Op-ed on World Contraception Day 2021: Adolescence and the importance of reproductive health services

This is an opinion piece published on World Contraception Day on September 26, 2021 authored by Md Mahbub Ul Alam, Family Planning Expert and Technical Director, USAID Sukhi Jibon Project, Pathfinder International Bangladesh.

Bangladesh’s family planning programme has seen laudable success. In our country, 52 per cent of the people use modern birth control methods, which is much higher than many countries of similar socioeconomic levels in Asia, Africa and Latin America. Our large force of skilled manpower provides family planning and mother and child healthcare services at a field level and at the service centres.

Bangladesh’s healthcare infrastructure which stretches down till the grassroots, is exemplary. With the implementation of the national population policy and the fourth health, population and nutrition programme, the government is strongly committed to achieve more success in the family planning programme alongside the ongoing socioeconomic development of the country.

Bangladesh’s demographic survey of 2017 reveals that there are certain challenges that accompany the success of the family planning programme. Sylhet and Chattogram lag behind other regions in the use of birth control methods. Here, the rate of long term users of birth control methods is only 8 per cent, men’s use of methods is only 16 per cent, and the rate of post-natal birth control method users is only 46 per cent. In these two regions of the country, the rate of pregnancy among young girls is 28 per 1000, much higher than other countries of the world.

It is a matter of serious concern that the rate of unwanted pregnancy among married couples is 42 per cent. And 37 per cent of the people stop using birth control a few days after they start using a method. And among every 100 married couple, 12 per cent do not use birth control even if they want to, for various reasons. That is why many women become pregnant even though they did not want to conceive a child. With the prevalence of child marriage in our country, relatively less young girls use birth control methods and so there is a higher rate of unwanted pregnancies among them.

Youth make up 31 per cent of the population in Bangladesh, signalling a bright future for the country. Bangladesh is one of the few countries in the world with such demographic dividends. Bangladesh’s bright future depends much on how far we can use this demographic dividend for the country’s socioeconomic development. Whether we can reach the economic development of the level of South Korea, Singapore and Malaysia, depends much on the correct management of the prevailing demographic dividend.

A country’s demographic advantage comes only once and in Bangladesh this will last till 2030. After that, the number of able persons will gradually decrease and the number of elderly will be on the rise. The question is, how much effort are we putting into using this demographic dividend for the country’s socioeconomic development?

Several measures are being taken at a policy level in the government, including: preparing a reproductive health strategy for adolescents, ensuring special facilities for adolescents at the service providing centres at the grassroots, providing stipends and other benefits for girls’ education, taking up government and non-government programmes to include more adolescent and teenage girls in technical education, etc.

The fallouts of adolescent marriage have been identified as lack of education, malnutrition, failing health, and dependency. In most case in our country, marriage means the end of all potential for a young girl.

The above measures have been yielding some success. For example, female participation in education and in various professions is seeing a steady increase. But there is still a long way to go. We must be successful in eliminating the festering ulcer of child marriage otherwise the potential of a large section of the huge youth population in joining the development process, will be nipped in the bud.

According to BDHS 2017, two-thirds of the girls in Bangladesh are married off before they are 18 and one-third of them become mothers. While the demand for family planning is higher (17 per cent) among girls of the 15 to 19 age group, users of modern birth control methods are very low in number (44 per cent). And 86 per cent of young girls stop going to school because of child marriage. It is painful to learn that 70 per cent of young girls face child marriage at the behest of their families.

The fallouts of adolescent marriage have been identified as lack of education, malnutrition, failing health and dependency. In most case in our country, marriage means the end of all potential for a young girl. The figures remind us that the overall situation of adolescent girls does not go in favour of the development of the girls, the community and the country’s overall socioeconomic development.

Our existing programme for the protection of adolescents’ reproductive health must pick up pace. Alongside the necessary reproductive health and counselling services at a grassroots level, there must also be public awareness mobilisation and motivational programmes.

The prevailing laws to prevent child marriage must be enforced properly and the participation of all is essential for building up a women-friendly society. And along with the service provided at the health centres, health education must also be introduced in schools and madrasahs. Family planning services must be ensured for girl victims of child marriage and programmes must also be adopted to increase the awareness of other members of the family.

Everyone’s concerted efforts are required to implement the slogan, ‘No marriage before 18, no child before 20.’ The family planning directorate and others must all endeavour to motivate married young girls to delay pregnancy by means of extended birth control.

On observation of World Contraception Day, we must commit ourselves to understand our duties and responsibilities to increase awareness in this regard and work towards that end.

Source: The Daily Prothom Alo (English version translated by