Family planning efforts stalls, population growth unchecked

Two reports on the country’s population situation have emerged within a span of ten days. The first was a nationwide survey conducted by UNICEF and the Bangladesh Bureau of Statistics (BBS). The second was data on Dhaka city’s population released by the United Nations Economic and Social Council (ECOSOC).

Both reports present alarming findings on population trends. Bangladesh has never had a history of increasing total fertility rates. However, UNICEF and BBS now state that the country’s total fertility rate is rising. Mothers are giving birth to more children than before, and this is a negative sign.

Meanwhile, the scale of Dhaka’s population was not fully evident before the ECOSOC report. ECOSOC, which publishes population data for major global cities, has stated that Dhaka is now the world’s second-largest city by population.

Twenty-five years ago, Dhaka ranked ninth. Today, Dhaka has a population of 36.6 million (3.66 crore). Due to the absence of effective programmes, the country’s population continues to grow uncontrollably, reflected clearly in Dhaka’s population.

This situation did not emerge overnight. The Awami League government did not view the country’s large population as a problem. During its 15 years in power, from 2009 until its removal in August 2024, the National Population Council met only once.

According to policy, this high-level body, chaired by the prime minister, should meet every two years. On 2 June 2010, Sheikh Hasina said in the parliament, “People in the country are already quite aware about population issues. Personally, I do not consider Bangladesh’s population to be a problem.”

That remark from Sheikh Hasina influenced the Ministry of Health and the field-level family planning programme. Staff shortages at field level grew worse over time, yet recruitment remained stalled.

Typically, the state minister in charge of the health ministry oversees the Directorate General of Family Planning (DGFP). From 2018 until the change of government in August 2025, the health ministers were Zahid Maleque and Samanta Lal Sen, but no state minister was assigned there.

Bangladesh’s population now exceeds 180 million (18 crore). Few countries in the world have such a high population density. More than 1,200 people live per square kilometer in this country, and the situation is at risk of worsening.

According to the latest UNICEF and BBS survey, the average number of children per woman has risen. The ‘Multiple Indicator Cluster Survey 2025’, released on 16 November, reports a total fertility rate (TFR) of 2.4. For decades, the TFR had been declining, but now an upward trend is visible.

The stagnation of family planning activities is also clear from government officials’ comments. DGFP Director General Ashrafi Ahmad told Prothom Alo that many field-level posts remain vacant, while others are regularly retiring. At the same time, supplies of contraceptives are also insufficient.

According to DGFP data, there are 54,226 sanctioned posts within the directorate from central to field level. Of these, 14,981 are vacant, nearly 28 per cent. When field positions remain empty, people do not receive family planning services.

Family Welfare Assistants (FWAs) provide door-to-door services in rural areas or through community clinics. There are 23,500 such posts nationwide, but 4,188 remain vacant. This means 18 per cent of the country lacks field-level family planning staff.

Family Planning Inspectors supervise and coordinate FWAs. There are 4,500 such posts, one in every union. However, 373 unions have no inspector, meaning FWAs there operate without supervision.

Additionally, there are 2,500 sanctioned Sub-Assistant Community Medical Officer (SACMO) posts at union and family welfare centres nationwide. Of those, 878 or 35 per cent of the SACMO posts are vacant.

Across the country, there are 6,361 sanctioned posts for Family Welfare Visitors (FWVs). Of these, 2,845 or 45 per cent remain vacant.

These four categories or workers- Family Welfare Assistants, Family Planning Inspector, SACMO, and Family Welfare Visitors are directly involved in delivering field-level services. Altogether, 8,293 such posts are empty now.

On 2 February 2024, Prothom Alo published a report titled ‘Contraceptives dwindling in government stock’. The government subsequently procured some contraceptives, but shortages have re-emerged in the field. DGFP currently lacks sufficient condoms for distribution on field.

According to DGFP officials, before the COVID-19 pandemic, before 2020, field workers distributed 7-8 million (70 to 80 lakh) ‘Sukhi’ birth-control pills per month. This number has now fallen drastically.

In this October, only 1.94 million (19.4 lakh) pills were distributed. Distribution of condoms, IUDs, implants and injectables has also dropped by nearly 50 per cent.

In Koyra upazila of Khulna, family planning officer M Suvramunium told Prothom Alo that supplies of all contraceptives have stopped. The family planning officer in Juri upazila of Moulvibazar said, there is no supply of IUDs or implants, while other items are in short supply.

In two unions of Sitakunda upazila in Chattogram, field workers report having only half the necessary supply of condoms and pills.

The 2012 population policy had set goals of reducing the TFR to 2.1 by 2015 and raising contraceptive use to 75 per cent. Neither of the two targets has been achieved.

TFR measures the number of children a fertile woman gives birth to in her lifetime (between ages 25 and 49). In 1971, the TFR in Bangladesh was above 6, meaning women had more than six children on average.

The then and subsequent governments placed great emphasis on reducing TFR. Extensive public campaigns and door-to-door services produced results, and the TFR steadily declined. This achievement is one of Bangladesh’s internationally recognised successes. TFR kept declining visibly from the 80s.  

Statistics show that the TFR has never risen in Bangladesh’s history. It has either declined steadily or remained unchanged for several years. For instance, from 1996 to 2000 the TFR was 3.3. Again, from 2012 to 2022 it stood at 2.3.

In other words, the TFR remained static for a decade. Although there was criticism over why the TFR was not falling, no effective measures were taken to reduce it further.

Whether in villages or cities, population pressure is increasing everywhere. Excess population is harming the environment, depleting forests, and leading to the encroachment of rivers, canals, and water bodies. The burden of overpopulation is affecting society and the state as a whole.

Crises are worsening across all sectors, including housing and transport. Government hospitals are overcrowded with patients. Child malnutrition remains high, with 24 per cent of children under five being stunted.

The number of unemployed people is also huge. Around 20 million (2 crore) people live below the poverty line. In such circumstances, if population growth slips out of control, all development plans and initiatives will be at risk.

Public health expert Abu Jamil Faisel told Prothom Alo, “The Awami League government’s policy stance, and the then prime minister’s remarks, had a deep impact on population activities. Laxity crept in at every level.”

“Officials of the Directorate General of Family Planning began to believe that all tasks were already accomplished and there was nothing more to do. For a long time, work has practically been stagnant. A major disaster has already occurred. I wouldn’t be surprised if the TFR reaches 3,” he commented.