July 12, 2024
DHAKA – The government’s family planning efforts are likely to be seriously hindered as supplies of contraceptives at the field-level offices are running dangerously low.
At present, there is no injectable contraceptive in any upazila and the stock of birth control pills will run out in a few months, according to officials of the Directorate General of Family Planning (DGFP). The stock of implants has also run out.
The reason for the supply running low is a halt in procurement for months due to a legal battle at the High Court.
Although the legal battle has ended recently and the procurement process has resumed, the DGFP officials cannot give a timeline for when the birth prevention materials, which are distributed for free, will be available at the field level.
Subsequently, the DGFP has started rationing and redistributing the current stock, they added.
The eligible couples in Bangladesh are provided seven options for contraception: permanent system for male and female, intrauterine devices, implants, oral pills, condoms and injectables.
At the end of May, there is no stock of the oral contraceptive pill Sukhi (3rd gen) in 287 upazilas, according to the DGFP stock status report. There is no stock of Sukhi (2nd Gen) in 414 upazilas.
The stock of the other oral contraceptive pill Apon is 13.33 million cycles and was projected to run out in June, according to the report.
While procurement of 45 million cycles of Sukhi (3rd gen) is under process, it will take several months to get the supplies in hand, according to DGFP officials.
There are no injectables in 462 upazilas. The stock of 0.151 million vials was supposed to run out soon, too.
The current stock of condoms is 20.32 million, and this stock can be used up to November.
Population experts fear that the scarcity of birth control materials will increase mother and child mortality rates as eligible couples might go for an unintended pregnancy causing abortion.
DGFP Director General ANM Al Firoz declined to make any comment on the issue.
“We have taken initiatives to procure contraception so that a crisis does not arise,” Health Minister Samanta Lal Sen told The Daily Star.
Of the total population of 16.98 crore, the number of eligible couples is 2.81 crore, according to DGFP data.
At present, 37 percent of eligible couples receive contraceptives from the government and 3 percent from non-governmental organisations, according to government data. The remaining 60 percent get their contraception from the private sector.
Since there is a shortage of contraceptives, poor couples will find it difficult to take service from the private sector because of their high price, said Mohammad Mainul Islam, a professor and former chairman of the Dhaka University’s population sciences department.
“Unintended pregnancies will also go up, which will scale up the mother and infant mortality rates. Pregnancy termination will also increase. Therefore, there is a risk to reproductive health.”
At present, the rate of unmet need for family planning is 10 percent and the government wants to bring it down to zero by 2030.
Unmet need for family planning is defined as the percentage of women of reproductive age, either married or in a union, who want to stop or delay childbearing but are not using any method of contraception.
If the supply is not uninterrupted, it will be difficult to meet that target, Mainul said.
“If unmet needs increase, unwanted pregnancies, abortions, maternal deaths — all will rise.”
Besides, achieving the total fertility rate of 2.1 will be difficult too, Mainul added.
Assuming there are no migration flows and that mortality rates remain unchanged, a total fertility rate of 2.1 children per woman generates broad stability of the population. It is also referred to as the “replacement fertility rate” as it ensures replacement of the woman and her partner with another 0.1 children per woman to counteract infant mortality.