Introducing Emergency Contraceptive Pill in the National Family Planning Program: Bangladesh Experience

The paper demonstrates how operations research (OR) results and its strategic use could help in adopting/changing national policy on emergency contraception (EC) and shares lessons learned in introducing EC in the national family planning program to make it easily accessible to all who need it. An OR undertaken by Directorate General of Family Planning, in collaboration with FRONTIERS Program demonstrated that Bangladeshi women, who are frequently exposed to unprotected sex because of various reasons, need EC to protect themselves from unwanted pregnancies. Based on OR results and strong media support for introducing ECP, Ministry of Health and Family Welfare (MOHFW) decided to introduce it in the national FP program. During the last three years, FRONTIERS Program assisted MOHFW in developing training curriculum, building their capacity in ECP training, monitoring quality of ECP services provided and documenting the processes. Assistance was also provided in modifying management information system and using service statistics for decision-making. Over the period, 45,000 doctors, paramedics and field workers were trained including 13 percent NGO providers. Currently, 19,000 ECPs packets are used every month, which we believe significantly less than the expected level of unprotected sex. Review workshops with program managers and providers recommended further policy change to make the service delivery more users' friendly and demanded mass media campaign. The program still faces many challenges including strengthening BCC activity and educating potential users.