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Sabina Parveen, director of the DGFP’s MIS and Planning Unit, said procurement was previously handled under the development budget instead of the revenue budget, creating complications after the transition following the Fourth Sector Programme.

She said Bangladesh maintained a “zero stock-out” status between 2015 and 2020, but the situation worsened during the pandemic and further declined due to reduced foreign assistance.

Mohammed Abul Kalam, director of the DGFP Logistics and Supply Unit, said shortages of condoms and oral contraceptive pills began in June 2023 at regional warehouses and upazila stores.

“We did not receive the necessary support from the then ministry for emergency procurement through the revenue budget, which ultimately resulted in the nationwide total stock-out in January 2024,” he said.

Dr Nasir Ahmed, director of Maternal and Child Health Services, blamed earlier policy decisions, saying the then secretary had suspended procurement after identifying irregularities during an inspection.

“Subsequently, negligence during the transition period surrounding the July uprising and prolonged delays in decision-making meant no field-level procurement could be operationalised. Once the system is empty, it cannot be restored overnight,” he said.

Dr Mohammad Manjur Hossain, assistant director (Maternal and Child Health Unit) at the DGFP, said that even if contraceptive supplies arrive within the next two to three months, their limited manpower would make distribution difficult at the grassroots level.

“Although our records show a workforce of 54,286, more than 50 percent of frontline posts are currently vacant, particularly Family Welfare Visitors,” he said.

He added that the decline in permanent contraceptive methods, including tubectomy and vasectomy, was linked to the retirement of experienced doctors recruited in 1991, while newer recruits had not received adequate training.

Prof Mohammad Mainul Islam, dean of the Faculty of Social Sciences at Dhaka University, warned that the combined rise in fertility rate and shortages in family planning commodities could undermine Bangladesh’s demographic dividend.

“Since independence, the total fertility rate has never increased in this way,” he said. “Research suggests that more than half of the Sustainable Development Goals may remain unattainable by 2030 if the current rates of child marriage and unintended pregnancy continue.”

Dr Zahirul Islam, health adviser at Swedish International Development Cooperation Agency, said policy failures and administrative delays under the previous interim administration had severely disrupted the primary healthcare system. “For almost a year, the health system had virtually collapsed.”

Dr Abu Sayed Mohammad Hasan, SRHR specialist at UNFPA Bangladesh, called for urgent reforms in procurement.

“An annual contraceptive procurement budget of Tk 517 crore is not an unmanageable amount for the government. The process must be shortened, immediate action must be taken, and there is no longer any scope for silence,” he said.

Dr SM Ziauddin Hyder, special assistant to prime minister, said the government plans a major shift in the healthcare system.

He said the country would move away from a treatment-centred and product-driven model towards a preventive and promotive healthcare system, supported by the recruitment of 1,00,000 grassroots health workers.

Under the proposed model, a health worker would visit every household in the country once every two months, delivering a comprehensive package of preventive and promotive healthcare.

Dr Hyder added that procurement obstacles had now been resolved and supplies were expected to arrive shortly, though improving health outcomes would require addressing broader social factors such as child marriage and high fertility in marginalised communities.

Kamal Ahmed, acting editor of The Daily Star; Rahat Ara Nur, programme director, IPAS Bangladesh; Dr Nurul Islam Khan, programme officer, WHO; and Barrister Sara Hossain also spoke, among others.

The event was moderated by Tanjim Ferdous, head of strategic partnership at The Daily Star.