Increasing dual protection among rickshaw pullers in Bangladesh.

Rickshaw pullers (RPs) are a special hard-to-reach group in Bangladesh. They constitute a large segment of the marginalized urban poor with limited access to family planning and reproductive health information and services. They are also frequently involved in risky behaviors and are considered a bridging population for sexually transmitted infections (STIs) and HIV. Beginning in 2004 the NGO Service Delivery Program (NSDP) a USAID-funded project and the Population Council’s FRONTIERS Program jointly conducted a 21-month study to provide reproductive health (RH) information and services to RPs. The main objective of the study was to increase contraceptive use among RPs with special emphasis on condom use. The study conducted in six urban clinics of Dhaka Division tested two strategies for delivery of information and services. Strategy I included provision of three RH education sessions by trained community educators (CEs) together with improved access to condoms. Strategy II provided only RH education by the CEs. Satellite clinics were set up at garages in the experimental areas to provide easy access to health services. RPs in the experimental areas received educational pamphlets and tin plates containing family planning messages to display at the back of their rickshaws. The RPs in control sites received none of the interventions. Pre- and post-intervention levels of knowledge behavior and use of contraceptives at the experimental sites were compared with those in control sites.