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People are having a double whammy of a shutdown in the supply of birth-control products with stocks finished at family planning offices and a price hike on the open market.
Field offices distribute birth control materials to able-bodied couples free of cost. These materials can also be collected from government health facilities.
These include condom, oral contraceptive, emergency contraceptive pill, injection and implant.
But the offices could not provide necessary contraceptives to people, particularly those on low incomes in rural areas, since last December due to procurement crunch, said official sources.
Meanwhile, the use of contraceptives has seen a gradual decline in the last three years since 2021.
Contraceptive use fell to 62.1 per cent in 2023 from 65.6 per cent in 2021, according to the Bangladesh Sample Vital Statistics conducted by the Bangladesh Bureau of Statistics (BBS).
Md Modabber Hossain, assistant director (family planning), Kurigram district, told the FE that they had a handful of pills only.
"There are no birth-control products like condom and injection, thus seriously disrupting their supply and use. We have to say 'No supply'. Same is the situation in field offices for a halt in procurement."
This crisis situation has certainly lowered the use of birth control among families, according to him.
"Once people go out of the coverage, then it'd be difficult to bring them back again under the programme…," feared Mr Hossain.
The family planning division has assured the authorities concerned of starting condom supplies in April and that of injections in May, he added.
Surprisingly, birth control supplies did run out of stock suddenly as offices can learn about stock of any product on the website.
Despite knowing the situation, the Directorate General of Family Planning could not assess the stock or procure the items in advance.
Prof Syed Abdul Hamid of the Institute of Health Economics at Dhaka University says when a source suspends supply of an essential product or medicine, there should be another source to ease supply crunch.
"The government halted supply as private companies hiked their prices of their products. It's causing a double blow. The government shut procurement without pre-assessing the stock," he told the FE.
Prof Hamid also questioned the quality of government products.
ATM Nazmul Huda, line director at the Directorate General of Family Planning, spoke about procurement of contraceptives, adding: "A tender process is in progress. Once done, we'll start supplying to field offices."
He claimed the quality of products was similar to the ones found on the open market. "There is no quality compromise."
Unexpected pregnancy, abortion feared to rise
Public-health experts fear supply disruption and price hike of contraceptives may put people in trouble and raise the risk of unexpected pregnancy.
"If the situation remains unchanged, the rate of unexpected pregnancy will rise. Such pregnancy leads to abortion. Of the total unborn babies in unexpected pregnancy, 66 per cent pregnancy ends in abortion," cited Prof Hamid.
Abortion bears a serious health and mental impact on women, especially on their reproductive health, he added.
Pay subsidies to cut prices
Prof Mustafizur Rahman, Distinguished Fellow at the Centre for Policy Dialogue, highlights a slow pace in providing birth control products, ensuring easy access to and investment in government extension services.
"It seems the government has done enough," he lamented.
This (attitude) has been a continuous trend in the last few years. Furthermore, government austerity and decreased purchasing power of people have turned the situation alarming, he told the FE.
"It's not a good sign. The progress we made in population management has slowed down. Both domestic and global factors worked behind the situation," continued Prof Rahman.
"But we have to have a priority list. And this service is a priority (ease access to birth-control supplies) as it's related to the country's per-capita income, poverty elimination and so many national indicators."
"If we fail to restore the service, it'll leave a negative footprint - a medium- and long-term effect," warned the economist.
Prof Hamid suggested that the government negotiate with the private companies that have a major market share, provide subsidies to lower the prices of birth-control items and other methods.
He also called for a reform in family planning as people were becoming dependent on the private sector.