Presented By Fahmeen Khaleque Nipa FPO, Asuganj Bangladesh

The People's Republic of Bangladesh is a sovereign state located in South Asia. It is bordered by India on all sides except for a small border with Burma (Myanmar) to the far southeast and by the Bay of Bengal to the south. The name Bangladesh means "Country of Bengal" in the official Bengali language.

Remnants of civilization in the greater Bengal region date back four thousand years, when the region was settled by Dravidian, Tibeto-Burman, and AustroAsiatic peoples. Islam was introduced to Bengal in the 12th century by Arab Muslim merchants; Sufi missionaries and subsequent Muslim conquests helped spread Islam throughout the region. Bakhtiar Khilji, a Turkic general, defeated Lakshman Sen of the Sena dynasty and conquered large parts of Bengal in the year 1204

Somapura Mahavihara in Paharpur, Bangladesh, is the greatest Buddhist Vihara in the Indian Subcontinent, built by Dharmapala of Bengal.

European traders arrived late in the 15th century, and their influence grew until the British East India Company gained control of Bengal following the Battle of Plassey in 1757 When India was partitioned in 1947, Bengal was partitioned along religious lines, with the western part going to India and the eastern part (Muslims majority) joining Pakistan as a province called East Bengal (later renamed East Pakistan), with its capital at Dhaka. The Bangladesh Liberation War lasted for nine months. The Bangladesh Forces formed within 11 sectors led by General M.A.G. Osmani consisting of Bengali Regulars, and Mukti Bahini conducted a massive guerilla war against the Pakistan. The Mitro Bahini achieved a decisive victory over Pakistan on 16 December 1971,taking over 90,000 prisoners of war.

At April 2010, USA - based ratings agency Standard & Poor's (S&P) awarded Bangladesh a BB- for a long term in credit rating which is below India and well over Pakistan and Sri Lanka in South Asia. However, Bangladesh gradually decreased its dependency on foreign grant and loan from 85% (In 1988)to 2% (In 2010) for its annual development budget. Its per capita income in 2010 was US$641 compared to the world average of $8,985. But, if purchasing power parity (PPP) is taken into account, Bangladesh's economy is the 44th largest in the world at US$257 billion according to the IMF. FAOSTAT, Bangladesh is one of world's largest producers of: Rice (4th), Potato (11th), Mango (9th), Pineapple (16th), Fruit, Tropical (5th), Onion (16th), Banana (17th), Jute (2nd), Tea (11th). In December 2005, four years after its report on the emerging "BRIC" economies (Brazil, Russia, India, and China), Goldman Sachs named Bangladesh one of the "Next Eleven", along with Egypt, Indonesia, Vietnam and seven other countries.

Bangladesh has been ranked as the 4th largest clothing exporter by the WTO (The World Trade Organization) The country has achieved an average annual growth rate of 5% since 1990, according to the World Bank The country is listed among the Global Growth Generator countries. It is a founding member of the South Asian Association for Regional Cooperation, the D-8 and BIMSTEC, and a member of the Commonwealth of Nations, the Organization of the Islamic Conference and the Non-Aligned Movement. One significant contributor to the development of the economy has been the widespread propagation of microcredit by Muhammad Yunus (awarded the Nobel peace prize in 2006) through the Grameen Bank.

The highest point in Bangladesh is in Mowdok range at 1,052 m (3,451 ft) in the Chittagong Hill Tracts to the southeast of the country. Cox's Bazar, south of the city of Chittagong, has a beach that stretches uninterrupted over 120 kilometers. Straddling the Tropic of Cancer, Bangladeshi climate is tropical with a mild winter from October to March, a hot, humid summer from March to June. A warm and humid monsoon season lasts from June to October and supplies most of the country's rainfall. Natural calamities, such as floods, tropical cyclones, tornadoes, and tidal bores occur almost every year, combined with the effects of deforestation, soil degradation and erosion. Bangladesh is now widely recognized to be one of the countries most vulnerable to climate change. Natural hazards that come from increased rainfall, rising sea levels, and tropical cyclones are expected to increase as climate change, each seriously affecting agriculture, water & food security, human health and shelter.It is believed that in the coming decades the rising sea level alone will create more than 20 million climate refugees

` ` ` ` ` `

Life expectancy is 63 years for both males and females. The majority of Bangladeshis are ethnic Bengalis, comprising 98% of the population. Nearly all Bangladeshis speak Bangla as their mother tongue and it is the official language. Health and education levels remain relatively low, although they have improved recently as poverty (31% at 2010) levels have decreased. The literacy rate in Bangladesh rose to 53.5% in 2007. The main religion practiced in Bangladesh is Islam (89.7%), but a significant percentage of the population adheres to Hinduism (9.2%). The Baul tradition is a distinctive element of Bengali folk music. Numerous other musical traditions exist including Gombhira, Bhatiali and Bhawaiya, varying from one region to the next. Folk music is often accompanied by the ektara, dotara, dhol, flute and tabla. Similarly, Bangladeshi dance forms draw from folk traditions, especially those of the tribal groups. The earliest literary text in Bengali is the 8th century Charyapada. Bengali literature reached its full expression in the 19th century, with its greatest icons being poets Rabindranath Tagore, Michael Madhusudan Dutt and Kazi Nazrul Islam. Bangladesh also has a long tradition in folk literature, for example Maimansingha Gitika, Thakurmar Jhuli and stories related to Gopal Bhar, Birbal and Molla Nasiruddin.

` ` ` ` ` ` ` ` `

Anthem Animal Bird Fish Flower Fruit Tree Sport Calendar

Amar Shonar Bangla Royal Bengal Tiger Oriental Magpie Robin Hilsa White Water Lily Jack fruit Mango Tree Hadudu Bengali calendar

Cox's Bazaar: Largest Sea Beach

The Sundarban: Largest Mangrove Forest

The Bandarban: Place of Three highest peak of Bangladesh

Mujibnagar: 1st Capital of Independent Bangladesh

Kantojir Mondir: Architectural Work of Post Muslim period

Lalbag Kella Architectural Work of Muslim Period

See More: http://www.youtube.com/watch?v=vku-nBnXBOM

` ` ` ` ` ` `

Capital: (and largest city) Co-ordinates Official language(s) Bangladeshi Government President Prime Minister Independence from Pakistan

` ` ` ` ` ` ` ` ` `

Dhaka 2342 N 9021 E Bengali Unitary state and parliamentary democracy Zillur Rahman Sheikh Hasina Declared March 26, 1971 Victory Day December 16, 1971 Area Total 147,570 km2 (94th) Population 2009 estimate 164.4 million(8th) Density 1,099.3/km2 (9th) GDP (PPP) 2010 estimate Total $258.608 billion Per capita $1,572 Currency Taka (BDT) Time zone BST (UTC+6) ISO 3166 code BD Internet TLD .bd Calling code 880

FAMILY PLANNING PROGRAMME

(Success, Challenges and Way Forward)

13

y Country Area : 1.47.570 sq. km. y Total Population : 146.6 Million (BBS 2009) y Sex ratio (male per 100 female) : 104.8 (BBS 2009) y Population Density (per sq. km.) : 993 persons (BBS 2009) y Number of Eligible Couples (Excluding City Corp.) : 25.4 million (MIS Jan 2011) y Population Growth Rate : 1.39 (BBS 2008) y Total Fertility Rate (TFR)/ per 1000 LB : 2.5 (BMMS 2010) y Contraceptive Prevalence Rate (CPR) : 55.8 percent (BDHS 2007) y Unmet need for Contraceptive : 17.6 percent (BDHS 2007) y Life Expectancy at BirthMale : 65.7 years (BBS 2009) Female : 68.3 years (BBS 2009) y Maternal Mortality Rate (MMR) ( per 1000 live births )

: 1.94 (BMMS 2010) y Infant Mortality Rate( per 1000 live births) : 52 (BDHS 2007) (<1 Yr) y Neonatal Mortality Rate (<1 Month) : 37 percent (BDHS 2007) y Child Mortality Rate (<5 ) : 65 per 1000 live births (BDHS 2007)

y EPI Coverage of Children : 81.9 percent (BDHS 2007) y Delivery by Medically trained personal : 26.5 percent (BMMS 2010) y Women delivering in a facility : 23.0 percent(BMMS 2010) y Underweight children (personnel <5 years) : 46 percent (BDHS 2007) y Births attended by skilled health : 23%(BMMS-2010)
14

Year 1650 1851 1941 1961 1974 1991 2001 2006 2008

Population (in ml.) 10 m 20.3 m 40.2 m 50.8 m 70.13 m 101.15 m 130 m 140.6 m 150 m
Source: BBS 1994, 2003, 2008

% of Increase 0.67 1.65 1.93 2.61 2.17 1.47 1.41 1.39

15

3 2.5 2 1.5 1 0.5 0 1981 1991 2001 2004 2006 2008

16

2.4

2.2 1.5 1.43 1.41 1.39

Bangladesh Family Planning program evolved through a series of developmental phases during the last 57 years starting from 1953.
Phase I : 1953-65: Family Planning Association initiated Family planning Program

Phase II : 1965-71: Field based Government Family Planning Program Phase III : 1972-74: Integrated Health & Family Planning Program Phase IV : 1975-80: MCH based FP and Multi-sectoral Program Phase V : 1980-85: Functionally Integrated Program: MCH-FP services Phase VI : 1985-90: Intensive Family Planning Program Phase VII : 1990-98: Reduction of rapid growth of Population through intensive service delivery and community participation Phase VIII : 1998-2003: Health & Population Sector Program (HPSP) Phase IX : 2003-2010: Health, Nutrition and Population Sector Program (HNPSP)

17

70 60 50 40 % 30 20 10 0 1993-1994 1996-1997 1999-2000 2004 2007

Modern method Traditional method
18

58.1 53.8 49.2 44.6

55.8

7.7

10.3

10.8

8.3

8.4 47.3 47.5

36.2

41.5

43.4

Bangladesh: 56% 66 56 32

63

56

44

19

Total Fertility Rate by division

Area
Bangladesh Barishal Chittagong Dhaka Khulna Rajshahi Sylhet
Source: BDHS-2007, * BMMS-2010
20
20

TFR 2.7 / 2.5* 2.8 3.2 2.7 2.0 2.4 3.7

Khulna 2.0 Barishal
2.8

Rajshahi
2.4

Sylhet Dhaka 2.7

3.7

Chittagong
3.2

Modern contraceptive use by methods

Pill Injectable Female sterilization Condom Implants IUD Male sterilization

28.5 7.0 5.0 4.5 0.7 0.9 0.7

21

Trends in specific m ethod use

(source:BDHS- 2007) (source:BDHS30 25 20 % 15 10 5 0 1993-94 1996-97 Pill 1999-2000 2004 PLTM
22

28.5 26.2 23.0 20.8 17.4 11.4 4.5 3.0 10.6 6.2 3.9 8.9 7.2 4.3 9.7 7.2 4.2 7.3 7.0 4.5

2007

Condom

Injectables

PLTM = Permanent and long lasting methods

sect r

Public sect r

Pri

te sect r

For contraceptive supply, we depend on foreign procurement which is complex and time consuming, to consuming, make procurement more faster we can positively think about local production of contraceptives through PPP which would be cost-effective , save time and help avoid unnecessary stock -out. cost-effective, stock-out.
23

ontracept ve d cont nuat n rate n f r t 12 onth of u e

(Source: BDHS-2007)

71

44

44

39

ethod

n ectab e

ondo
24

Want no 62

ore

Undecided 2

Want child soon 12 Infecund 3 Want child later 21

We have to strategize to address 62% couples who want no more children because they have already completed their desired family size and for another 21% couples who want child later we need strategic and very focused interventions. interventions.

25

Bangladesh: 18% 26 18

12

13

21

24

26

56% 52% 49%

33% 29%

1996-97

1999-2000

2004

2007

2009
27

Delivery assistance by medically trained providers have increased from 12.2 % to 26.5% during 2001 to 2010.(BMMS-2010)

28

Postnatal care from medically trained providers



BDHS 2007 postnatal care from medically trained providers : 21% for mothers; 22% for children Postnatal care has increased by 4 percentage points in the last three years for both mothers and newborns Most postnatal care occurs within the crucial first two days of delivery

29

` ` ` ` ` ` ` ` `

CPR: 55.8% in 2007 and 7.7% in 1975. Population growth rate: 1.39% in 2008 and 2.61% in 1974 TFR: 2.5 in 2010 and 6.3 in 1971. Neo-natal death: 52 in 2007 and 150 in 1975 Maternal death: 194 in 2010 and 322 in 2001 Unmet need of family planning: 17.6% in 2007 and 19% in 1994. Life expectancy: 65.4 years in 2007 and 56.1 in1991 Drop out rate has been reduced from 49% to 44% Comprehensive EmOC services being provided at 70 MCWCs

30

Key Challenges in Family Planning Programs

 Over

Population of 146.6 Million (BBS-2009)

 Regional difference of TFR (Sylhet-3.7, Rajshahi-2.4)  Unmet need for contraception (17.6% BDHS 2007)  Male Participation in Contraception is very low ( .2 in 2007)  Maternal Mortality is still high (1.94/1000 Live birth, BMMS-2010)  Rapid & Unplanned Urbanization ( 67 Million in 2015)  Early marriage and early child bearing  Emerging threat of HIV/AIDS

31

` ` `

Reaching replacement level of fertility Adolescent fertility Population momentum

Early marriage Number of women in reproductive age Young age group

` ` `

Urban population and ageing population Food security Climate change

32

    

Increasing number of eligible couples Number of eligible couples per FWA (1200-1500 & in some places 2000) Inadequate activities in the urban areas (City Corporation and Pauroshovas). Inadequate activities in the remote and hard to reach and hilly areas Poor monitoring and supervision (field level)

33

   

Vacant Posts Conflict between Cadre vs. non-cadre Carrier Planning of Doctors/Officers Insufficient Training for FWAs & other service providers

34

   

Infrastructure & Maintenance Procurement (IDA Fund)- Time Consuming Inadequate transport Contraceptive security ( procurement, Storage, Distribution) Lack of adequate research, evaluation & monitoring.

35

` ` ` ` ` ` ` ` ` ` ` ` ` ` `

Special emphasis on long-acting & permanent FP Addressing discontinuation rates of temporary methods Increased male participation in FP Program Six months midwifery program for FWV Up-gradation of 1500 union UH&FWCs for PLTM and normal delivery Providing services as per client segmentation Identifying need of services as per geographic areas Life cycle approach to provide services Active participation of NGOs and private sector Involvement of elected representatives Increased involvement of print and electronic media Decentralization of population policy activities Orientation of Marriage registrars, elected representatives and other stake holders EmOC services through all MCWCs. Special activities in Sylhet & Chittagong division along with other hard-to reach areas
36

Developing a short, mid & long term strategic and evidence based programming with focus on the following:
` ` ` ` ` ` ` ` ` ` ` `

Commitment from the policy maker and political leaders BCC, IPC & the use of local/folk media Marketing the benefit of family planning Functional coordination Policy and media advocacy Infrastructure development Filling vacant posts Logistics and commodity security Increasing male involvement Community participation and involvement of peoples representatives and electronic & print media Ensure quality service Research, evaluation & monitoring

37

THANK YOU ALL

Prev
38