FrontLines: Demographic and Health Surveys Helped Bangladesh Track and Reduce Rate of Population Growth

March 2004

Bangladesh today is home to 138 million people, but it could have had a much larger population if it had not adopted family planning (FP) 20 years ago.

The country, which is the size of Wisconsin, could have been home to more than 450 million people by 2050, if it had not adopted FP. As is, the Bangladeshi population will only grow to 255 million by 2050.

Demographic and Health Surveys (DHS) backed by USAID helped Bangladesh shape its policies and led the Agency to support health and education programs that promoted contraception.

The USAID-funded 1975 Bangladesh Fertility Survey found that almost 68 percent of mothers either did not want their last pregnancy or any more children. Still, only 13 percent of respondents had ever used any method of contraception.

In 1976, the Dhaka Government declared rapid population growth as the country’s number one problem and adopted an FP program that USAID supported.

Since then, the average number of children a Bangladeshi woman can expect to have over her lifetime has dropped from 6.3 to 3.3, according to DHS.

As the population growth rate fell, Bangladesh’s economy has grown slowly. Smaller families mean more resources for family members. More people can send their children to school and afford health care.

Smaller families create what is called a “virtuous circle.” Educated children grow up to have higher-paying jobs. They, in turn, have smaller families who are better provided for.

But change comes slowly. Some 45 percent of the population live below the poverty line; unemployment is high; state-owned enterprises are inefficient; and social service institutions are weak.

The decline in population growth is attributed to increased use of contraception and availability of FP. Contraceptive prevalence has grown from 8 percent of married women of reproductive age in 1975 to 54 percent in 1999. The pill is the most popular contraception method.

“When you talk to women in Bangladesh, they can tell you that family planning has changed everything,” said Margaret Neuse, director of the Office of Population/Reproductive Health. “They can do more, they can get jobs, enjoy their families. Family planning has generated a major change in women’s status in terms of education, access to credit, and employment.”

USAID helped the Ministry of Health (MOH) hire about 40,000 women health advisors in rural communities. They work at satellite clinics that the Agency helped create that offer condoms, contraceptive pills, and health care services.

In urban areas, USAID has been educating Bangladeshis about FP through ads in the mass media. In rural areas, the message is spread by the women from the MOH, who visit villages and hold workshops for mothers and girls soon to marry. Local religious leaders have also been helping educate people about the benefits of FP.

Women typically get contraceptives from health clinics. They are encouraged to make regular visits to such clinics and get frequent health checkups, especially if they are pregnant or have small children. USAID supports 278 such clinics run by local non-governmental organizations throughout the country.

Commercial sales of contraceptives and other health supplies are also improving. Condoms and pills are available at small shops. An estimated 40 percent of Bangladeshi women obtain FP through such shops, which are backed by USAID.