Home : About MDG Portal : About SDNP : Contact Us

Improving Reproductive Health and Stabilizing Population Growth
Associated with Bangladesh since 1974, the primary objective of the United Nations Population Fund (UNFPA) is to improve the quality of life of both women and men in Bangladesh by reducing maternal mortality, morbidity, infant mortality, and provision of contraceptives to reduce unwanted pregnancies, and stabilizing population growth in the country. Through its efforts, UNFPA has been helping the Government in its efforts to achieve its demographic objectives of achieving Net Reproductive Rate(NRR) = 1.

Success Stories:

In Bangladesh where 92% of deliveries take place at home and maternal mortality is one of the highest with 12,000 to 15,000 women dying annually due to pregnancy related causes, the Government has taken a bold initiative to bring safe motherhood at the doorsteps of the women. Government has taken the strategy of creating a cadre of SBAs for home delivery and accordingly a pilot project had been undertaken in 6 districts. The Family Welfare Assistant (FWA) and Female Health Assistant (FeHA) working in the community were trained for 6 months in MCWCs and district level hospitals to make them SBA’s. FWA and FeHA are grass root level female service providers within the Government’s Health and Family Planning infrastructure and will be available round the clock for delivery services. WHO, UNFPA and the Obstetric of Gynecological Society of Bangladesh (OGSB) supported the pilot initiative.90 SBAs were trained and certified to practice in the field who are conducting 50 % of home deliveries in their communities. WHO developed the protocols and provided technical supports.

The piloting programme was so successful that the government has requested UNFPA to expand the SBA Training programme to 50 districts. The implementing agency Directorate General of Health Services (DGHS) has expanded the training program 19 districts. An accreditation body and process has been developed for certifying the SBAs by the Nursing Council. Through these SBAs, Bangladesh looks forward to a decrease in maternal mortality rates and meeting the MDG Goal 5 of Improving Maternal Health in the coming future.
 

The ongoing projects in these respect are:

BGD 06/01/01 – 03/P01 – Strengthening Delivery of Reproductive Health Services : The main focus of this project will be to provide quality Reproductive Health services at the field level. The project will be implemented by the Directorate of Family Planning and executed by DGFP and UNFPA. Within the 6th Country Programme (2003-2005) cycle , the project is designed to consolidate the gains made in the 5th CP and increase the sustainability and strengthen services to ensure efficiencies and effectiveness. In addition to a strong focus on institutional strengthening and national execution, efforts will be made to focus on 2 districts to be able to measure the impact and be able to replicate on the basis of lessons learnt, in future. Through 4th and 5th CP UNFPA had been supporting 64 MCWC to provide both basic and comprehensive EOC, which has been globally recognized. Out of these six MCWCs will be upgraded as Centres of Excellence and will be strengthened to provide a wide range of services like special male clinics, cater to Adolescent reproductive health issues, violence against women, RTI/STI/AIDS/HIV and provide basic screening services for detection of cervical cancer. 300 Skilled Birth Attendants will be trained to ensure safe home delivery at selected sites. Postnatal care will be taken into special consideration. A National Obstretic Fistula Centre will be set up in the Dhaka Medical College and Hospital.

BGD 06/01/02 – 03/P02 – Capacity Development through Training of the Reproductive Health Programme : This component project will work for capacity development of the health and family planning personnel through skills development and competency based training for the provision of standard reproductive health services. The project will be implemented by the Directorate General of Health Services with close collaboration of the Directorate of Family Planning and other agencies like UNICEF, USAID, WHO, and NGOS. In the delivery of improved RH services different categories of providers will be trained and their training evaluated and monitored. In the 6th Country Programme the already existing training programme (training on clinical contraception, RTI/STI case management, & EOC) will continue and in addition , training and orientation on new areas like VVF, Cervical Carcinoma, sexual and reproductive counseling and VAW case management will be initiated. A limited number of training will be arranged overseas while most of the training will be within the country. This project will draw upon the lessons learnt from the pilot project for training of Skilled Birth Attendants, and ensure safe home delivery in 45 unions of 6 selected districts. Research on RH issues will be encouraged.

BGD06/01/03-03/P03 Strengthening Reproductive Health Services for the Urban Poor : This component project will be implemented by the Local Government Division of the Ministry of the Local Government Rural Development and Cooperatives and executed by the 4 City Corporations as well as local governments of large cities and partner NGOs. This project aims to continue to address the Reproductive health needs of the poor in the urban sector as rapid urbanization has resulted in an accelerated increase in the numbers of slum dwellers who face the most acute and chronic hardships of life due to poverty and ill health Under the 5th Country Programme UNFPA undertook initiatives to address the RH implications of urbanization and funded the Urban Primary Health Care Project (UPHCP) along with ADB and Nordic Development Fund, to initiate the institutionalization of a full and broad range of RH care. This component project strengthened the RH services to the city dwellers through the development of infrastructure network, capacity building of the health personnel through skills and competency training and strengthening management capacities. Already 25 Maternity centers (11 city corporations and 14 of Partner NGOs) were upgraded to Comprehensive Reproductive Health Care Centers through renovation, installation of equipment and training of doctors and paramedics. These centers are serving as referral institutions within a network of PHC centers and providing – ANC, PNC, Normal Delivery, EOC services, Clinical and non clinical contraceptives, RTI/STI treatment, promotion of breast feeding and neonatal care. There is now one PHC for every 50,000 living in 4 city corporations. All support system developed and adopted under the previous project will be strengthened further and bigger towns and municipalities will be included in the coverage. Issues like Adolescent RH, Male Participation and Care, Violence Against Women (VAW) will be introduced and incorporated and emphasis will be given on BCC on RH. An Urban Health MIS will be developed as there is no continuous and standard recording system to measure the health care and health seeking behaviour of the city dwellers.