- Maternal Mortality and Morbidity
Although the Maternal Mortality Rate has decreased considerably from 514 in 1986-
1990 to 400 in 1998-2000, it is still one of the highest in the world. In 2001, approximately
half of mothers did not receive antenatal care, and two-thirds of currently pregnant women
did not intend to have assistance during delivery. Dealing with maternal mortality and morbidity is crucial, because mothers play in integral role in raising their children.
Although the prevalence rates of HIV/AIDS and STDs in Bangladesh are currently
low, several factors indicate that these diseases are important emerging problems. Between 32 percent and 43 percent of sex workers and 18 percent of Intravenous Drug Users (IDUs) in this
area had syphilis. This suggests that there is strong potential for HIV/AIDS and
sexually transmitted infections (STD)s to become serious problems in Bangladesh.
Increasing urbanization is a significant population and development concern in Bangladesh.
In 1974, 8.2 percent of Bangladesh’s population, 6.27 million people, lived in urban areas,
and by 2001, it had increased to 23.4 percent which equaled 21 million individuals. Dhaka, Chittagong, Khulna, and Rajshahi were the four largest cities and the population of each of these cities increased substantially from the year 1974 to 2001. These data show the rapid urbanization that has occurred in Bangladesh and such trend is projected to continue.
The population policy goals
The major objectives of the Bangladesh National Population Policy was to improve the status of family planning, maternal and child health including reproductive health services and to improve the living standard of the people of Bangladesh through making a desirable balance between population and development. There were also more specified objectives to attempt to accomplish the population policy. One of those objectives was to reduce Total Fertility Rate and increase the use of family planning methods among eligible couples through raising awareness of family planning.
The methods used to achieve the population policy goals
The country has been mainly dependent on foreign aid. Contraceptive service delivery through a national family planning program was seen as the primary means of achieving those goals. The exclusive thrust of the program was to increase the use of modern birth control methods by married women in their childbearing ages through a doorstep delivery service. There was also a motivational campaign to promote the two-child norm and legitimize the use of modern methods of contraception. Population control and family planning, therefore, were a top priority of the government and social workers.
Evaluation of the population policy
Since 1976, this policy emphasis has been reflected in all successive 5-year plans and programs. As a result, the rate of family planning methods users has increased from 8 percent in mid-70s to 54 percent by the year 1999-2000. Total fertility rate (TFR) has decreased from 6.3 to 3.32 and it has become possible to reduce the population growth rate from 3 percent in mid-70s to 1.47
percent by the year 2000.
In the mid-1980s, there were indications that government and nongovernment agency efforts were beginning to pay off. Population growth had declined from 3 percent to 2.3 percent between 1961 and 1981. Contraceptive practices increased from 12.7 percent of eligible couples in 1979 to 25 percent in mid-1985. Of the methods available, sterilization was the most commonly sought in government plans through fiscal year 1990. A continuous demographic survey also showed a decline in fertility rates and an increase in the female marriage age, but undercutting this progress was the uneven application of the family planning program in rural areas, which constituted the most populous sections of the nation.
In 1985 there were reported only 3,716 family planning facilities in the country and a total of 15,619 family planning personnel, of whom 4,086 were male in a country where the females were traditionally reserved when discussing sexual matters with men. Even when they were physicians, men were reluctant to discuss sexual matters with women. From 1980 to 1985, only about 55 percent of national family planning goals were achieved.
However, the environment for improved quality of life for the mass has yet to be achieved. High population growth is still an obstacle to the national development. In addition to population density (1020 persons per square kilometer3, one of the highest in the world), deforestation and reduction of cultivable land, air and water pollution, scarcity of pure drinking water, inadequate shelter, unemployment, malnutrition and slow pace of progress in the health and nutrition sectors are the major impediments to the development efforts of the country.
