This article examines the consequences of a “population-as-crisis” theme on the institutional configuration and resource endowments of health care services in an integrated Ministry of Health and Population Control in Bangladesh. The Ministry's focus on women as child bearers and its emphasis on sterilization supported by incentives has contradictory consequences as women become vulnerable to a limited health service and incentives encourage a focus on meeting sterilization targets. Both undermine people's access to and use of primary health care services. Findings from three studies, undertaken between 1978 and 1983, support the argument that despite international concern with preventive and promotive primary health care, simultaneous support for and emphasis on population control inhibits meeting the goals of a broad-based rural primary health care service.
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