Thirty-Five Years Later: Long-Term Effects of the Matlab Maternal and Child Health / Family Planning Program on Older Women's Well-Being

Reduced fertility from better access to contraception may not improve women’s health

“…Both the treatment and comparison areas were part of an existing Demographic Surveillance System (originally created for evaluating cholera vaccines), providing an excellent platform for implementing a study of family planning and health interventions. As numerous papers using the Matlab data have shown, including Barham et al ( 3 ), the treatment area looked very similar at baseline to the comparison area on key social, demographic, and economic characteristics. This provides the basis for a large body of research built around analyzing the impact of the MCH/FP intervention on a variety of outcomes.…”

“…Now that we are decades away from the early stages of rapid fertility decline in these countries, it is interesting to look at the life trajectories of the women and children who were affected by the introduction of family planning programs. The PNAS paper by Barham et al ( 3 ) allows us to do that, providing an intriguing analysis of the impact of a well-known family planning program in Bangladesh on the later life health and well-being of the women who were participants in the program. The surprising conclusion of this carefully executed study is that women who were in the treatment area do not have measurably better health than women in the comparison area 35 y later, despite the fact that they had fewer children, longer child spacing, and younger age of completed childbearing.…”

“…While the MCH/FP was not a randomized controlled trial in the standard sense, it had a quasi-experimental design, which consisted of a geographically contiguous treatment area and a comparison area that included two areas adjacent to the treatment area ( 3 ). Both the treatment and comparison areas were part of an existing Demographic Surveillance System (originally created for evaluating cholera vaccines), providing an excellent platform for implementing a study of family planning and health interventions.…”

Thirty-five years later: Long-term effects of the Matlab maternal and child health/family planning program on older women’s well-being

“…Data Availability. The analysis file for this study is available for download and reanalysis at openICPSR (https://www.openicpsr.org/openicpsr/project/ 143101/version/V1/view) (24).…”