nakedzero
July 11, 2011, 12:48 AM
Efforts to limit population growth lacks 'priority' in Bangladesh, world's seventh densely populated country where the fertility transition is underway, signalling a future explosion of births, experts say.
The Bangladesh Bureau of Statistics' projection showed the number of population stood over 150 million this June. If the current trend continues, demographers predict the number will double in the next 50 years.
"Once the issue (population) was prioritised, but now it's not on top of government agenda," observed Dhiraj Kumar Nath, former director general for family planning.
He strongly felt that there must be 'specific' policies to limit population growth.
Due to the success of family planning programme in 1980s, fertility rate has declined rapidly from 6.3 in 1975 to 3.3 in 1994.
But statistics show over the decades, the country is experiencing slow pace in fertility decline—3.3 in 1994 to 2.5 in 2010—causing concern in reaching replacement level fertility, where couples would have just enough babies to replace themselves, by 2015.
On the other hand, there is no significant increase in contraceptives prevalence rate over the period 2000-2009 even though it increased seven folds during 1975 to 2000.
The use of long-acting and permanent birth-control methods has declined from 36 percent in 1989 to 13 percent in 2007, the latest Bangladesh Demographic and Health Survey shows.
As the country observes World Population Day on Monday, the one question that confounds many is why family planning programmes fell apart, despite gaining momentum in the 1980s.
ICDDR, B's population scientist Peter Kim Streatfield attributed 'a combination of factors' to the family planning (FP) programme being in decline.
"Lack of coordination across the two directorates (family planning and health), some technical aspects of the fertility decline and a loss of donor support and motivation combine the factors," he told bdnews24.com.
"It (lack of coordination) 'obstructed' the adoption of necessary clinical family planning methods," he said, adding that the family planning programme had relied 'too much and for too long' on oral contraceptive pills only because 'these can be distributed by family planning fieldworkers.'
"They never successfully promoted medium, long acting and permanent methods as these require a smooth relationship between the staff of family planning and health, because the clinical methods require health staff," Streatfield said in an e-mail response.
Things started going wrong during the shift to sector-wide approach in 1997 which was supposed to combine the two wings or directorates together.
The plan was that the both directorates would be merged at field level and their staff would be managed by the Thana Manager.
"But there was strong resistance from family planning staff, because many of them would lose their jobs to health staff who had medical qualification," Streatfield said.
The long-lasting split between the "two wings" of the Ministry of Health and Family Welfare has been an obstacle to smooth referrals from family planning field staff across to health's clinical staff.
But the FP programme needs to accept that it cannot rely mainly on oral pills in future. Only 2 countries have more than 30 percent of couples using pills (Algeria and Morocco), Streatfield said.
"In Bangladesh with early marriage, many women are finished with childbearing before they reach 30. They need family planning for another 20-25 years.
"Therefore, long term methods are best for them, and cheaper for the country."
Streatfield said in the 1980s the family planning programme had a lot of momentum, good ratio of fieldworkers to population – there was recruitment of 10,000-15,000 family welfare visitors (FWAs) in late 1980s – and strong donor support as the family planning program was 90 percent funded by development budget up until 1998.
But, in the late 1980s the incentive payments to FP programme fieldworkers and service providers were stopped.
Besides that, the field staff (family welfare visitors) are getting old now–many were recruited in 1970s and 1980s, but no fresh recruitment had taken place since 1997.
"Now we are starting to recruit, but it is very late. More are needed."
The population scientist said another global issue was the 1994 Cairo Conference on Population and Development, which resulted in family planning being downgraded by many agencies including UNFPA.
"There was a global shift away from family planning to reproductive rights, and broader issues of sexually transmitted infections, women empowerment, which caused resources (financial and human resources) to be redirected away from FP program."
"But that has changed back a bit to emphasise population again partly because of concerns with global warming and the future negative impact of large and growing numbers of humans on the planet," Streatfield said.
Health and family welfare minister AFM Ruhal Haque on Sunday said the government attached 'highest' priority to the population problem, but he could not say how.
Dr Abu Jamil Faisel, country representative, Engender Health Bangladesh, said family planning programmes are still neglected.
"It got only 18 percent of the five-year sector plan's (July 2011 to June 2016) budget, while 21 percent have been allocated for infrastructure development, despite a robust structure in Bangladesh."
He said population programme suffer from 'leadership crisis.'
"National Population Council does not meet in time. The ministry's executive committee on population never met since its inception during the last caretaker government."
"It's time for the government to address population issue seriously," Nath, the former DG said.
"Or else, this small country will crumble under the pressure of its population in not-far-away future."
SOURCE (http://bdnews24.com/details.php?id=200544&cid=2)
The Bangladesh Bureau of Statistics' projection showed the number of population stood over 150 million this June. If the current trend continues, demographers predict the number will double in the next 50 years.
"Once the issue (population) was prioritised, but now it's not on top of government agenda," observed Dhiraj Kumar Nath, former director general for family planning.
He strongly felt that there must be 'specific' policies to limit population growth.
Due to the success of family planning programme in 1980s, fertility rate has declined rapidly from 6.3 in 1975 to 3.3 in 1994.
But statistics show over the decades, the country is experiencing slow pace in fertility decline—3.3 in 1994 to 2.5 in 2010—causing concern in reaching replacement level fertility, where couples would have just enough babies to replace themselves, by 2015.
On the other hand, there is no significant increase in contraceptives prevalence rate over the period 2000-2009 even though it increased seven folds during 1975 to 2000.
The use of long-acting and permanent birth-control methods has declined from 36 percent in 1989 to 13 percent in 2007, the latest Bangladesh Demographic and Health Survey shows.
As the country observes World Population Day on Monday, the one question that confounds many is why family planning programmes fell apart, despite gaining momentum in the 1980s.
ICDDR, B's population scientist Peter Kim Streatfield attributed 'a combination of factors' to the family planning (FP) programme being in decline.
"Lack of coordination across the two directorates (family planning and health), some technical aspects of the fertility decline and a loss of donor support and motivation combine the factors," he told bdnews24.com.
"It (lack of coordination) 'obstructed' the adoption of necessary clinical family planning methods," he said, adding that the family planning programme had relied 'too much and for too long' on oral contraceptive pills only because 'these can be distributed by family planning fieldworkers.'
"They never successfully promoted medium, long acting and permanent methods as these require a smooth relationship between the staff of family planning and health, because the clinical methods require health staff," Streatfield said in an e-mail response.
Things started going wrong during the shift to sector-wide approach in 1997 which was supposed to combine the two wings or directorates together.
The plan was that the both directorates would be merged at field level and their staff would be managed by the Thana Manager.
"But there was strong resistance from family planning staff, because many of them would lose their jobs to health staff who had medical qualification," Streatfield said.
The long-lasting split between the "two wings" of the Ministry of Health and Family Welfare has been an obstacle to smooth referrals from family planning field staff across to health's clinical staff.
But the FP programme needs to accept that it cannot rely mainly on oral pills in future. Only 2 countries have more than 30 percent of couples using pills (Algeria and Morocco), Streatfield said.
"In Bangladesh with early marriage, many women are finished with childbearing before they reach 30. They need family planning for another 20-25 years.
"Therefore, long term methods are best for them, and cheaper for the country."
Streatfield said in the 1980s the family planning programme had a lot of momentum, good ratio of fieldworkers to population – there was recruitment of 10,000-15,000 family welfare visitors (FWAs) in late 1980s – and strong donor support as the family planning program was 90 percent funded by development budget up until 1998.
But, in the late 1980s the incentive payments to FP programme fieldworkers and service providers were stopped.
Besides that, the field staff (family welfare visitors) are getting old now–many were recruited in 1970s and 1980s, but no fresh recruitment had taken place since 1997.
"Now we are starting to recruit, but it is very late. More are needed."
The population scientist said another global issue was the 1994 Cairo Conference on Population and Development, which resulted in family planning being downgraded by many agencies including UNFPA.
"There was a global shift away from family planning to reproductive rights, and broader issues of sexually transmitted infections, women empowerment, which caused resources (financial and human resources) to be redirected away from FP program."
"But that has changed back a bit to emphasise population again partly because of concerns with global warming and the future negative impact of large and growing numbers of humans on the planet," Streatfield said.
Health and family welfare minister AFM Ruhal Haque on Sunday said the government attached 'highest' priority to the population problem, but he could not say how.
Dr Abu Jamil Faisel, country representative, Engender Health Bangladesh, said family planning programmes are still neglected.
"It got only 18 percent of the five-year sector plan's (July 2011 to June 2016) budget, while 21 percent have been allocated for infrastructure development, despite a robust structure in Bangladesh."
He said population programme suffer from 'leadership crisis.'
"National Population Council does not meet in time. The ministry's executive committee on population never met since its inception during the last caretaker government."
"It's time for the government to address population issue seriously," Nath, the former DG said.
"Or else, this small country will crumble under the pressure of its population in not-far-away future."
SOURCE (http://bdnews24.com/details.php?id=200544&cid=2)