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Family Planning Needs More Practical Approach

by Kazi M Sakhawatullah
If the Government sincerely wishes to contain population boom, it may like to consider changes in the application method, by keeping the population programme in place.
Anew landmark is said to have been reached in the country's family planning drive through sales of one billion condoms and 43 million pills. On the basis of these figures of distributed contraceptives II is claimed that the country's rate of birth has come down from 3.4% in 1975 to under 2.2% tn 1991. It is also claimed on behalf of the Social Marketing Company (SMC) that in 1975 only 7% of married couples practiced family planning but today 40% do the same. The moot question remains to be answered as to how much of this enormous quantities has gone to the use of married couples and how much gone into possession of unmarried youths and teenagers, and how much is wasted as toy balloons •old to rural children? According to SMC chairman, they have "no access to people’s bedrooms' or any other means to know the actual acceptability and use by those for whom contraceptives are meant. Is not then the conclusion hypothetical and the satisfaction deceptive and self-contradictory? (The Daily Star 25 1-92).
It Is also claimed tliat when mobile promotional teams go to villages large number of people including women come out to hear them- and watch
the videos and slide shows. Can SMC say how many of these are married couples interested In planned parent hood and how many are unmarried youths, 'teenagers and children interested in the video entertainment? SMC chairman also admitted that there are complaints from educated people about ruination of nation's youths as well as widespread misuse. Il is fact that contraceptives are freely available at stationery and gro eery shops and there Is no restriction on sales to any class of buyers or users. I have seen Innocent and ignorant elders to buy condoms and distribute to children as toy balloon gifts. For lack of knowledge they don't know that these art-useful items for them. Docs t Ik-concerned authorities know or can deny this? Are not the quantities gone into the possession of unmarried persons and the quantities sold as toy gifts misused and wasted? Have such figures been excluded from the figures counted for the achievements? Is keeping open the facility for free access to contraceptives by those for whom these arc not meant not an open door policy to their moral degrada tlon? SMC chairman also admitted the resistance to contraception. He deserves thanks for admitting facts Tlwre Is
more than that. In fact there is widespread objection to the family planning programme Itself from sections of both educated and uneducated sensible rural people. Indu ding Ulemas, only because of unbridled propaganda and unrestricted distribution of contraceptives. A video cassette containing forceful speech and strong condemnation of the method Is very popular in the rural areas. Fertile married couples only are supposed to be the programme's target and a< 11 vtlies thereof should have been kept limited to tills section of the population Instead, the entire society. Irrespective of its married or unmarried sections.’ has become the target of this Injudicious policy.
There are three partners tn the Family Planning Project: the Government. the donor and the SMC. the latter being the real beneficiary. As marketing agency of the manufacturers of contraceptives SMCs primary and
foremost interest is unrestricted distribution, more sale and Increased importation for commercial gain, reduced birth rate may be of secondary interest. But those concerned with the population problem may wish to go deep into the Issue. Assumed achievement calculated on the basts of arithmetic figures may impress the layman. Sincere, serious and sensible social thinkers may be wiser to have close scanning look into the scenario. I behevc the donors also are not quite convinced about the effectiveness of the existing method. Five years back in 1987. in course of a study discussion with the USAID Population & Health Unit Chief Ms. Sheron Epstein I learned that they were thinking of change in the contraceptive distribution system — only through the Family Planntpg and Health workers . direct to the interested married couple, which Implied their realisation of the folly in the unrestricted distribution. What happened to the Idea
later I have no ns-ans <■> know. To me that would be right method.
If the Government sincerely wishes to contain population boom. Il may like to consider changes in the application method, by keeping the population programme in place, on the following suggested lines:
(1) Discontinue unrestricted distribution and sales of contraceptives and propa ganda thereof Married Health & Family Planning field work ers only will distribute contraceptives direct to the fertile interested married couples.
(2) Importation, storage, supply and distribution of all types of contraceptives bi placed at the disposal and con trol of a centralized designated authority. All other avenues be closed.
(3) Availability will be restricted lo the union family planning clinics and health centres under the custody, responsibility and control of tlic Officer-in-Charge of the respective centres. Family Planning A Health workers will draw from there.the required quantity for distribution personally to the married couples, as suggested at (I).
(4) Above steps will reduce / the Importable quantity to rhe bare requirement for the married couples only who will be
listed and registered with by the Family Planning field workers.
Misuse and wastage will thus be slopped and the savings In the donated fund accrued by reduced importation may be utilised in more aggressive educative pro grammes.
(5) Priority be given lo educate and motivate married couples. Each union or more than one unions may form a unit for the purpose and married couples only be employed for the purpose. Additional fund required for increased educative activities may be available from tile savings Indicated at (4). Donor's willing consent will be required, which can be expected provided we are convinced and can convince them.
(6) Employment of unmarried male and female persons as field workers be discontinued and existing incumbents be transferred to other Jobs.
Modifications, in the application of population programme on the suggested lines will remove the causes of dis content, resistance, opposition towards the • family planning project as a whole and as a result popular support and interest can be expected.
The writer Is retired Consultant. UNCTAD, Geneva.