Bali, Indonesia: More counselling, follow-up, and awareness raising attempts are needed among the couples on long-term and permanent contraceptive methods to further control population growth and for batter family planning awareness in Bangladesh perspective, said health leaders and experts at the International Conference on Family Planning (ICFP) in Bali, Indonesia.

While Bangladesh’s progress in family planning had been impressive over the last two decades, it has been almost stagnant for the last four years, which is a matter of concern, they said.

‘The problem with the temporary methods is drop-out, which is almost 30 percent in Bangladesh,’ said Dr Reena Yasmin, senior director [services] of Marie Stopes Bangladesh, who is attending the five-day ICFP at Bali Nusa Dua Convention Centre beginning on 25 January.

‘While you take pills, you need to take those every day, and when you use condoms, you need to use them every time you have sex. It is also costly. But, if you take IUDs like implants, or injections, you are safe for three, five or ten years,’ said Dr Loshan Moonesinghe, family planning specialist at the UNFPA Bangladesh.

Due to drop-outs in temporary contraceptive methods, around 13 lakh women face unintended pregnancies in Bangladesh, while abortion among them is 18 in each 1000 pregnancies, she told this correspondent referring to a 2010 study by the Bangladesh Association of Preventive and Septic Abortion.

To avoid such unintended pregnancy and abortions that have psychological, physical and economic consequences, experts suggest that Bangladesh focus on long-term and permanent methods.

‘And, permanent methods help permanently,’ he told this correspondent at Bali Nusa Dua Convention Centre.

As there are high risks of missing in the use of temporary methods like pills and condoms, long-term and permanent methods are encouraged in the countries like Bangladesh having huge population.

For this to happen, Dr Loshan suggested that the family planning personnel counsel, follow up, and authorities create awareness among the couples on long-term and permanent methods.

Dr Reena Yasmin of Marie Stopes said absence of doctors and trained health workers at the remote and rural Bangladesh is a real hurdle in the promotion of long-term and permanent methods.

Besides, private sector is also not coming up with such methods widely, she said.

Dr Moin Uddin, director of the Directorate General of Family Planning (DGFP), endorsed the problems.

Almost 50 percent posts of 1200 family planning and welfare officers of the DGFP at the upazila levels remained vacant for over a decade, he said.

‘Also, the health personnel are not doing so well in counselling and client screening [couples for long-term and permanent methods],’ Dr Moin Uddin, who is attending the ICFP, told this correspondent on Tuesday.

The government is working on ways to accelerate family planning, especially long-term and permanent methods, he said.

The total fertility rate (TFR) has been stagnant at 2.3–each adult woman having 2.3 children–for the last four years. The TFR declined to 2.3 in 2011 from 6.3 in 1975, according to the Bangladesh Demographic Health Survey 2014.

Also, contraceptive prevalence rate is 62 percent among the married couples, and only 54 percent of them use modern contraceptives, and the rest eight percent use traditional ones.

Of the 54 percent, only 8 percent use long-term methods–injections, intrauterine devices (IUDs) and permanent methods–vasectomy and tubectomy, while the rest use temporary methods including oral pills and condoms.