Reproductive health care programmes to get obstacles

The family planning programme in Bangladesh has proved to be highly successful in achieving its goals under a challenging environment

The decision of the USA as revealed by the State Department to stop funding to United Nations Population Fund might have serious implications on the family planning programs 150 developing countries round the world and Bangladesh in particular. In case of Bangladesh as we observed, UNFPA has been providing supports to popularize the small family norms, dissemination of knowledge of safe delivery, training of service providers at home and abroad, supply of contraceptives and above all, supporting policy framework in behavior change communications, management of the family planning program as a whole. It is an erroneous accusation that UNFPA is supporting coercive abortion and involuntary sterilization. 
In Bangladesh, family planning program itself is a voluntary program with cafeteria approach of contraceptives and acceptance of permanent methods depending on the informed consent. There is no scope of coercion or compulsion in such a voluntary program like one child family norm as practiced in China earlier. All political governments since independence were in favor of family planning program in Bangladesh and faith based societies including Imam training institutes also supported the small norm family and safety of mother and child. 
The menstrual regulation or medical termination of pregnancy is an accepted norm practiced in limited case that might not be construed as abortion with coercion or undue influence.  It was felt sometimes necessary for safety of mother to ensure preventable deaths and disabilities. 
In fact this decision cut off budget is being criticized as anti women policy as observed by Ms..Serra Sippel, President of the Center for Health and Gender Equity: According to her, “Today’s action shines a light on Trump’s anti-woman agenda. She said this cut “jeopardizes the health and rights of millions of women and girls around the world”. Trump is relentless in his crusade against the health and rights of women and girls globally,
The sudden budget cuts by exercising the policy of “global gag” might not be supported by people at large especially in this population sector where USA is the fourth largest donor to UNFPA contributing about US$ 75 Million to the core budget and other specified of program efforts in 2015. The UN Population Fund will lose $32.5 million in funding from the 2017 budget as the State Department said, with funds shifted to similar programs at the US Agency for International Development. 
The administration accused this agency that through its work with China's government, of supporting population control programs in China that include coercive abortion. UNFPA itself refuted this claim of coercion, as all of its work promotes the human rights of individuals and couples to make their own decisions, free of coercion or discrimination. 
This sudden strike might trigger more social instability and create a serious bottleneck in achieving the targets of goal -3 of SDG 2030, to “ensure healthy lives and promote well-being for all at all ages” and also to reduce the global maternal and neo-natal mortality in particular as targeted. This decision might act as deterrent to achieve the goal of “Universal Health Care” and “Health for all”. Thus this cut provoked a storm of outrage and anger with activists attacking what they call Trump’s “anti-women agenda”.
Some agencies supporting family planning programs like International Planned Parenthood Federation and other international and national non-government organizations contributing much for demographic transition including Family Planning Association of Bangladesh will be adversely affected to continue their programs in future. In fact, this decision might affect the NGO-Health Services Delivery Project ( Smiling Sun initiative)  being implemented by the Pathfinder Fund International with the financial support of the Office of Population, Health, Nutrition and Education of USAID located in Dhaka. 
Family Planning Program in Bangladesh has proved to be a model in achieving its successes under challenging environment. The total fertility rate has reduced 2.3 per women (BDHS-2014) that reached almost near to the replacement level of fertility, maternal mortality reduced to 176 in hundred thousand (WHO) and contraceptive prevalence rate reached  to 62.4% (BDHS-2014) percent with the increase of life expectancy at birth to almost 71.years in general. 
The under -5 mortality rate has been reduced to 46 per thousand whereas neo-natal mortality also reduced 28 per thousand. The present Prime Minister received awards for such successes. The achievement of these demographic indicators was possible due to the support of the UNFPA to the initiatives of the Bangladesh in particular in a massive way during 1980 and 1990s and implementation of decisions of ICPD-1994 held in Cairo and follow –up. 
Bangladesh Government has formulated National Population Policy where UNFPA, WHO, USAID, DFID, SIDA, World Bank etc have contributed much to make it more implementable and Bangladesh made remarkable successes to achieve the targets of MDGs. UNFPA especially supported the Maternal and Child Welfare Centers of government (more than 100) throughout the country and furnished those centers  with diagnostic equipment that contributed much in reducing maternal, child and neo -natal mortality and providing services of pre- natal post natal care. In addition UNFPA arranged to provide ambulance for risk management almost in all centers related to mother and child care of the government. 
 UNFPA provided technical supports to Unban Primary Health Care Services Delivery Project being implemented by Local Government Division with support of Asian Development Bank, Swedish Embassy by extending support to about 134 Comprehensive Reproductive Health Centre’s and Primary Health Care Centers.  It also helped  to  create  training opportunities to their physicians and other services providers. The list is long where UNFPA supported the health and family planning program in Bangladesh.
 We agree to the views of the UNFPA that this organization worked “to ensure that every pregnancy is wanted, every child birth is safe and every young person’s potential is fulfilled”.
 In fact, such a decision to cut off support to reproductive  health care programs was also earlier taken before by Republicans that hampered the total reproductive health care services round the world adversely quite for a long time. Donald Trump after being President has changed the decision. This decision of cutting off the population fund might also affect the third world population programs that could promote unchecked population growth leading to social disorder and poverty. 

The writer is a former secretary to the Government 

Reproductive health care programmes to get obstacles

The family planning programme in Bangladesh has proved to be highly successful in achieving its goals under a challenging environment

The decision of the USA as revealed by the State Department to stop funding to United Nations Population Fund might have serious implications on the family planning programs 150 developing countries round the world and Bangladesh in particular. In case of Bangladesh as we observed, UNFPA has been providing supports to popularize the small family norms, dissemination of knowledge of safe delivery, training of service providers at home and abroad, supply of contraceptives and above all, supporting policy framework in behavior change communications, management of the family planning program as a whole. It is an erroneous accusation that UNFPA is supporting coercive abortion and involuntary sterilization. In Bangladesh, family planning program itself is a voluntary program with cafeteria approach of contraceptives and acceptance of permanent methods depending on the informed consent. There is no scope of coercion or compulsion in such a voluntary program like one child family norm as practiced in China earlier. All political governments since independence were in favor of family planning program in Bangladesh and faith based societies including Imam training institutes also supported the small norm family and safety of mother and child. The menstrual regulation or medical termination of pregnancy is an accepted norm practiced in limited case that might not be construed as abortion with coercion or undue influence. It was felt sometimes necessary for safety of mother to ensure preventable deaths and disabilities. In fact this decision cut off budget is being criticized as anti women policy as observed by Ms..Serra Sippel, President of the Center for Health and Gender Equity: According to her, Todays action shines a light on Trumps anti-woman agenda. She said this cut jeopardizes the health and rights of millions of women and girls around the world. Trump is relentless in his crusade against the health and rights of women and girls globally, The sudden budget cuts by exercising the policy of global gag might not be supported by people at large especially in this population sector where USA is the fourth largest donor to UNFPA contributing about US$ 75 Million to the core budget and other specified of program efforts in 2015. The UN Population Fund will lose $32.5 million in funding from the 2017 budget as the State Department said, with funds shifted to similar programs at the US Agency for International Development. The administration accused this agency that through its work with Chinas government, of supporting population control programs in China that include coercive abortion. UNFPA itself refuted this claim of coercion, as all of its work promotes the human rights of individuals and couples to make their own decisions, free of coercion or discrimination. This sudden strike might trigger more social instability and create a serious bottleneck in achieving the targets of goal -3 of SDG 2030, to ensure healthy lives and promote well-being for all at all ages and also to reduce the global maternal and neo-natal mortality in particular as targeted. This decision might act as deterrent to achieve the goal of Universal Health Care and Health for all. Thus this cut provoked a storm of outrage and anger with activists attacking what they call Trumps anti-women agenda. Some agencies supporting family planning programs like International Planned Parenthood Federation and other international and national non-government organizations contributing much for demographic transition including Family Planning Association of Bangladesh will be adversely affected to continue their programs in future. In fact, this decision might affect the NGO-Health Services Delivery Project ( Smiling Sun initiative) being implemented by the Pathfinder Fund International with the financial support of the Office of Population, Health, Nutrition and Education of USAID located in Dhaka. Family Planning Program in Bangladesh has proved to be a model in achieving its successes under challenging environment. The total fertility rate has reduced 2.3 per women (BDHS-2014) that reached almost near to the replacement level of fertility, maternal mortality reduced to 176 in hundred thousand (WHO) and contraceptive prevalence rate reached to 62.4% (BDHS-2014) percent with the increase of life expectancy at birth to almost 71.years in general. The under -5 mortality rate has been reduced to 46 per thousand whereas neo-natal mortality also reduced 28 per thousand. The present Prime Minister received awards for such successes. The achievement of these demographic indicators was possible due to the support of the UNFPA to the initiatives of the Bangladesh in particular in a massive way during 1980 and 1990s and implementation of decisions of ICPD-1994 held in Cairo and follow up. Bangladesh Government has formulated National Population Policy where UNFPA, WHO, USAID, DFID, SIDA, World Bank etc have contributed much to make it more implementable and Bangladesh made remarkable successes to achieve the targets of MDGs. UNFPA especially supported the Maternal and Child Welfare Centers of government (more than 100) throughout the country and furnished those centers with diagnostic equipment that contributed much in reducing maternal, child and neo -natal mortality and providing services of pre- natal post natal care. In addition UNFPA arranged to provide ambulance for risk management almost in all centers related to mother and child care of the government. UNFPA provided technical supports to Unban Primary Health Care Services Delivery Project being implemented by Local Government Division with support of Asian Development Bank, Swedish Embassy by extending support to about 134 Comprehensive Reproductive Health Centres and Primary Health Care Centers. It also helped to create training opportunities to their physicians and other services providers. The list is long where UNFPA supported the health and family planning program in Bangladesh. We agree to the views of the UNFPA that this organization worked to ensure that every pregnancy is wanted, every child birth is safe and every young persons potential is fulfilled. In fact, such a decision to cut off support to reproductive health care programs was also earlier taken before by Republicans that hampered the total reproductive health care services round the world adversely quite for a long time. Donald Trump after being President has changed the decision. This decision of cutting off the population fund might also affect the third world population programs that could promote unchecked population growth leading to social disorder and poverty. The writer is a former secretaryto the Government