A Critical Evaluation of the

Bangladesh Population Policy

Presented by
Md Mojibur Rahman
Department of Population Sciences
University of Dhaka, 2016
Presented to
Dr. Mohammad Mainul Islam
Associate Professor
University of Dhaka
& the student of Master of Population Sciences

Introduction
Current Population of Bangladesh is 162,956972 as of
Monday, July
11, 2016, based on the latest UN
estimation. Bangladesh is the eighths most populous
country in the world (UN 2015). A total land area of
mere 147,500 sq. kms accommodating the above
population size makes it by far the most densely
populated among the populous countries. The per capita
GNI PPP is around $1466 which is still among the lowest
in the world (PRB 2015). Even after a considerable rise
in adult literacy in recent years reaching 56 percent of
male and 49 percent of female population 15 years and
above, nearly half the people still cannot read and write
(BBS 2009).
3

Introduction cont..
In the face of ever shrinking agricultural land, the
extremely high density of population, rapid unplanned
urban growth, widespread illiteracy and conservative
socio-cultural environment, together with poor
reproductive health status characterised by as yet
high maternal and infant mortality and morbidity,
high incidence of communicable diseases, wide
spread malnutrition and a very high teen-age fertility
rate with limited access to services for adolescents
makes the population problems in Bangladesh
desperately serious. The above situation depicts the
challenging scenario for the policy makers.
4

Concept of Population
Policy
Population Policy represents a strategy for
achieving a particular pattern of population
change. That means, population policy
influences population growth & distribution
involving a wide range of decisions & actions
by governments both direct & indirect .

Rationale of population policy In

terms of the challenges
The
interrelationship
between
population
and
development, though complex, is understood mostly by
the concept that development is a continuous process
with an aim to improving the well-being of the people.
The concept of development thus presupposes that
while a healthy, well-nourished, well-educated and
skilled labour force is the best foundation for
sustainable development, the development efforts of a
nation need to increase peoples development choices
with regard to quality of life, education, health,
environment, etc. in order to enable them to render
further contribution to development.
6

Rationale of population policy In

terms of the challenges
Although, aggregate gains from reduced population growth
are genuine enough, continuing widespread poverty and poor
living standards coupled with the low level of aggregate
economic development has prevented the gains from the
demographic bonus from being equitably distributed. Poor
people particularly lose out since they are neither able to take full
advantage of smaller completed families, because of inability to
invest in children, nor able to compensate for the reduction
in childrens contributions to their present and future
consumption because of the absence of well developed
markets and institutions that provide security in old age and
risk insurance against income erosion. This is, of course, a part
of the general development challenges facing Bangladesh. Now
this time government should review o past policy rationales and
the new challenges facing policy.
7

Rationale behind Updating the

Bangladesh Population Policy
The Population Policy 2004 failed to achieve
Replacement Level Fertility and Net Reproduction Rate
(NRR) = 1 by the year 2010. It is important to achieve
NRR = 1 within a definite time span, and if it can be
achieved by 2015 then the population of Bangladesh
would be 22 crores in 2050 and it would stand still at 2325 crores in the year 2070 (PP2012). If achieving NRR =
1 is delayed, it would take more time to achieve a stable
population due to the momentum originated from a
young population age structure. Therefore, it is
indispensable to update the population policies and
strategies in order to keep the population of the country
within tolerable limits.
8

Vision of Population Policy of

Bangladesh 2012
Develop a healthier, happier and wealthier
Bangladesh through planned development
and control of the nations population.

Objectives of Bangladesh
Population Policy 2012
Increasing the use of family planning to 72%,

reduce TFR in 2.1 & achieve NRR =1 by 2015.

Ensure availability of family planning &
reproductive health service with making
awareness about STD & HIV among
adolescents.
Reduce ,maternal & child mortality & improve
their health services.

10

Objectives of Bangladesh
Population Policy 2012
Ensure gender equity, womens empowerment

& decrease gender discrimination.

Transform population into human resources by
taking short & long term steps.
Ensuring availability of family planning &
reproductive health service to all
(GoB 2012)

11

Reasons of failure previous

policies & Current population
policy of Bangladesh
After independence in 1971 a large number of
new policies were incorporated into first &
second FYP (1973-78) & 1980-85 respectively.
In June 1976 the government came out with
concrete proposal on a national population
policy. But the policy in the time of Martial law
in 1982 from previous population policy there
were some specific reasons for failure.

12

Reasons of failure previous policies

& Current population policy of
Bangladesh
1. Inadequate availability of contraception
2. Lack of field related services & service related activities
3. Neglect & inadequate follow ups in case of complications and side
4.
5.
6.
7.
8.
9.

effects
Fear & anxiety over the efficiency of the available methods of
contraception
Lack of sufficient motivations and demand for family planning
Improper & untimely introduction of various contraceptive
methods
Corruption & inflated reporting
Lack of commitment & dedication of the workers from up to grass
root level
Negligible involvement & participation at a mass scale etc.

13

Major Strategies for

Implementation of the
Population Policy

Client-Centred Service
Ensure services through existing Health and
Family Welfare Centers in districts, upazillas, and
unions, including Satellite and Community Clinics
in the community
Ensure all maternity services with the support
of skilled and trained service providers
Ensure 24-hour services at Union Health and
Family Welfare centres.
Urban Health Care
Undertake action plans through effective
coordination between the Ministry of Local
Government and the Ministry of Health and
Family Welfare with the aim of ensuring urban
health care services
Area-Based Plans and Strategies
Coordinate local family planning activities with
field-level programs of other Ministries, and
undertake collaborative activities if required
Behaviour Change Communication (BCC)
Program
Make all-out efforts to popularize and establish
the slogan No more than two children, but one is
better
Assist in promotion of
behavioral change

Adolescent Welfare Program

Ensure providing information and advice in favour
of late marriage and having children with adequate
birth intervals
Participation of Non-Government and Private
Sectors
Strengthen communication and coordination
among government, non-government and private
sectors,
and undertake programs through identifying specific,
priority-based fields of activities
Empowerment of Women and Equal Partnership of
Men
and Women
Eliminate women and child trafficking and all types of
oppression and sexual abuse
Create gender equality among boys and girls in terms of
access to health services, nutrition, education and
employment
Human Resources Development
In order to ensure quality services in government
facilities
as per existing population,
assess
manpower
requirement

Legal Measures
Use birth certificate during admission into school and marriage
registration in order to ensure birth registration; Make marriage
registration mandatory
Welfare Services for the Elderly, Poor and Disabled People
A considerable portion of the population of Bangladesh is elderly,
poor and disabled. Undertake special priority programs for them with
regard to health, education and social security/safety net
Population and Environment
Discourage establishment of housing blocks and industrial factories
causing depletion of agricultural lands in urban and rural areas
Assist in excavation of canals and ponds in rural areas, and
prevent soil and river erosion
Keep the natural forest harmless, prohibited any kind of illegal activity
like felling tree, hunting etc

Discourage
Urban
Migration
and
Introduce
Planned
Urbanization
Minimize disparities between citizens facilities/services in rural and
urban areas in order to discourage migration from villages to towns,
and create new employment opportunities in rural areas
Integrated Information Collection and its Use
Conduct regular survey and research on population, health and
nutrition
Encourage the use of modern digital information technology for
integrated collection and use of information, and ensure free flow
of all information through different media including websites
Decentralization of Administrative and Financial Power
Decentralize administrative and financial decision-making power
Strengthen the role of local government to facilitate transparent
administration and peoples participation
Production and Supply of Family Planning Commodities
Every year the Government imports family planning commodities at
the expense of a huge amount of foreign currency;take necessary
steps to ensure contraceptive security at all levels
Coordination with Different Policies and Plans
Formulate strategies
for
implementation of this policy in
coordination with the related policies, plans and programs of the

Special attention
need to reach the
target

19

Improve contraceptive
effectiveness by strengthening
client-provider interaction
Regarding cause of discontinuation, as shown in BDHS 2004
(note: cause specific break down of discontinuation pattern
was not investigated in BDHS 2007), side effects and
health reasons were among the most common as reasons
for discontinuation, with 20.8 percent for pills and 33.6
percent for injectables. This pattern of discontinuation,
especially the rising trend in recent years, requires
strengthening of inter-personal communication and clinical
counselling to dispel doubts and confusion about the
methods. Stoppage of home visits by outreach workers may
have contributed to increased rates of discontinuation.
Improve service centre practices and door-to-do0r services
to ensure effective and strong client-provider interaction.
20

Ensure continuity of commodity

supplies:
The high method discontinuation is known to be
at least partly due to inadequate or irregular
supplies and temporary stock-outs. Therefore,
regular supplies of commodities must be
ensured at every service point. To ensure
regular channels to all service points and to
avoid small pockets of temporary unavailability,
it may be useful to establish a reproductive
health commodity supply (RHCS) monitoring
cell under the logistics system that will keep a
watch on stock levels at peripheral points.
21

Define problems through research

The existing method acceptance pattern is inconsistent with
expressed demand structure implying insufficient understanding
of the methods and their implication. Therefore, besides actions
proposed above, scientific efforts, including operations research
on quality of care, acceptability studies are needed to identify
method-specific issues and problems. Clinical studies are
needed to define the incidence and pattern of contraindications
and gaps in clinical practices and technical competence. For
example, a useful study can be undertaken by using
interdisciplinary approach in methodology to define existing
incidence and pattern of reproductive tract infections (RTIs),
current practices in clinical procedures in IUD insertion, MR
procedure and antenatal care, which would greatly contribute to
improved reproductive health as well as increased method use.
22

Strengthening of community
level services including
community clinics
Importance of bringing services closer to people is
underscored by a finding in Bangladesh that couples were
two and a half times less likely to use contraception if
obtaining a method would require a travel time of 30
minutes or more from home (Levin et al. 2000). Success of
the clinics depends on the appropriate training and
supervision of this cadre. Several propositions in this regard
are (i) contracting out some selected clinics, especially
those located within operational reach of, to some reputed
NGOs for operational management and supervision; and (ii)
making community leadership responsible to oversee a few
selected clinics on experimental basis. In reference to
premature stoppage of outreach services by field workers,
as indicated from BDHS 2007.
23

Improving quality of care

Improvement of quality of care is essential to reduce method
discontinuation, frequent switching of methods, promote
acceptance
and,
thereby,
promote
effective
use.
Improvement of quality of care remains as the major frontline
for the program to focus on if further gains in contraceptive
prevalence are to be achieved (Khan 2000).
Two strategies are important: First, improved provider skills in
counselling can effectively address issues such as
appropriate choice of methods, knowledge to deal with side
effects and encourage continuity (Bruce 1989). Secondly,
improved technical skills, especially for aseptic precaution
and screening for contraindication, can reduce side effects
and
complications
and,
thereby,
promote
method
continuation and effectiveness.
24

Focussing communication
strategies
Communication efforts in support of family planning programs
and services have been grossly inadequate or unfocused in
recent years
A few areas of essential communication support are to
disseminate appropriately designed information that would (a)
improve knowledge of methods, including their benefits, side
effects, use instructions, especially those for more effective
methods such as IUDs and sterilization; (b) dispel existing
doubts, misinformation and rumours about contraceptives; (c)
popularize the community clinic system; (d) create awareness
about health and social implications of early marriage and
early child bearing; (e) promote social equity for and
participation of women in all walks of life; and (f) create social
awareness about maternal and child health issues.
25

Empowerment of Women and Equal

Partnership of men and Women
The women of Bangladesh are still far behind with
regard to equal ownership for men and women gender
equality. So we have to improve formulate gender
sensitive strategies for both men and women in all
government and non-government activities. Womens
skills development, Establish necessary child care
facilities, Eliminate women and child trafficking and all
types of oppression and sexual abuse, Undertake
awareness campaign to make men more responsible
regarding womens need and requirements for family
planning and reproductive health services. Also create
gender equality among boys and girls in terms of access
to health services, nutrition, education and employment.
26

Strengthen technical
support
A technically competent support system is
needed to monitor quality of care on a regular
basis, including clinical procedures, aseptic
precautions, counselling practices, follow-up
arrangements, and availability of equipment
and supplies.

27

Implement region-specific
strategies
Socio-cultural factors that affect family size norm or act as a
barrier to contraceptive practice are uniquely different in
magnitude and nature between regions, which calls for
formulation of region-specific micro-strategies.
In this respect, the basic principles underlying policy
proposition Decentralize population activities and ensure
the peoples participation in population, nutrition and health
activities, decentralization of services through devolution of
power to the upazila level and further below appears sound
and should be acted upon (GOB 2004). However, while
decentralization is appropriate to address the local issues
and problems, there must be back-up support for technical
oversight and quality assurance to be applied uniformly
without compromise.
28

Some significant
results
of Policy Adoption

Trends in total fertility rates

1975-2014

TFR

7
6
5
4
3
2
1
0

6.3

5.1

4.3

3.4

3.3

Years

3.3

2.7

2.3

2.3

Trends in Contraceptive
70
Use
62.4

Percentage

61.2
58.1
60
54.1
53.8 55.8
52.1
49.2 47.3
47.5
50
44.6 43.4
39.9 41.6
40
36.2
31.2
30.8
30
25.3
23.2
19.1
18.4
20
13.8
10.8 9.2
10.3
8.7
8.4
8.3 8.4
7.7
7.6
107.7
5 5.46.9
2.7
0

Years

Contraceptive_Use
Modern_method
Traditional_method

Current Age Structure

Future Pattern

Future Pattern

Future Pattern

Policy and Programme

Implications: some missing links
Again, although the problematic rationale
behind past population policy and
current
population policy there should be two priority is
a must. First one clear and explicit declaration
of policy goals, distinct from means or
strategies and another one is financial security
and
programme
sustainability.
Financial
security ensures the pace of the running
programme or planning any programme on the
other hand programme sustainability ensures a
better outcome of the policy.
38

New emerging issues which

should be include in the
policy looking at current
situation

39

Focus on youth
According to UNFPA (2014) 47.6 million or 30 percent of the total
158.5 million people in Bangladesh are young (10-24 years), and
it will be between 10 and 19 percent by 2050. This means that
Bangladesh needs to invest right now in the human capital of its
young people if it wants to reap the benefits of a large
demographic dividend. Nabi 2011 said that this demographic
bonus could bring a huge dividend, if this raw capital is converted
into circulatory capital. If we fail to grab this opportunity
immediately, this young population could create a disastrous
hazard for the nation which we already have started to
experience in recent days.
Again UNFPA (2014) says that the
youth population of Bangladesh
need at least five criteria.
They are: 1.Quality education,
2. Better health service,
3.opportunities for jobs & employment,
4.nutritious foods,
5.honest & responsive government.

40

Focus on alarming proportion of

aging population
By 2050, the 60+ population will
account for 20% of the total
population a four-fold increase
from the present time. Little
attention has been given by the
policy makers to their health and
social needs. There should be
much focus on pension, old age
allowance
programme,
micro
credit, health, nutrition, and
population sector programme,
community empowerment etc.
should mostly take for some
direct and indirect benefits of the
elderly population.
41

Focus on child marriage &

adolescent fertility
Bangladesh has the highest rate of marriage
involving girls under age 15. Adolescence
pregnancy involves a great cost to society & has
significant ramifications are personal & societal
level. About 58 percent of adolescents by age of
19 begin childbearing while 51 percent have
given birth, 7 percent get pregnant with first
child and 8 percent have two children. About
194 pregnant mother die while giving birth in
every one lakh pregnant mother in the country.
And most of them are adolescent mothers.
42

Focus on disable
population
5th Population and Housing Census 2011
showed the number of people with disability is
only 1.4 percent of Bangladesh's total
population. The percentage is far below the
estimation of Bangladesh Bureau of Statistics'
(BBS) Household Income Expenditure Survey
(2010) that had found people with disability at
9.07 percent of the population. However, the
percentage was 0.6 percent in the 2001 census.
This alarming rate is creating pressure to rethink
about the existing policy on disabled population.
43

CRITICISM
No strong measures have been taken in the population policy
of government which can ensure check on the growth rate of
population
Unmet need of contraception rate is still high
Lack of legislative action. Ministry of law, Justice and
Parliamentary affairs was not included in this policy.
No special measures taken for underprivileged and
vulnerable group of population.
Lack of indicators to measure the objectives.
No emphasis on financial matters. Still now overall budget is
low in health and education sector.
Not addressing international migration.
Not addressing overall health condition of population.
Lack of emphasis on literacy rate.
Lack of emphasis on measures preventing child marriage.
No incentives or remuneration for special cases.

EVALUATION OF POPULATION
POLICY

Evaluation
of
population
policy

achievemen
ts

failures

ACHIEVEMENTS
Wide

scope
Engagement of different Ministries,
Non-Government Organizations and
Private sector in Population program
Coordination with different policies and
plans
Increase in awareness
Wide publicity

FAILURES
Failure

to achieve replacement level

of fertility by 2015
Failure to reach the contraceptive
prevalence target within the
stipulated time period.
Unmet need of contraceptive use
Limited utilization of present infra
structure
Limited research

Recommendations
1)To reduce unmet need of contraception. To make contraceptive
methods and devices easily available both urban and remote
areas.
2)In remote areas like char and islands both govt. and NGO
activities can be carried out by telemedicine programs to Increase
awareness among both parents and teenagers about negative
effects of early marriage and early pregnancy. e.g. increased
maternal and child mortality.
3)Increased awareness through increased free secondary
education equally for both boy and girl child.
4)Increased social security for geriatric population as elderly
people increasing in Bangladesh.
5)For a healthy future generation improve nutritional status and
food security of both male and female child and women of child
bearing age.
6)ensure at least 4 ANC s and safe hospital delivery of child .
7)Human resource development by training different skills ,so that
they become asset .
8) In labor force market female participation is still less than
male. It should be increased.

Conclusion
The Government of Bangladesh must expand its
public awareness campaigns and improve provision
of contraception and associated information. The key
to population control is to improve the social status of
women ensuring gender equity. Although Bangladesh
has quite better several population policies but the
implementation
is
always
problematic.
The
institutional weakness, lack of political will as well as
inadequate
resources
impacts
on
policy
implementation. The bureaucracy in administration is
also challenging actor in policy implementation. It is
crying need to make efficiency and effectiveness in
administration. An alarming statement will end this
presentation, according to Nabi (2003) the country
has the capacity to support with given resources a
population of about 178 million which will be

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Planning, Bangladesh.
BDHS 2011: NIPORT - National Institute of Population Research
and Training, Mitra and Associates, and ICF International. 2013.
Bangladesh Demographic and Health Survey 2011, Dhaka and
Calverton: NIPORT, Mitra and Associates, & ICF International.
BDHS 2014: NIPORT-National Institute of Population Research
and Training, Mitra and Associates, and ICF International. 2015.
Bangladesh Demographic and Health Survey 2014: Key
Indicators. Dhaka, Bangladesh, and Rockville, Maryland, USA:
NIPORT, Mitra and Associates, and ICF International.
Haque, M. M., F. Ahmed, S. Anam, M. R. Kabir (2012). Future
Population Projection of Bangladesh by Growth Rate Modeling
Using Logistic Population Model, Annals of Pure and Applied
Mathematics, 2: 192-202
MDG 2015: Millennium Development Goals: Bangladesh
Progress Report 2015, Bangladesh Planning Commission.
UNFPA (2014a). Future Population Prospects and Their Policy
Implications.

Thank
you !