Materials by Country :

Bangladesh

To assess the acceptability of Sino-implant (II) to Bangladeshi women during an initial introduction period and before nationwide scale-up, RESPOND conducted a noncomparative prospective observational study complementing a global FHI 360 study. Researchers collected information from 595 women using a structured survey to evaluate insertion complications, method acceptability, pregnancy, and adverse events at three, six, and 12 months.

Also, in Bangladesh, RESPOND supported the Mayer Hashi Project, an associate award under RESPOND, to produce evidenced-based documentation on of key activities.

Reality Check Experiences: Use of a Program Planning and Advocacy Tool for Family Planning Initiatives (Project Brief No. 22)
Reality Check is an easy-to-use tool that family planning (FP) programs can use to set realistic FP goals and plan for service expansion to meet them, as well as to generate data for advocacy purposes. Between 2010 and 2014, RESPOND conducted Reality Check activities in Bangladesh, Burkina Faso, Ghana, Kenya, Malawi, Senegal, Tajikistan, and Togo. This brief summarizes outcomes from and experiences in these countries and identifies keys to successful adoption.
Available in English (PDF, 3.2 MB)

Reaching Young Married Couples in Bangladesh: An Underserved Population for Long-Acting Methods of Contraception (Project Brief No. 18)
In Bangladesh, more than 70% of married adolescents become pregnant before their first anniversary, and the mean age at first pregnancy is 16.4. Young couples rarely use contraception before the birth of their first child. An 18-month project to provide young married couples with better information and services on family planning trained peers to be the main source of information for young men and women in the community and to serve as a link between the community and a facility. An evaluation revealed a small increase in contraceptive use and a shift to more effective methods (the intrauterine device [IUD] and hormonal implants), as well as higher levels of communication about family planning between spouses.
Available in English (PDF, 3.4 MB)

Introducing Postpartum Family Planning in Maternal Health Services in Low-Performing Areas of Bangladesh (Project Brief No. 17)
A holistic programming effort to mainstream postpartum family planning services through the public-sector health care system was implemented between June 2009 and September 2013 in 21 disadvantaged project districts in Barisal, Chittagong, and Sylhet divisions in Bangladesh. A total of 111 facilities introduced postpartum family planning services where these were previously not available. Overall, uptake of these services increased over time (particularly for tubal ligation), due both to increased demand and to greater availability at more facilities. Integrating postpartum family planning with maternal health services can contribute significantly to increasing postpartum contraceptive use.
Available in English (PDF, 3.3 MB)

Strengthening National Family Planning Information Systems through Data Quality Assessment: Lessons from Bangladesh (Project Brief No. 16)
Data quality assessment (DQA) was used in Bangladesh to strengthen the public-sector management information system (MIS). An auditing process for assessing the quality of the reported data/statistics, DQA identified duplication of LA/PM performance reporting; transcription errors and data inconsistencies; and weak record keeping and reporting of drop-out. DQA also revealed that the MIS underreported use of long-acting and permanent methods. EngenderHealth provided technical assistance to help strengthen the capacity of Directorate General of Family Planning staff to manage and report data.
Available in English (PDF, 3.4 MB)

Achieving Positive Policy Changes for Family Planning in Bangladesh (Project Brief No. 8)
While contraceptive prevalence in Bangladesh has increased nearly eight-fold over the past 30 years and the total fertility rate has fallen, policy barriers and outdated medical eligibility criteria still sometimes impede clients' access to the method of their choice—particularly long-acting and permanent methods. Using EngenderHealth's Supply-Enabling Environment-Demand (SEED) programming model, the RESPOND/Mayer Hashi project worked with the Directorate General of Family Planning to improve the policy environment around LA/PM use, through a careful, structured process that relied heavily on consultation with local partners about critical obstacles in the field. Regulations on access to tubal sterilization and to implants were loosened, clinic registration procedures were streamlined, and postpartum family planning services were introduced into private facilities.
Available in English (PDF, 3.2 MB)

Acceptability of Sino-Implant (II) in Bangladesh: Six-Month Findings from a Prospective Study (Project Brief No. 7)
Bangladeshi women's interest in hormonal implants appears to have risen in recent years. The RESPOND Project and Mayer Hashi were asked by Bangladesh's Directorate General of Family Planning to conduct an acceptability trial of one implant, Sino-implant (II), to inform the decision on whether to introduce this implant into the national family planning program. As of the midpoint of the one-year study, users of Sino-implant (II) appear to have found it acceptable, with relatively few discontinuing its use and most users reporting their general satisfaction with the method.
Available in English (PDF, 3.2 MB)

Preventing Postpartum Hemorrhage: Community-Based Distribution of Misoprostol in Tangail District, Bangladesh (Project Brief No. 2)
Deaths related to postpartum hemorrhage (PPH) present a major challenge to health systems, particularly in rural areas of Bangladesh, where infrastructure is poor and health care facilities often lack skilled staff, drugs, and equipment. Misoprostol is a proven uterotonic drug that is increasingly used in clinical and home delivery settings to prevent and manage PPH. This project brief discusses the implementation of a pilot project in the Tangail District of Bangladesh to determine the effectiveness of using government and nongovernmental field workers at the community level to distribute misoprostol tablets and ensure that women take the drug immediately postpartum. In addition to the programmatic intervention strategies, it looks at health outcomes, women's views and experiences, as well as lessons learned and recommendations for moving forward.
Available in English (PDF, 3.3 MB)

Blood, Men and Tears: Keeping IUDs in Place in Bangladesh
The intrauterine device (IUD) is an effective method of contraception, but in Bangladesh it is associated with high levels of discontinuation within the first year. Among a retrospective cohort of women who had an IUD inserted 12 months earlier, 330 women were interviewed about factors associated with discontinuation. Nearly half had discontinued use one year postinsertion. IUD discontinuation was strongly associated with side-effects (heavier periods; abdominal pain) and spousal factors (not discussing IUD with husband prior to insertion), but not with service delivery factors. Among those who discontinued, spouses were generally unsupportive and sometimes abusive, particularly when not involved in the decision to use the IUD. Culture, Health & Sexuality, Volume 11, Issue 5, June 2009, pages 543–558.
Available online in English

Acceptability of Sino-Implant (II) in Bangladesh: Final Report on a Prospective Study (Report No. 8)
Bangladeshi women's interest in hormonal implants appears to have risen in recent years. The RESPOND Project and Mayer Hashi were asked by Bangladesh's Directorate General of Family Planning to conduct an acceptability trial of one implant, Sino-implant (II), to inform the decision on whether to introduce this implant into the national family planning program. The noncomparative prospective 12-month observational study was conducted at 10 study sites in Bangladesh, among 595 women who had the device inserted in June and July 2011. Both at baseline and at the 12-month follow-up, most women were satisfied with the implant. The majority (94–97%) said their experience with the method was very or somewhat favorable. No serious adverse events or pregnancies were reported. At 12 months, two-thirds of the women reported no changes in physical or mental health that could be related to the implant use.
Available in English (PDF, 1.9 MB)

Community-Based Distribution of Misoprostol for the prevention of Postpartum Hemorrhage: Evaluation of a Pilot Intervention in Tangail District, Bangladesh
Hemorrhage is a leading cause of maternal mortality, and deaths related to postpartum hemorrhage are a major challenge in rural areas of Bangladesh, where infrastructure is poor and health facilities often lack skilled staff, drugs, and equipment. Misoprostol is a proven uterotonic drug that is increasingly used in clinical and home delivery settings to prevent and manage postpartum hemorrhage. In 2008, the Mayer Hashi/RESPOND Project implemented a pilot project in the Tangail District to determine the effectiveness of using community-level field workers to distribute misoprostol tablets and ensure that women take the drug immediately postpartum. This evaluation report discusses the implementation of the pilot project and reviews project documents and activity reports, as well as interviews and focus group discussions, to assess the effectiveness of the community-based misoprostol intervention and to provide recommendations for national scale-up.
Available in English (PDF, 2.5 MB)

A Prospective Acceptability Study on Sino-Implant (II) in Bangladesh
FHI 360 LA/PM EOP Meeting, February 13, 2013, Washington, D.C.
Available in English (PDF, 2.8 MB)

Changing Maternal Health Policy and Programs in Bangladesh: Misoprostol for Prevention of Postpartum Hemorrhage
Global Maternal Health Conference, January 15-17, 2013, Arusha, Tanzania
Available in English (PDF, 2.8 MB)

Advocacy as a Tool for Policy Change: A Success Story from Bangladesh
International Conference on Family Planning: Research and Best Practices, November 29–December 2, 2011, Dakar, Senegal
Available in English (PDF, 2.9 MB)

Increasing Male Involvement Contributes to Uptake of No-Scalpel Vasectomy in Bangladesh
International Conference on Family Planning: Research and Best Practices, November 29–December 2, 2011, Dakar, Senegal
Available in English (PDF, 2.6 MB)

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COPE, Men As Partners, and MAP are registered trademarks of EngenderHealth. SEED is a trademark of EngenderHealth.
Photo credits: M. Tuschman/EngenderHealth; A. Fiorente/EngenderHealth; C. Svingen/EngenderHealth.

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The RESPOND Project Digital Archive, Version 2.0