farmland over time because they don’t require manual labor to sustain.
The average home value for older and more educated women in the program area was as much as 19 percent higher than the average for similar women in the comparison villages. Since homes require a long period of saving, women were able to invest years of savings from supporting fewer children in their homes.
Women in the program area were more likely to seek antenatal care, and had longer intervals between their second and third births compared to comparison areas. This led to healthier outcomes for both the mother and children, as longer birth intervals are associated with reduced birth complications and death for mothers and infants. Children were also more likely to be vaccinated against polio, measles, and diphtheria/tetanus/pertussis than children in the comparison areas. These factors contributed to declines in child mortality of 20 percent or more in the program area.
Sons in the program area were more likely to be enrolled in school. As they grew older, they also achieved higher levels of education than older children in comparison areas. Since school attendance contributes to poverty reduction by building literacy and preparing youth for higher-skilled, better-paying jobs, increased school attendance means that using family planning can continue to positively impact a family well into the next generation.
Daughters in the program area had higher body mass index, meaning that they were closer to a healthy weight for their height than girls in comparison villages. Increased nutrition as a young child also means that girls in the program area are less likely to experience stunted growth because adult height is believed to be largely determined by the time a child reaches age five.
In addition, girls in the program area were more likely to be enrolled in school, which lays the foundation for higher-skilled, better-paying jobs later in life.
Households in the program area invested in making well water for drinking and cleaning more readily available. In these households, women and children did not have to travel long distances to gain access to water, and were able to spend their time on activities improving the wellbeing of themselves and their families like earning higher incomes and attending school.
Families in the program area were able to invest more in agriculture. Over time, they were able to acquire more farmland, more ponds for aquaculture, and more orchards for raising perennial crops. For these families, the ability to use family planning created a virtuous cycle. By having smaller families, parents were able to invest more money in their livelihoods; in turn, this allowed them to earn more money and become more prosperous.
In 1977, the International Centre for Diarrhroeal Disease Research, Bangladesh, initiated an experimental family planning and maternal and child health program in the religiously conservative Matlab area, which included 149 villages with a total population of 180,000. Initially, community health workers made regular home visits to married women in the villages and offered them a choice of family planning methods. Over time, the program expanded to include other cost-effective interventions, such as immunizations, to improve family health.
Shareen Joshi and T. Paul Schultz used data collected through the first twenty years of the program (1977-1996) to examine the effects of long-term investment in family planning and maternal and child health in Matlab. They found that families in communities where the program was implemented became wealthier and healthier than families who lived in other communities that were similar when the Matlab program was begun.
Rhonda Smith et al., Family Planning Saves Lives, 4th ed. (Washington, DC: Population Reference Bureau, 2009).
Population Action International, Voluntary Family Planning: An Investment in Our World’s Future (Washington, DC: Population Action International, 2006).
Ruth Levine et al., “Contraception,” in Disease Control Priorities in Developing Countries, 2d ed., ed. Dean T. Jamison et al. (New York: The World Bank and Oxford University Press, 2006): 1082.
Shareen Joshi and T. Paul Schultz, “Family Planning as an Investment in Development: Evaluation of a Program’s Consequences in Matlab, Bangladesh,” working paper (2007), Yale University Economic Growth Center, available at: http://ssrn.com/abstract=962938.
The content in this infographic was adapted from the PRB policy brief, Family Planning and Economic Well-Being: New Evidence from Bangladesh, written by James Gribble and Maj-Lis Voss. Special thanks to Marissa Yeakey, senior policy analyst at PRB, Carolyn Lamere, program assistant at PRB, Rifat Hasan of the World Bank, and Shamma Alam of the University of Washington – Seattle, for their valuable contributions in the development of this graphic. This graphic is made possible by the generous support of the American people through the United States Agency for International Development (USAID) under the terms of the IDEA Project (No. AID-OAA-A-10-00009). The contents are the responsibility of the Population Reference Bureau and do not necessarily reflect the views of USAID or the United States Government.
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