UNRWA introduced family planning services in 1994 as an integral part of its expanded maternal and child health care programme.    In 1995, a baseline study was conducted in Jordan, Gaza, Lebanon, Syria and the West Bank to assess the change in the practices of contraceptive use among refugee mothers of children 0-3 years of age attending UNRWA MCH clinics. In 2000 a follow-up study was conducted along the same methodology and targeting the same population of the baseline study. The ultimate objective of the study was to assess the current situation regarding contraceptive practices after 5 years from the baseline study in order to measure the progress attained towards achieving programme objectives and identify future programme needs.   The study will also provide a quantitative basis for future monitoring of the progress of UNRWA's family planning programme.   This report compares the results of the follow-up study with those of the 1995 study in order to demonstrate the changes that had taken place.   The total sample size was (n= 5,565) mothers: 954 from Jordan, 1660 from Gaza, 992 from Lebanon, 1034 from Syria and 925 mothers from the West Bank.   The mean marital age has increased from 19.2 years to 19.7. The percentage of women who got married before the age of 20 years dropped from 61.5% in the baseline to 56.1% in the follow-up study. The mean number of total pregnancies was 4.39 pregnancies in the baseline while it decreased to 4.14 pregnancies in the follow-up study. The mean number of live children was 3.47 in the follow-up compared to 3.85 children in 1995. The mean birth interval increased from 29.8 months in the baseline study to 34.3 months in the follow-up. The overall prevalence of modern contraceptive use increased from 32.1% to 49.9% during the last five years. The preferred method is still IUD followed by pills and condoms. 75.5% of the users obtained the methods from UNRWA health centres. Reasons for non-use included pregnancy (21.5%), lactation 41.7%) and the desire to have children (19.5%).   Although mothers between age 25 and 39 had higher use rates than the other age groups similar to the pattern of the baseline study, nevertheless, contraceptive prevalence among women at the extremes of reproductive age has almost doubled during the five-year period. The use rate was highest among women having 4-6 children while in the baseline study the highest prevalence was among mothers having more than 10 children.   In the follow-up study, there was a marked increase in contraceptive prevalence regardless of the number or sex of living children. However, the rate of contraceptive use was the lowest among families with no male children.   The 1995 baseline study showed that contraceptive prevalence increased steadily with the age of the youngest child. The 2000 study revealed that there was a marked increase in the prevalence rates of contraceptive use among mothers of young children, whereas, the lowest prevalence was among mothers whose youngest children were 25-30 months of age, which is in accord with the birth spacing policy of the Agency€™s.   Data showed that there was no significant difference neither in the prevalence of contraceptive use nor in the pattern of contraceptive method mix among mothers whose youngest child is male or female.