Dissemination Workshop on Strengthening Family Planning through Advocacy: Learnings and Opportunities

Marie Stopes Bangladesh has been working in Bangladesh since 1988 with a mission that translates Children by Choice, not Chance. It has been providing high-quality sexual and reproductive healthcare across the country and significantly contributing to the government's goal of reducing maternal and child deaths.

As a part of its mandates, since 2016 with the technical support of Advance Family Planning, Marie Stopes Bangladesh and its partners AVAS, Serac, Shushilan, and Team Associate have been implementing a project titled "Strengthening Family Planning through Advocacy" to strengthen government's health systems and infrastructure in collaboration with the Ministry of Health and Family Welfare, Directorate General of Family Planning and civil society organizations. The project is going to end, thereby sharing the project's achievements, learnings, and future directions to achieve Bangladesh's commitments to Family Planning 2030 and the Sustainable Development Goals, Marie Stopes Bangladesh has organized an impact dissemination workshop on 10th December 2022. In the workshop, the Chief guest was Md. Saiful Hassan Badal, the honorable Secretary, of the Medical Education and Family Welfare Division; Dr. Ashrafi Ahmed, NDC, Additional Secretary, of the Medical Education, and Family Welfare Division; Abdus Salam Khan, Joint Secretary, Ministry of Health and Family Welfare;  Shahin Islam, NDC, Director General, National Institute for Mass Communication; Mervyn Christian, Advance Family Planning, Senior Program Officer; Johns Hopkins, Bloomberg School of Public Health; Dr. Nurun Nahar, Line Director, CCDDP, DGFP and Dr. Mahmudur Rahman, Director, MCH unit, DGFP  along with other respected guests. 

At the beginning of the dissemination, Ms. Monjun Nahar, the Lead Advocacy, shared that Advance Family Planning (AFP) in collaboration with civil society organizations, family planning experts, and the Government of Bangladesh, worked together to achieve critical success using the SMART advocacy approach. They i) secured local funding for family planning; ii) expanded access to quality contraceptive services; iii) strengthened Bangladesh's commitment to accountability; iv) improved the visibility of family planning through media; and v) galvanized civil society as a powerhouse.

Mr. Kishwar Imdad, Country Director, Marie Stopes Bangladesh expressed his gratefulness to all the respected guests. He said that Marie Stopes Bangladesh has been working since 1988 in Bangladesh to promote women's health and to ensure women's choices and rights. He thanked the Advance Family Planning, Johns Hopkins University for their support to Marie Stopes Bangladesh. Also, thanked the government officials for their cooperation. He said that MSB is committed to promoting gender equality by promoting women's and girls' choices and rights on their reproductive health issues.

Md. Saiful Hasan Badal, the Secretary of the Medical Education and Family Welfare Division, remarked that in Bangladesh, family planning has been one of the top priorities in the 4th Health Sector Programme as a path toward achieving the Sustainable Development Goals. He said that the Ministry has strengthened its efforts to increase trained service providers, including deploying midwives to all sub-district hospitals; improving supervision of family planning services by placing clinical teams in all districts; and engaging the private sector for addressing gaps in service provision and supply of commodities.

Additional Secretary, of Medical Education and Family Welfare Division, MOHFW, Dr. Ashrafi Ahmed, NDC said that the AFP project contributed to creating scope to work jointly in a platform with GO/NGO/civil society for promoting the health rights of women. The project has demonstrated that organized collaboration of multi-sectoral groups, leveraging the knowledge and skills of advocates, and an effective advocacy strategy, can contribute significantly to strengthening accountability.

Shahin Islam NDC, DG of the National Institute of Mass Communication mentioned that three issues are important for women empowerment- intellectual, mental, and physical strength. And to increase the physical strength of women, they need to take FP services. Therefore, it is important to increase access and availability of quality family planning services which AFP, MSB is doing.

Abdus Salam Khan, Joint Secretary, MOHFW said that they are working to reduce unmet needs, and dropout rates, and ensure institutional delivery. Model Union Health and Family Welfare centers provide 24/7 maternal care including institutional childbirth. The initiative is also helping to promote post-partum family planning. One of the priorities is for private-public partnerships to cover all the reproductive-aged people, especially women and girls of the country.

The initiative of the project to involve Private Medical College and Hospitals unlocked a new arena by opening FP corners for increasing FP access and gradually other medical colleges will replicate it--Iffat Ara

Our Medical colleges and hospitals are willingly taking the challenge of setting up FP corners and successfully providing FP services. Prof. Dr. Sehereen F. Siddiqua, Head of Gynecology and Obstetrics and Laparoscopic Surgeon, Anwar Khan Modern Cardiac Hospital, hopes that other private medical colleges could take the supplementary role.

We know how to manage and secure local budgets for FP services from the UP. - Advocate Shahneyaj Mili, a District Advocacy working member.

MSB has contributed to changing some policies and procedures like approval of tubal hook, uterine elevators, laparoscopic approach, local anesthetic, infection-prevention guidelines for IUD, etc.  Besides, an initiative for the development of an FP strategy for hard-to-reach areas will create more access to contraceptives where people lack access to services. -Dr. Nurun Nahar, Line Director, CCSDP, DGFP

Dr. Prof. Ainoon Naher, Jahangir Nagar University says he has found the approach for advocacy is unique to influence decision makers as it is evidence and solution based. He hopes the social advocate will be benefited by using the SMART advocacy too.

Mervyn Christian, Senior Program Officer at Johns Hopkins Bloomberg School of Public Health, Baltimore said that AFP's achievements on policy and programmatic advances to improve the quality of care and expanding the availability of family planning services in hard-to-reach areas are evidence of AFP's strong partnership with government and civil society and the government's commitment to ensure quality family planning services for all. He thanked the government officials, and civil society organizations for their support of the project.

Quazi Mohiul Islam, Former DG, DGFP said that family planning is one of the pre-conditions to reduce maternal death and is key to leading a healthy life. It is not about only contraception, rather it is a lifestyle.

From the learning of the advocates and experts, the project gave some critical Recommendations to take further actions

• Prioritize family planning issues within health and development with a focus on Bangladesh's FP2030 and SDG 2030 goals.
• Implement geographically targeted service packages (including behavior change communications campaigns and contraceptive delivery) for low-performing upazilas within low-performing regions, chars, and coastal areas.
• Expand task-sharing initiatives by involving nurses to mitigate the shortage of skilled human resources to provide family planning services.
• Strengthen partnerships, especially with the private sector, that can help the public sector to reach the current demand for quality family planning services.
• Strengthen the monitoring system and improve the coordination between national and subnational family planning departments.
• Increase dialogue between donors and the Government to enable a mutual understanding of priorities and possibilities.