Bangladesh is now Asia’s fifth and the world’s eighth most populous country with an estimated population of about 147.00 million (BBS 2011). The growth rate of the population has fallen from 3% per annum at the first five year plan (1973-78) to about 1.34% p.a. in 2011 (BBS 2011). The population is expected to grow by another 40% by mid century, to 222 million, and finally stabilize around 240 million several decades after that. The rural population, currently about 73% will cease growing at around 140 million by 2025, mainly due to rural to urban migration, but the urban population will continuously grow. The urban population is currently made up of one third slums, and two-thirds non-slums, but the slums are growing at twice the rate (5% p.a.) than the overall urban growth rate (2.5% p.a.), meaning that the slums will account for a rapidly increasing proportion of urban dwellers.
Bangladesh has achieved success in family planning programs against the backdrop of low literacy rate, low status of women, low income and so on. Despite this, one must note that due to past high fertility and falling mortality rates, Bangladesh’s population has a tremendous growth potential built into its age structure. So, population continues to remain as the most pressing challenge towards development as well as one of the major causes of poverty in Bangladesh. The Government has recognized that a massive population forms an obstacle to economic development, and has developed the National Population Policy which seeks to reduce fertility to replacement level by 2015. This requires a further TFR decline of 0.5 children per couple. But even at replacement fertility, the country will be adding two million annually to the population, and many in the population field, feel that the decline needs to be greater (i.e., to TFR 1.7), projected to have substantial benefits across many sectors. It will not fall any lower, so all future population growth will be determined entirely by the fertility level.
Replacement level of fertility by 2016 at the earliest is the priority vision of the GOB. In line with this vision present TFR of 2.5 children per woman (in 2010) needs to be reduced to 2.0 children per woman to attain net Reproductive Rate (NRR) =1 by 2016. To achieve replacement level of fertility by 2016, corresponding CPR has to be increased to 74% by mid-2016 from 61.7% (in 2010). Early marriage and motherhood is very common in Bangladesh. Two in three women marry before the legal age of marriage, which is 18 and one in three women starts child bearing before age 20 (BDHS 2007). Notwithstanding the above facts, 27% of young women aged 15-19 years have given birth and another 6% are pregnant with their first child. Maternal along with neonatal mortality reduction in Bangladesh has been achieved through strong Government commitment in HPSP, HNPSP and other national policies and program implementation, notably the successful implementation of IEC/BCC interventions together with CEmOC services, CSBA training, FP service coverage, the provision of safe MR services, piloting of maternal voucher schemes, expansion of private sector services and the expansion of female education at large.
Bangladesh is on track in terms of achieving MDG targets particularly MDG 4 & 5. Neonatal mortality rate remains still high at 37 per 1000 live births (BDHS 2007), and is the only component of childhood death that is not showing satisfactory reduction. Successive BDHS in 2004, 2007 and BMMS 2010 showed an increase in antenatal care coverage with a skilled provider from 21 percent to 53.7 percent in 2010. Skilled birth attendance during pregnancy, childbirth and the post-natal period remains a critical issue. BMMS 2010 showed an increase in antenatal care coverage with a skilled provider to 53.7 percent, but only 23.4 percent made the recommended four or more visits. Due to absolute shortage of skilled manpower like midwives, nurses and doctors, great disparity exists in use of skilled birth attendants between urban (48%) and rural(24%).
To reduce TFR, MMR and IMR further, and thereby to achieve development goals, strategic and targeted interventions have been undertaken by the Directorate General of Family Planning in association with the development partners and NGOs which is reflected in the new sector programme (HPNSDP). The DGFP website realigned with the government web-portal provides latest and updated information relating to FP-MCH issues. With the critical analyses and use of FP-MCH data, the population scholars, researchers, academia, students, policy makers, media and the advocates of population and family planning can contribute to advance the family planning programme, and thereby ensure that every pregnancy is wanted and every birth is safe.