Family planning has been functionally integrated with health in Bangladesh since the Second Five-Year Plan was launched (1980-85). The integration was resented by both health and family planning functionaries at the upazila level and below, and, except on paper, there is no integration of any form in practice. There are separate budgets, and, consequently, the Upazila Health and Family Planning Officer (UHFPO) as the authority of the grassroots level functionaries of the Health Wing and the Family Planning Officer (FPO) as the authority of the grassroots level functionaries of Population Control and Family Planning (PCFP) Wing maintain separate and parallel administration and delivery systems. Problems of integration include: no accountability, i.e., as the UHFPO has no administrative control of the FPO, the FPO can bypass the UHFPO; differential pay scales; discrimination in the allocation of office rooms and in the provision of residential accommodations and fees for sterilization operations; noncompliance of functional responsibilities on the part of grassroots level functionaries; anarchy in the subcenters; and the neglect of maternal and child health services. To improve the operational efficiency of the health care and family planning programs, it is recommended that the PCFP Wing be separated totally from the Health Wing, that the total responsibility of the action program for health and family planning be vested in the Ministry of Health, and that the National Family Planning Control Board working under the President's Secretariat be headed by an Executive Director with the rank and status of a Minister.

作者：M R, Khan

来源：Bangladesh Development Studies 1986 年 14卷 2期