'Long-lasting birth control should be encouraged'
Nearly two-thirds of Bangladeshi married women with one or more children want no more children, but experts say their 'inappropriate' choice of birth control methods is raising the risk of 'unwanted' pregnancies.
According to the preliminary results of 2011 Bangladesh Demographic and Health Survey (BDHS), 65 percent women do not want more children. The rate is 82 percent in couples having two children and 90 percent with three or more children.
But only 8 percent use long-term or permanent methods, effective ways of protecting pregnancies experts suggest for Bangladeshi women, most of who complete childbearing in their twenties, with two decades of reproductive life in hand.
"Long-acting and permanent methods (sterilisation, IUD –intrauterine device, and implants) can help them protect from unwanted pregnancies, but there is no specific programme to promote those," says a former director of National Institute of Population Research and Training (NIPORT) Dr Ahmed Al Sabir.
He says more women are using birth control methods now than before, but the use of long-acting and permanent methods remained 'stagnant' with only 13 percent of all contraceptive use.
The use of female sterilisation has stalled at about 5 percent since 2004 after a fall from more than 9 percent in 1991.
Population scientist Dr Peter Kim Streatfield, an ICDDR,B Director, presenting BDHS figures in April said, long-acting and permanent methods need to be increased and "it is possible as it was in the 1980s."
Analysing figures it is found that the female sterilisation rate increases with the ages of women.
It is nearly 14 percent in women between 45 to 49 years of age when the reproductive life ends.
But it is only 4.3 percent among married women between 15 and 29 years of age, the main childbearing age in Bangladesh, who comprises more than 50 percent of all women interviewed in the survey.
The long acting method of placing intrauterine device (IUDs) in the uterus has been declined from about 2 percent in 1991 to 0.9 percent in 2007 to 0.7 percent in 2011.
"It (long-acting and permanent methods) never got priority from the family planning directorate," Sabir says, "It requires trained doctors."
It is alleged that lack of coordination between the two wings of the Ministry of Health and Family Welfare –health and family planning – stood in the way of promoting clinical methods of long-acting and permanent birth control mechanism.
The family planning directorate depends 'heavily' on oral contraceptive pills as their field staff can distribute it easily.
Dr Abu Jamil Faisel, country representative of EngenderHealth that works with the family planning directorate, says those who are already mothers of two or three children are also getting oral contraceptive pills in Bangladesh.
"There should have a strategic plan to promote permanent methods to them," he said.
He, however, said with the shortages of service providers, the rate of IUDs has declined by 30 percent in the last quarter of the last fiscal while the rate of sterilisation has declined more than 50 percent compared with the first quarter.
Bangladesh celebrates World Population Day on Wednesday with officials say they are now waiting for the Bureau of Statistics report.
The preliminary reports last year showed population stood at 14.23 crore with annual growth rate of 1.34 percent.