Use of birth control methods decreases to level of 8 years ago

The rate of contraceptive use in the country has fallen to what it was eight years ago. The use of birth control methods has decreased in 2023 and stands at 62.1 per cent. This is the lowest rate since 2015. This was revealed in a report of Bangladesh Bureau of Statistics (BBS).

Population experts say, just as the fall in quality of government services and lack of attention is responsible for the decrease in use of birth control methods, lack of awareness, poverty and the increase in the price of contraceptives has also been a deterrent.

In its report, 'Important Results of Bangladesh Sample Vital Statistics 2023', BBS has published the latest figures in the use of contraception methods. In the report published yesterday, Sunday, the rate of using latest birth control methods was 61 per cent and the use of conventional methods was one per cent higher. The use of contraceptives was low in villages as compared to cities. In the cities this rate is nearly 64 per cent and in the villages nearly 62 per cent.

Speaking to Prothom Alo, assistant director of the Fa­mily Planning Directorate's Clinical Contraception Services Deliver Programme, Md Rafiqul Islam Talukdar, said that there was no deficiency in government services. Campaigns were also being conducted. The objective of population management was to keep the total fertility rate (TFR) in control and reduce infant mortality. So even if the number of birth control method users has fallen, this was not a matter of concern.

A review of 10 years of BBS' Bangladesh Sample Vital Statistics from 2014 to 2023, shows that in 2014 the rate of contraception use was 62.2 per cent. The next year, 2015, it decreased somewhat to 62.1 per cent. Then right up till 2023 this rate did not fall any further.

The BBS 2023 report only provides the results. It does not clarify why and where the use of contraception has fallen.

Senior public health expert Jamil Faisal told Prothom Alo, the government pays no attention to the population control programme now. The programme may have a shortage in workforce, but it has no lack of funds. Yet simply due to lack of attention, it has fallen flat on its face. There is often a shortage of contraceptives. From November last year to January this year, there was no supply of pills and injectable methods at a field level. It is apprehended that if the use of contraceptives falls, there is the fear of increased abortions and death due to abortion. In 2016 the rate of death due to abortion was 6 per cent, but now has gone up to 14 per cent. Abu Jamil Faisal said that there needs to be a proper investigation into why the population programme has fallen flat on its face.

The contraception services provided all over the country by the government are oral pills, condoms, long-term injections, intra-uterine device (IUD) or Copper T and Implant, permanent methods and emergency pills.

The BBS report said that among married women the rate of emergency pill use is 1 per cent higher. The emergency pill is taken within 72 hours of unplanned sexual intercourse.

Speaking to Prothom Alo, Professor Mohammad Mainul Islam of Dhaka University's population sciences department said, there were problems in both accessibility and supply of contraception methods in the country. The government services are inadequate in delivering contraceptive items to the char (shoal) areas, the haors (wetlands) and remote areas. Contraceptives have become dependent on the private sector. The private sector has pushed up the price of contraceptives. As a result, poor people are often unable to buy contraceptives and do not adopt any form of contraception. He said, the failure to use contraception increases the fear of unwanted pregnancies at a young age. This also increases the risk of maternal and infant deaths.

The BBS report did not state where the users mostly availed contraceptives. But according to the Bangladesh Demographic and Health Survey 2022 of another organisation of the government, National Institute of Population Research and Training (NIPORT), 55 per cent use modern methods and 9 per cent conventional methods contraception. And 60 per cent of those using modern methods avail these from the private sector, that is, private hospitals, physicians, pharmacies, shops and other sources. In 2011 this rate was 42 per cent. In 2017-2018 it was 50 per cent.

Mymensingh divisional director of the Family Planning Directorate, Latif Mollah, told Prothom Alo, people are better off than before. Rather than waiting for the government supply, they buy contraceptives from whether it is convenient. That is why contraceptive sales in the private sector have increased. He said, the government has its eyes on the population situation. Work in being carried out on the new population policy.

The BBS report, however, says that the unmet demand for contraception has lessened to an extent compared to the previous year. In other words, there has been an improvement in contraception reaching those who want to practice birth control and space between births. In 2023 the unmet demand rate was almost 16 per cent. In 2022 it was almost 17 per cent.

Professor Mohammad Mainul Islam said, family planning is an overall lifetime process. Family planning is essential for a living a healthy life and for future activities. Population control is a part of family planning. Accessibility and supply of birth control methods must be increased. Government services must be of a standard quality. Government and non-government organisations of various levels must be attached to this task and monitoring on the overall work must be increased.