Rethinking family planning programmes

Bangladesh is one of the largest densely populated countries in the world and is facing an increasing trend of population growth. However, the rate of growth of population has declined over the last few decades; in the recent years it remains static which is a matter of great concern. The current population growth is 1.34 per cent. From the view of socio-economic, cultural, political and religious aspects, this rate remains more or less positive but the implications of this rate are huge. Study shows that, with a growth rate of 1.34 per cent, every year 1.8 to 2.0 million people are being added to the total population. Additionally, the projection shows that the population is likely to grow up to 222 million around 2051, and will be stabilised at 250 million by 2081. It will be difficult to cope with this huge population with the limited resources of the country.  

World Population Day is observed in the country on July 11 with various promotion activities to raise the awareness about population issues, such as the importance of family planning, gender equality, poverty, maternal health and human rights. Every year this day has a separate theme. This year the theme is: 'Family Planning: Empowering People, Developing Nations'. How will Bangladesh will perform with the theme? It needs to be analyzed.

According to the latest Bangladesh Demographic and Health survey (BDHS), about 4 in every 10 women are still outside the use of contraception. Contraceptive prevalence rate has shown a little increase from 58.3 per cent in 2011 to 62.1 per cent in 2015 with a growth rate of only 1.3 per cent per year. In the case of rural women, the figure will be much lower.

Based upon the secondary data sources it is estimated that the median age at marriage for females is 15.3 years. The legal age at marriage for girls is, however, set at 18 years. The figures show that 68 per cent of the adolescent girls are married by the age of 18, and 55 per cent of them become mothers before reaching the age of 19 years.

 Currently in Bangladesh, more than 35 per cent of the total population is below 15 years of age and the largest proportion of young population ever is waiting to enter the reproductive age. Young mothers are now contributing more to the total fertility rate (TFR) than before. The estimated number of women of reproductive age is 40.8 per cent, and will rise to about 48 per cent by 2021. The pace of momentum is being accelerated by the malpractice of early marriage of girls.

It is evident that, access to safe, voluntary family planning is a human right. It is central to gender equality and women's empowerment, and is a key factor in reducing poverty as well.

Bangladesh needs to control early marriage of its female population because it extends a woman's reproductive span, thereby contributing to large family size, especially in the absence of contraception. This, in turn, results in high population growth.

The family planning programme of Bangladesh seems to be very weak due to the bifurcation of family planning and health. Statistics show that only 20 per cent of currently married women are exposed to field workers in a month.

Women in the country generally complete their childbearing by the age of 25 years, risking their lives for unintended pregnancies without protection due to improper method mix and unmet need for family planning methods. About two-thirds of the women do not want any more children and their demands for family planning remain increasingly unmet. Unmet need for family planning methods is 12 per cent. Campaign for behaviour change communication (BCC) and advocacy for family planning are very inadequate.

According to the UN World Population reports, the population of world is increasing by 83 million every year. Likewise, Bangladesh is experiencing the increasing pressure of population.

In the past, Bangladesh's national family planning policies were a model for other countries to emulate. But the scenario has changed over the time. It is more or less limited to the official statement of programme objectives in terms of national demographic goals. Family planning facilities are still inaccessible to the people of the lower strata. It is also difficult to control population growth through contraception methods or other family planning methods due to the presence of conservative elements in society. The government should therefore control population growth by effective implementation of various policies and programmes related to family planning and population like greater incentives for those having one child.

Though the budgetary allocation in family planning has increased over the last few decades, the achievement of such allocation is not satisfactory. All the programmes are more or less document-oriented rather than result-oriented.   

The government should discard the failed old policies and needs to be innovative in devising the strategies and approaches of family planning programmes. Only then the targets of family planning programmes will be achieved.  

The writer is an independent consultant and chairperson at Research Institute for Social Transformation-RIST (a policy research organization based in Rajshahi).

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