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Optimum coverage still a far cry despite rise in contraceptive use
The rate of contraceptive use has increased from a mere 8 per cent in 1975 to 54 per cent by married women in 1999-2000 in Bangladesh decreasing the total fertility rate, although a lot remain to be done tor optimum coverage, reports UNB.
Khulna Division topped the table of contraceptive users with 64 per cent prevalence while Sylhet division Is groping at the bottom with 34 per cent, says a study of Bangladesh Demographic Health Survey (BDHS).
According to the study the current contraceptive use rates in four other administrative divisions are: Dhaka 54 per cent, Chittagong 44 percent. Rajshahi 59 per cent and Barisal 59 per cent.
Contraceptive use has increased in all divisions since the 1996-1997. however, relatively more rapidly in the Sylhet division.
The trend of fertility in Bangladesh has declined almost imperceptibly from 3 4 for the period 1991-93 to 3.3 in 1994-96 and then remained constant in 1997-99. it said about the cause of yet-high population growth.
In South Asian context, however. Bangladesh showed a great success in family planning while fertility rates in Pakistan remain high and India shows a mixed picture. Family size in Bangladesh declines steadily by 3.3 per cent, said a UNFPA report.
It observed that the trend
towards smaller families had been greatly helped by the wider availability ot good-quality, sale and affordable familyplanning services, and easier access to them, especially lor women.
At present the developing countries represent 95 per cent of global population growth and it would ue almost 98 per cent over the next 30 years, the report said.
However, the level ot current contraceptive use in Bangladesh is higher in urban areas (60 per cent) than in rural areas (52 per cent) where married women in their 30s use the family-planning method, says the BDHS studs
Pill is by far the most commonly used method, having been used by over half (58 per cent) of currently married women both in urban and rural areas while injectables. condoms and periodical abstinence are the next widely used method.
Educational differentials in contraceptive use have narrowed over the time. Among women in all categories, the pill is the most widely used method, the second popular method among uneducated female is sterlisatlon while those completed secondary school most widely used condom.
More than three-quarters (78 per cent) of currently married women in Bangladesh have had experience in using family-planning methods ’Almost all
of them who had ever used a method have used a modern contraceptive: 70 per cent of currently married women have used a modern method while 30 per cent have used a traditional method. ' reveals the survey report
However. 38 per cent of married women aged 15-19 use at least a family-planning method, but most of them use modern methods, the study noted
The trend of contraceptive use is higher (67 7 pei cent) among the women aged 35-39 but the trend Is lower among younger women it said. It Is 'probably due to their desire to have more children."
The study shows that the contraceptive use varies in accordance with women's education levels. A little more than hall of married women (51 per cent) with no formal education used a method, compared with 53 per cent with either incomplete or complete primary school, and 59 per cent ol those with at least some secondary education.
About maternal health the study report showed that some 81 per cent mothers received at least one tetanus toxoid injection during pregnancy in comparison to 76 per cent in 1996-1997.
Tetanus toxoid coverage is lower for births to older mothers (age 35 and over), births in rural areas, births in Sylhet division, births to less-educated women and higher older births (birth order 6 and over). It is the highest for births to women with at least some secondary education and women in urban
areas.
It said antenatal care coverage' also marked uptrend in the recent years. In 1996-97 women received antenatal care for 31 per cent of births.
In urban-rural differential antenatal care coverage Is quite large. Some 59 per cent of the) urban births had antenatal care, compared to less than hall only 28 per cent of rural areas.
Mothers In Sylhet Division arc the least likely to receive antenatal care; mothers had one or more antenatal care visits for only 27 per cent of their most recent births in Sylhet Division, the report revealed. "Antenatal care from doctors and nurses is received most often for births to mothers who have some secondary education and for first births."
Doctors or trained nurses or midwives assist at the delivery of only 13 per cent of births in Bangladesh. The proportion ol births with medical assistance during delivery has increased since 1996-97 — from 10 per cent to 13 per cent.
Medically assisted deliveries are more common for urban births and births to highly educated mothers, as well as births to women in Khulna Division. But still most of the remaining births are assisted by Dais (traditional birth attendants) with high risk.
In South Asia. UNFPA said, one out of 35 women die due to complications during pregnancy and childbirth. Some 70.000 women die each year for unsafe abortion, almost all in developing countries.