Contraceptive Use In Bangladesh Research Articles

Globalization, economic and social development, and fertility decline in Bangladesh

ABSTRACT The fertility rate in Bangladesh has declined spectacularly from 6.8 in 1975 to 1.9 in 2021. This macro-level study assesses the role of globalization and a few economic and social variables on fertility rate for an extended period, 1975–2021, and separately for 1981–2021 and 1990–2021. It finds that globalization and each of its components are instrumental in declining fertility. The role of income is mostly positive. Educational attainment causes a declining fertility rate. Besides, a few estimations involving mean years of schooling (MYS) of males and females reveal an interesting fact that the MYS of males causes declining fertility, while that of females has the opposite impact. The impact of life expectancy is positive in the long run but negative in the short run. Population growth causes a rise in the fertility rate, while gender development has no consequential impact. The findings of this thorough analysis are unique as they document the impact of globalization as well as some other potential variables on the fertility rate. Previous studies have mostly concentrated on the role of family programs and the use of contraceptive use in Bangladesh.

Examining the decline in modern contraception usage among married women in Bangladesh: Applying Blinder-Oaxaca decomposition analysis.

Controlling population expansion and reducing unintended pregnancies through the use of modern contraceptives is a cost-effective strategy. In recent years, the rate of modern contraceptive use in Bangladesh has been declining. So, this study aimed to investigate the associated factors of the deterioration in modern contraceptive usage. This study used data from two successive Bangladesh Demographic and Health Surveys (2014 and 2017-18) and applied the Blinder-Oaxaca decomposition analysis to understand the drivers. A popular binary logistic regression model is fitted to determine the factors that influence the use of modern contraceptive methods over the years. This study revealed that highly educated women were more likely to use modern contraception methods, and their use increased by 3 percent over the years. Factors such as women's working status, husband's education, number of living children, and fertility preference were found significantly associated with decreased usage of modern contraception methods over years. The result of the Blinder-Oaxaca (BO) decomposition analysis found a significant decrease between 2014 and 2018. Respondent's age, working status, husband's age, opinion on decision making, region, and media exposure were the most significant contributors to explaining the shift between 2014 and 2018. The two factors that contributed most to narrowing the difference between the two surveys were women's decision on own health (26%), and employment status (35%). The factors that influence modern contraceptive prevalence are important to know for policy implication purposes in Bangladesh. The findings indicate the need for further improvement of factors for balancing the usage of modern contraception methods.

Women's Sexual Empowerment and Its Relationship to Contraceptive Use in Bangladesh: Findings From a Recent National Survey.

Objectives: This study aimed to assess the relationship between women's sexual empowerment and contraceptive use among married Bangladeshi women from a nationally representative sample. Methods: Secondary data analysis was conducted using the Bangladesh Demographic and Health Survey (BDHS) 2017-18. The investigation covered a total of 14,515 married, non-pregnant women who were residing with their spouses. Multivariable logistic regression analysis was fitted to assess the relationship between the variables of interest. Results: A unit increase in the sexual empowerment scale increases the odds of contraceptive use by 13%. While increasing age, being Muslim, having a spouse who is older by more than 10years, and living in rural areas are associated with lower odds of using contraceptives than their respective counterparts, secondary or higher levels of education, having more living children, exposure to TV or radio, and employment are associated with higher odds of using contraceptives. Conclusion: The study's findings point to the need for addressing women's perceptions of their right to sexual and reproductive health and equity in order to further efforts to achieve universal access to reproductive health services.

Assessment of Contraceptive Usage Patterns and Associated Factors among Women in Bangladesh: A Hospital-Based Observational Study

Background: The use of contraceptives is crucial in managing family size, improving maternal health, and enhancing socio-economic development. Despite progress in promoting contraceptive use, challenges persist in countries like Bangladesh, where socio-cultural dynamics can affect the uptake and usage patterns. This study aimed to assess contraceptive usage patterns and associated factors among women attending a hospital in Bangladesh. Material & Methods: This prospective observational study was conducted at the Outpatient Department of Obstetrics and Gynecology, Holy Family Red Crescent Medical College Hospital, Dhaka, Bangladesh, from January 2021 to December 2022. The study included 150 women of reproductive age (18-45 years) who visited the hospital for gynecological problems or regular check-ups. Data was collected through structured interviews using validated questionnaires assessing knowledge and usage of contraceptive methods. Descriptive statistics and Chi-square tests were used for data analysis. Results: Among the participants, 66.00% reported regular contraceptive use, 10.67% reported irregular usage, and 23.33% stated they were not using contraception. Oral contraceptive pills were the most common method (43.48%). There was a significant association between contraceptive usage patterns and education level, age group, marital status, and number of children. In contrast, residence did not significantly associate with contraceptive practice. Conclusion: Despite high awareness levels, there exists a gap between knowledge and consistent contraceptive use. Education level, age, marital status, and number of children significantly influence contraceptive usage patterns. This study highlights the importance of integrating these socio-demographic factors in the planning and implementation of family planning policies to promote effective contraceptive use in Bangladesh. Future research should investigate the reasons behind irregular or non-use of contraceptives among informed women and devise strategies to bridge the knowledge-practice gap.

Availability and readiness of healthcare facilities and their effects on long-acting modern contraceptive use in Bangladesh: analysis of linked data

AimIncreasing access to long-acting modern contraceptives (LMAC) is one of the key factors in preventing unintended pregnancy and protecting women’s health rights. However, the availability and accessibility of health facilities and their impacts on LAMC utilisation (implant, intrauterine devices, sterilisation) in low- and middle-income countries is an understudied topic. This study aimed to examine the association between the availability and readiness of health facilities and the use of LAMC in Bangladesh.MethodsIn this survey study, we linked the 2017/18 Bangladesh Demographic and Health Survey data with the 2017 Bangladesh Health Facility Survey data using the administrative-boundary linkage method. Mixed-effect multilevel logistic regressions were conducted. The sample comprised 10,938 married women of 15–49 years age range who were fertile but did not desire a child within 2 years of the date of survey. The outcome variable was the current use of LAMC (yes, no), and the explanatory variables were health facility-, individual-, household- and community-level factors.ResultsNearly 34% of participants used LAMCs with significant variations across areas in Bangladesh. The average scores of the health facility management and health facility infrastructure were 0.79 and 0.83, respectively. Of the facilities where LAMCs were available, 69% of them were functional and ready to provide LAMCs to the respondents. The increase in scores for the management (adjusted odds ratio (aOR), 1.59; 95% CI, 1.21–2.42) and infrastructure (aOR, 1.44; 95% CI, 1.01–1.69) of health facilities was positively associated with the overall uptake of LAMC. For per unit increase in the availability and readiness scores to provide LAMC at the nearest health facilities, the aORs for women to report using LAMC were 2.16 (95% CI, 1.18–3.21) and 1.74 (95% CI, 1.15–3.20), respectively. A nearly 27% decline in the likelihood of LAMC uptake was observed for every kilometre increase in the average regional-level distance between women’s homes and the nearest health facilities.ConclusionThe proximity of health facilities and their improved management, infrastructure, and readiness to provide LAMCs to women significantly increase their uptake. Policies and programs should prioritise improving health facility readiness to increase LAMC uptake.

Influence of the preference for sons on contraceptive use in Bangladesh: A multivariate analysis

The preference for sons has been documented not only in Bangladesh but also in many Asian and African countries across various religions and social strata. This paper examines the levels, trends, and differentials in the use of contraceptives and investigates the effects of the preference for sons on contraception in Bangladesh. This research project extracted data from the last four nationally representative Bangladesh Demographic and Health Survey datasets (BDHS: 2004, 2007, 2011, and 2014) to examine the trends of preference for sons. The use of contraceptives among the respondents who had only daughters was comparatively lower than among those who had only sons due to a preference for sons. The analysis also reveals that the preference for sons was invariant with regards to various demographic and socioeconomic factors. Moreover, the analysis of religion in all four survey datasets indicates that Muslim women had stronger preferences for sons than their non-Muslim counterparts. Furthermore, the analysis showed that the preference for sons was strongest among women who had no education, did not work, and lived in rural areas.

Regional variations of contraceptive use in Bangladesh: A disaggregate analysis by place of residence.

This study advances current knowledge on contraceptive use in Bangladesh by providing new insights into the extent of regional variations in contraceptive use across rural and urban areas of Bangladesh. We examined the regional variations in contraceptive use among 15,699 currently married women ages 15–49 years using data from the 2014 Bangladesh Demographic and Health Survey (BDHS). Multivariate logistic regression models of contraceptive use were calibrated with sociodemographic attributes and cultural factors. Based on the aggregate sample (i.e., rural and urban combined), we found significant regional variations in contraceptive use across the administrative divisions in Bangladesh. Based on a disaggregate sample (i.e., rural and urban separately), we found that there were significant differences in divisional variations in contraceptive use in rural areas. In contrast, no significant variation in contraceptive use across divisions in urban areas of Bangladesh was found. More specifically, among women living in rural areas, the Rajshahi and Rangpur divisions had higher odds of contraceptive use than the Barisal division, whereas the Chittagong and Sylhet divisions had much lower odds of contraceptive use even after adjusting for selected sociodemographic attributes and cultural factors. A separate analysis of the divisional variations in usage of modern methods of contraception also revealed similar findings with only one exception. Findings of this study provide an evidence-based direction for adapting a pragmatic approach to reducing the divisional disparity of contraceptive use in rural areas of Bangladesh.

Identifying factors influencing contraceptive use in Bangladesh: evidence from BDHS 2014 data

BackgroundBirth control is the conscious control of the birth rate by methods which temporarily prevent conception by interfering with the normal process of ovulation, fertilization, and implantation. High contraceptive prevalence rate is always expected for controlling births for those countries that are experiencing high population growth rate. The factors that influence contraceptive prevalence are also important to know for policy implication purposes in Bangladesh. This study aims to explore the socio-economic, demographic and others key factors that influence the use of contraception in Bangladesh.MethodsThe contraception data are extracted from the 2014 Bangladesh Demographic and Health Survey (BDHS) data which were collected by using a two stage stratified random sampling technique that is a source of nested variability. The nested sources of variability must be incorporated in the model using random effects in order to model the actual parameter effects on contraceptive prevalence. A mixed effect logistic regression model has been implemented for the binary contraceptive data, where parameters are estimated through generalized estimating equation by assuming exchangeable correlation structure to explore and identify the factors that truly affect the use of contraception in Bangladesh.ResultsThe prevalence of contraception use by currently married 15–49 years aged women or their husbands is 62.4%. Our study finds that administrative division, place of residence, religion, number of household members, woman’s age, occupation, body mass index, breastfeeding practice, husband’s education, wish for children, living status with wife, sexual activity in past year, women amenorrheic status, abstaining status, number of children born in last five years and total children ever died were significantly associated with contraception use in Bangladesh.ConclusionsThe odds of women experiencing the outcome of interest are not independent due to the nested structure of the data. As a result, a mixed effect model is implemented for the binary variable ‘contraceptive use’ to produce true estimates for the significant determinants of contraceptive use in Bangladesh. Knowing such true estimates is important for attaining future goals including increasing contraception use from 62 to 75% by 2020 by the Bangladesh government’s Health, Population & Nutrition Sector Development Program (HPNSDP).

Developing mHealth Messages to Promote Postmenstrual Regulation Contraceptive Use in Bangladesh: Participatory Interview Study.

BackgroundAbortions are restricted in Bangladesh, but menstrual regulation is an approved alternative, defined as a procedure of regulating the menstrual cycle when menstruation is absent for a short duration. Use of contraception after menstrual regulation can reduce subsequent unintended pregnancy, but in Bangladesh, the contraceptive method mix is dominated by short-term methods, which have higher discontinuation and failure rates. Mobile phones are a channel via which menstrual regulation clients could be offered contraceptive support after leaving the clinic.ObjectiveThis study aimed to support the development of a mobile phone intervention to support postmenstrual regulation family planning use in Bangladesh. It explored what family planning information women want to receive after having a menstrual regulation procedure, whether they would like to receive this information via their mobile phone, and if so, what their preferences are for the way in which it is delivered.MethodsWe conducted participatory interviews with 24 menstrual regulation clients in Dhaka and Sylhet divisions in Bangladesh. Women were recruited from facilities in urban and peri-urban areas, which included public sector clinics supported by Ipas, an international nongovernmental organization (NGO), and NGO clinics run by Marie Stopes. Main themes covered in the interviews were factors affecting the use of contraception, what information and support women want after their menstrual regulation procedure, how respondents would prefer to receive information about contraception, and other key issues for mobile health (mHealth) interventions, such as language and privacy. As part of the in-depth interviews, women were shown and played 6 different messages about contraception on the research assistant’s phone, which they were given to operate, and were then asked to give feedback.ResultsWomen were open to both receiving messages about family planning methods on their mobile phones and talking to a counselor about family planning methods over the phone after their menstrual regulation. Women most commonly wanted information about the contraceptive method they were currently using and wanted this information to be tailored to their particular needs. Women preferred voice messages to text and liked the interactive voice message format. When asked to repeat and identify the main points of the messages, women demonstrated good understanding of the content. Women did not seem too concerned with privacy or with others reading the messages and welcomed including their husbands in speaking to a counselor.ConclusionsThis study found that menstrual regulation clients are very interested in receiving information on their phones to support family planning use and wanted more information about the method of contraception they were using. Participatory voicemail was the preferred modality.

The role of son preference on modern contraceptive use in Bangladesh

This study tries to examine the relationship between son preference and contraceptive use at different parities of women in Bangladesh. This study reveals that the sex composition of the surviving children moderately influences the women’s practices of modern contraceptive use at lower parities. The more sons a women has, she is more likely to use modern contraceptive at parity one and two. But this is not true for the women at parity three or more. At lower parities, this behavior may be primarily because women with at least one son among their living children are less likely to want more children and they are satisfied with the sex composition of their children. Among the women at parity three or more, contraceptive using rate is lower among them who have two or more son than those women who have one living son. This variation in contraceptive use at parity three or more may owe to have at least one daughter or not satisfied with the sex composition of children or lack of consciousness about family planning. Keyword: BDHS, modern contraceptive, parity, sex composition, son preference, trend.

Effect of post-menstrual regulation family-planning service quality on subsequent contraceptive use in Bangladesh

ObjectiveTo determine whether the quality of post-menstrual regulation family-planning services (post-MRFP) affected contraceptive use at 3-month follow-up. Methods915 women who received post-MRFP in 2 public and 1 NGO clinics in a district in Bangladesh were interviewed to obtain information on service quality and other characteristics. Quality was scored based on 21 items and the score divided into 3 categories: low (0–6); medium (7–11); and high (12–21). Three months after menstrual regulation, 902 of the women were interviewed at their residence or a clinic and contraceptive status was recorded. Adjusted odd ratios (aORs) for using contraception were calculated via multivariate logistic regression. ResultsContraceptive use was positively correlated with the level of service quality, with 78% use among women who received the lowest-quality care and 92% use among women who received the highest-quality care. The aOR for contraceptive use was 1.80 (95% confidence interval [CI], 1.11–2.93) among women who received moderate-quality services and 3.01 (95% CI, 1.43–6.37) among women receiving high-quality services compared with those who received poor-quality services. ConclusionGood-quality post-MRFP increases contraceptive use, at least in the short term.

Spatial variation in contraceptive use in Bangladesh: looking beyond the borders.

This article promotes a more complete understanding of social change by analyzing spatial patterns of contraceptive use in Bangladesh and the contiguous state of West Bengal in India. Multilevel analyses that control for variations in individual- and household-level correlates show an important role for cross-border influences only in those districts that share a common language across the border. The districts that are positive outliers in contraception hug the Bangladesh-West Bengal border. A map of outliers shows that the positive outliers form a contiguous band in a manner suggestive of a role for contagion.

Spatial Variation in Contraceptive Use in Bangladesh: Looking beyond the Borders

This article promotes a more complete understanding of social change by analyzing spatial patterns of contraceptive use in Bangladesh and the contiguous state of West Bengal in India. Multilevel analyses that control for variations in individual- and household-level correlates show an important role for cross-border influences only in those districts that share a common language across the border. The districts that are positive outliers in contraception hug the Bangladesh—West Bengal border. A map of outliers shows that the positive outliers form a contiguous band in a manner suggestive of a role for contagion.

The Effect of Sex Preference on Contraceptive Use in Bangladesh

The Effect of Sex Preference on Contraceptive Use in Bangladesh

Does Sex Preference Affect Contraceptive Use in Bangladesh?

Using the data derived from the three national surveys, this article attempts to find the effect of sex preference on the use of contraception. The findings showed that in the absence of sex preference, there would have been an increase in the contraceptive prevalence rate indicating that sex preference is still prevalent in Bangladesh. But this effect has been weakened with increase in contraceptive prevalence rate. Analysis of variance suggests that son preference is an important determinant of contraceptive use.

Mass media exposure and its impact on family planning in Bangladesh.

This paper analyses mass media exposure and its effect on family planning in Bangladesh using data from the Bangladesh Demographic and Health Survey (BDHS) 1993-94. The findings indicate that radio and television are two important mass media for disseminating family planning information in Bangladesh. However, access to them and exposure to family planning through them are still limited. Slightly more than 40% (42.1%) of respondents reported that they had heard family planning messages via radio, while 17.2% said television, 8.4% said poster and 5.4% said billboard. Respondent's place of residence, education, economic status, geographical region and number of living children appeared to be the most important variable determining mass media exposure to family planning. Multivariate analysis shows that both radio and TV exposure to family planning messages and ownership of a radio and TV have a significant effect on current use of family planning methods. These factors remain significant determinants of contraceptive use, even after controlling socioeconomic and demographic factors. The study reveals that both socioeconomic development policies and family planning programmes with a special emphasis on mass media, especially radio, may have a significant effect on contraceptive use in Bangladesh. The principal policy challenge is to design communications strategies that will reach the less privileged, rural and illiterate people who are by far the majority in Bangladesh.

Postpartum Contraceptive Use in Bangladesh: Understanding Users' Perspectives

Qualitative and quantitative data are used to explore postpartum contraceptive use in two populations in Bangladesh. Findings from in-depth interviews with contraceptive users illustrate that women are primarily concerned with their own and their newborn child's health and well-being in the period following childbirth. In addition, women are aware of a diminished risk of pregnancy during the period of postpartum amenorrhea. These perceptions, plus a belief that modern methods of contraception are "strong" and potentially damaging to health, mean that the majority of women are reluctant to adopt family planning methods soon after birth, despite a desire to avoid closely spaced pregnancies. Supplementation of the child's diet is also shown to be an important factor determining the timing of postpartum contraceptive initiation. The findings suggest that current policies promoting contraception to women in the immediate postpartum period are inappropriate for many Bangladeshi women.

Socioeconomic development, status of women, family planning, and fertility in Bangladesh: a district level analysis.

In this paper we examine the effects of socioeconomic development, the status of women, and family planning on fertility and the extent to which these effects vary among the nineteen districts of Bangladesh. The 1983 and 1991 Bangladesh Contraceptive Prevalence Survey data are used to examine the effects of these factors on differences in contraceptive use among currently married women aged 15-49. The proportion of currently married women aged 15-49 using contraception was 46.3 per cent in 1991, a considerable increase from 26.5 per cent in 1983. Contraceptive use rates for all the districts increased substantially over the period between 1983 and 1991 and the gap between Dhaka's rate and those of other districts was narrower in 1991 than in 1983. An analytical model composed of socioeconomic development, status of women, and family planning variables is tested using logistic regression. The logit model is used to evaluate the effects of a selected group of variables on the probability of using contraceptive methods. The analysis demonstrates clearly that socioeconomic development and women's status significantly impact the use of contraceptive methods in Bangladesh. The results also suggest that better-educated, employed women are more likely to use contraception than those who have little or no formal education and who are not employed. In 1983, rural-urban differences in contraceptive use were significant, but in 1991 area of residence was not significant, which suggests that family planning programs may have played an important role in providing contraceptive information and technology to rural areas. Our analysis also suggests that family planning programs operated more efficiently in some districts than in others, and regional differences remained important in 1991 as they were in 1983. Decomposition analysis suggests that shifts in population structure favored increased contraceptive use in Bangladesh. This analysis also indicates that change in rate is also important, contributing about 21 per cent of the overall increase in contraceptive use.

Role of government family planning workers and health centres as determinants of contraceptive use in Bangladesh

The use of contraceptives in Bangladesh has risen steadily over the last two decades. In 1975, the contraceptive prevalence rate (CPR) was 8 per cent and rose to 40 per cent in 1991. The country experienced the steepest increase in CPR between 1975 and 1985: the rates rose from 8 per cent to 25 per cent, a more than three-fold increase in only 10 years.

Poor women's participation in income-generating projects and their fertility regulation in rural Bangladesh: Evidence from a recent survey

The paper assesses the impact of poor women's participation in income-generating projects on their knowledge, attitude, and practice of family planning in rural Bangladesh. By analyzing a 1992 national level household sample survey data collected from the female recipients of collateral-free loans of three relatively large rural development agencies in Bangladesh—the present study shows that the participation in income-generating projects by poor rural women has led to an increased level of contraceptive use and to a decreased level of desire for additional children. These effects are much higher than those of the corresponding levels for Bangladesh as a whole, indicating both the additional effect of income-generating projects as well as the effects of their population education components. Implications of these findings for inducing further increase in contraceptive use in Bangladesh are discussed in the paper.