Bangladesh is one of the most densely populated countries in the world, with an average of 1,119 people living per square kilometre. The country lacks sufficient resources to meet the overall demands of its vast population. Additionally, the population of this country grows by more than 30 lacs every year, which impacts health, education, housing, arable land, food supply, the environment, forests, mineral resources and many other things.
A major concern is the rapid increase in population density in urban areas due to economic and other factors, especially employment opportunities. According to the latest census and household survey, cities like Dhaka, Narayanganj, Gazipur, Chattogram, and Cumilla are experiencing significant population growth pressure. In Dhaka alone, more than 10,000 people live per square kilometre. This increasing population density makes it challenging for authorities to ensure even the most basic civic services like water supply, sewerage facilities, electricity, etc in Dhaka and other urban areas. Poor people who come in search of employment mostly live in slum areas and their fertility rate is also high. As a result, unplanned population growth has intensified urban problems.
The most logical solution to controlling population density is birth control through family planning. However, family planning should not be seen solely as a means of population control. It plays a crucial role in ensuring maternal health by allowing a gap of at least two years between the first and second pregnancies. This helps prevent malnutrition, allows the mother to regain physical strength for childbirth, reduces pregnancy complications, and lowers the risk of maternal mortality, especially for women under 20 and over 35.
The importance of enabling women's participation in the economy is increasingly recognised. Family planning is essential in this regard, as planned pregnancies allow women greater mobility, increased participation in economic activities, and more employment opportunities. A family built on the joint efforts of both spouses is more likely to achieve financial stability.
However, due to ignorance, illiteracy, superstitions, societal norms, religious beliefs, and other factors, family planning campaigns-especially the use of approved contraceptive methods-still face obstacles in Bangladesh. Statistics indicate that nearly half of married couples in the country do not use any form of contraception.
Recommended contraceptive methods include birth control pills, contraceptive injections, copper-T (IUD), tubal ligation, subdermal contraceptive implants, condoms, and vasectomy. The challenge is that among these methods, only condoms and vasectomy are for men, yet many men are reluctant to use them. On the other hand, women, influenced by social and family pressures and superstitions, hesitate to adopt the contraceptive methods available to them. Some women use these methods incorrectly without consulting family planning workers, which leads to side effects and discourages them from continuing birth control.
Equal participation of both husband and wife is essential in family planning. Studies show that in Bangladesh-especially in impoverished families-there is a higher number of mothers aged 15 to 19, as they have limited decision-making power. Such families require proper guidance on family planning and easy access to contraceptives.
Encouragingly, alongside the Ministry of Health and Family Welfare, the Ministry of Local Government, Rural Development, and Cooperatives has also taken initiatives to promote family planning. Under the leadership of the Local Government Division, projects such as the Urban Primary Healthcare Project (initiated in 1998) and the Urban Primary Healthcare Services Delivery Project (Phase I and II) are encouraging couples aged 15 to 49-especially the ultra-poor and low-income working-class populations-to adopt modern contraceptive methods.
Under these projects, 45 Nagar Matrisadan Kendro marked with the "Rainbow" symbol, 167 urban health centres, and 334 satellite clinics, supported by development partners and skilled service providers, are ensuring access to family planning advice and resources while promoting a positive attitude toward contraception in society. Currently, about 70 per cent of eligible married couples under this project use modern contraceptive methods, whereas the national average is approximately 54 per cent.
To achieve the goal of reducing the total fertility rate to 2 per cent and ensuring safe maternal health, it is crucial to raise awareness about family planning, especially among underprivileged, uneducated, and superstitious populations. Conscious citizens must come forward to spread awareness and promote the benefits of family planning for a healthier and more sustainable society.
Dr Farhana Hossain is a Senior Program Officer (RH), UPHCSDP-II.
spo.rh.uphcsdp@gmail.com
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