Public health experts stress strengthening primary healthcare amid decline in family planning programme

Public health experts and policymakers stressed the need to strengthen primary healthcare (PHC) services at a policy dialogue organised by Bangladesh Health Watch titled "Declining Primary Health Care Programme in Bangladesh: The Story of the National Family Planning Programme," according to a press release sent by Bangladesh Health Watch.

The event was held today (7 May) at the CIRDAP Auditorium in the capital and brought together veteran health experts and policymakers to discuss the growing crisis in Bangladesh's national family planning programme.

Speakers said Bangladesh had reduced its total fertility rate from 7 at independence to 2.3 over the past five decades but warned that the progress is now under threat due to weakening programme momentum and declining performance over the last 15 years.

In her presentation, Dr Yasmin Ahmed traced the evolution of Bangladesh's family planning programme from the post-independence period to the present, identifying a severe collapse in the contraceptive supply chain as the main driver of the current crisis.

According to the presentation, procurement has remained stalled since July 2024 following the non-approval of the 5th Health, Population and Nutrition Sector Program (HPNSP) and the interim government's subsequent withdrawal from the sector programme.

The presentation stated that procurement of both short-term and long-acting contraceptive methods has remained frozen for more than two years, placing the system under significant strain.

Field reports indicate that many areas are receiving less than 10% of the required supplies, contributing to rising unintended pregnancies and leaving many low-income women without protection.

Following the presentation, discussants proposed several solutions to address the crisis.

Managing Director Toslim Uddin Khan stressed the urgent need for greater investment in the family planning sector.

Senior public health expert Dr Ubaidur Rob emphasised the importance of stabilising population growth and making better use of technology and existing manpower to reach communities effectively.

State Minister for Health Dr MA Muhit, attending as chief guest, said the government would increase domestic financing for the health sector and assured that the national health budget would rise in the upcoming fiscal year.

Guest of honour Dr SM Ziauddin Hyder, special assistant to the prime minister on health affairs, stressed improving efficiency within the health system and placing greater emphasis on preventive healthcare.

Director General of the Directorate General of Family Planning Dr Ashrafi Ahmad assured participants that the current procurement crisis would be resolved by August.

The press release also said ongoing supply shortages have contributed to a sharp decline in field-level engagement, with field visitation trends falling from 41% in 1993–94 to 17% in 2022.

It added that stockouts at the Central Medical Stores Depot and reduced outreach have undermined the credibility of field workers and left vulnerable populations, particularly young married girls and postpartum women, underserved.

Data from 2025 further indicates that fertility rates are rising again, with the national Total Fertility Rate (TFR) increasing to 2.4 while the Contraceptive Prevalence Rate (CPR) has started to decline.

Speakers collectively urged the government to take immediate action to remove procurement barriers and restore the primary healthcare framework to prevent a long-term public health setback.