Potential interventions to improve the use of long-acting reversible contraceptives and permanent methods in Bangladesh

Potential interventions to improve the use of long-acting reversible contraceptives and permanent methods in Bangladesh
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Abstract: Bangladesh has done exceedingly well in family planning (FP) and achieved a total fertility rate (TFR) of 2.3 births per woman, nearly a replacement-level fertility, with a contraceptive prevalence rate (CPR) among married women of reproductive age of around 62 percent in 2017 (NIPORT, et al., 2019). One central programmatic concern is the consistently low use (9%) of long-acting reversible contraceptives (LARC), which are IUDs and implants, and permanent methods (PM), which are tubal ligation and no-scalpel vasectomy (NSV). Most couples—those who want to space births and those who want to limit pregnancies—rely on short-term methods, namely pills (28% in 2014 and 25% in 2017-2018), injectables (12% in 2014 and 11% in 2017-2018), condoms (6% in 2014 and 7% in 2017-2018), and traditional methods (8% in 2014 and 10% in 2017-2018) (NIPORT, et al., 2016; NIPORT, et al., 2019).

In this policy brief we argue that shifting the method mix towards LARC and PM, even without increasing CPR, would lead to a total fertility rate (TFR) of 2.0 or below per woman and would reduce the incidence of abortion that can result in reduced maternal morbidities and mortality. The recent remarkable increase in facility delivery (currently at 50%; NIPORT, et al., 2019) offers an opportunity for providing postpartum IUDs, implants, and tubal ligation (PPIITL) at the delivery table. To increase the uptake of LARC and PM, we suggest that several potential interventions are indicated—the realization of which would require meaningful engagement from both public and private health sectors.
Shortname: wp-20-243-d4i
Author(s): Mizanur Rahman, M. Moinuddin Haider, Sian Curtis
Year: 2020
Language: English
Region(s): BANGLADESH