Introducing medical menstrual regulation in Bangladesh: Operations research study to test feasibility of introducing & acceptability of menstrual regulation with medication in Bangladesh

Despite the increased use of family planning methods in Bangladesh, usage of menstrual regulation is also increasing. About one-third of the pregnancies are unplanned or unwanted and remained same over the past five years. Using the nationwide government health infrastructure and NGO clinics, the Government of Bangladesh is providing MR services through MVA even the lowest-level government facilities, i.e. UH&FWCs are well equipped to offer MVA. Several studies suggest that performing MVA by unskilled providers in unhygienic condition contributes more than one third post MVA complications which result in the added risk of maternal morbidity. The burden of unsafe MR and related maternal morbidity is mostly attributed to poor quality of services, poor infection control and seeking service from unskilled providers. Population Council Bangladesh, in collaboration with the DGFP of Bangladesh and Marie Stopes Bangladesh, with funding from WHO, started an operations research study to test the feasibility of introducing menstrual regulation with medication and its acceptability in Bangladesh by using mifepristone and misoprostol. It is expected that the findings from the study will be utilized to revise polices regarding the provision of MRM in the public sector. The key interventions to provide quality MRM services are: training of service provider on MRM service; orientation of Family FWVs and NGO field-workers on demand generation; and establishment of ‘Round-the-clock' call centers for emergency response. Initial finding revealed that there is huge demand of MRM services both in urban and rural areas and also the providers want to provide these services.