Bangladesh

Bangladesh is one of the world's most densely populated countries. Although social norms favor early marriages and large families, the government is committed to improving women’s status as well as expanding family planning options. Over the years, Bangladesh has emerged as one of the world’s successes in terms of lowering fertility and improving living standards for women. Yet, the country is still straining from a large and growing population.

Since 1974, EngenderHealth’s work in Bangladesh has helped expand the availability, quality, and use of reproductive health care services. Our current activities focus on:

• Expanding family planning
• Preventing and treating obstetric fistula
• Promoting maternal health and preventing postpartum hemorrhage

 
Expanding Family Planning
Today, through EngenderHealth’s RESPOND Project, we work with local partners and the Bangladeshi government to revitalize family planning in Bangladesh. We focus particularly on expanding access to and use of long-acting and permanent contraception, as use of methods like the IUD and vasectomy has declined over the last two decades. Our activities include:

• Building a skilled health care workforce by training health care professionals and faculty from medical colleges and training institutions
• Improving the quality of health care services
• Strengthening the health care system through techniques such as COPE® and facilitative supervision
• Improving counseling and educational materials on family planning and reproductive health
• Encouraging and facilitating male involvement in family planning counseling
• Meeting the contraceptive needs of postpartum women by working with skilled birth attendants and community health workers
• Integrating family planning with postabortion care and fistula repair services
• Raising awareness of family planning through media campaigns and community outreach
• Targeting activities toward young married couples, urban poor, and other populations in need of services

 
Preventing and Treating Obstetric Fistula
EngenderHealth promotes efforts to prevent and treat obstetric fistula in Bangladesh through the Fistula Care Project. Our efforts include:

• Providing technical assistance to three large private hospitals: LAMB Hospital in Dinajpur, Memorial Christian Hospital in Cox's Bazar, and Kumudini Hospital in Tangail
• Upgrading instruments and equipment
• Training doctors and nurses in fistula repair and postoperative care, comprehensive case management, and counseling
• Engaging religious leaders to raise awareness of fistula prevention and repair services
• Linking fistula services with family planning and emergency obstetric care

 
Promoting Maternal Health and Preventing Postpartum Hemorrhage
Most women in Bangladesh deliver at home without skilled birth attendants, and the country has a high maternal mortality rate. The leading cause of maternal death in Bangladesh is postpartum hemorrhage.

EngenderHealth promotes practices to prevent postpartum hemorrhage at both facility- and home-based deliveries. Our staff helped establish a national task force to address postpartum hemorrhage, and this group developed guidelines for medical providers in Bangladesh on the active management of the third stage of labor, a set of practices proven to prevent postpartum hemorrhage. EngenderHealth is now supporting implementation of the new policy, enabling women throughout the country to access this essential package of care. As part of our efforts to make childbirth safer, we help to ensure birth attendants and health care professionals are skilled and that essential drugs are available—even at the community level.