Why is contraceptive access no longer a national priority?

The use of contraceptives was first promoted in Bangladesh (then East Pakistan) in the 1950s. By the 1960s, it had been incorporated into government family planning programmes aimed at curbing rapid population growth and reducing maternal mortality. Over the past six and a half decades, Bangladesh has made remarkable progress: the fertility rate has dropped to less than a third of what it was, accompanied by a significant decline in maternal mortality.

However, in recent years, that progress has begun to stall. A severe nationwide shortage of contraceptives is now exacerbating the situation, coinciding with a worrying rise in HIV infections and related deaths. According to a report in this daily, HIV infections in Bangladesh have increased steadily, in contrast to a global declining trend. Between 2000 and 2024, recorded HIV cases increased by more than 45 percent. Some 882 new cases have been detected by June this year. The report suggested that the alarming rise in recent cases is partly attributed to the disrupted supply of condoms, needles, and syringes to vulnerable populations, including drug users, sex workers, and transgender individuals, driven by insufficient funding.

The Daily Star's report "Contraceptive crisis grips health centres," published on October 20, 2025, mentions a collapse in distribution of contraceptives based on supply chain data: between July 2024 and 2025 free condom distribution plummeted from 72.7 lakh to 35.6 lakh and oral contraceptive pills dropped from 48.6 lakh in May 2024 to a mere 12.2 lakh in July 2025, leaving many upazilas completely out of stock. Supplies of intrauterine devices (IUDs), implants, and crucial iron-folic acid tablets for pregnant women and adolescent girls who suffer from anemia have also dwindled significantly or ceased entirely.

According to officials of the family planning department, the shortage started in mid-2024 after the cancellation of a procurement project last year and the failure of the interim government to allocate necessary funding for a subsequent two-year procurement project submitted in 2024.

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Many health workers and experts are deeply concerned, warning that this shortage will impact both the population growth and economy of the country. Unexpected pregnancies, abortions, and maternal health problems have economic consequences. Besides, a rise in birth rate will put pressure in the country's capacity to ensure food, housing, education, healthcare, and jobs for its population, given our limited resources. It also has environmental and social consequences.

While reporting on the contraceptive crisis, I have visited remote areas in several districts, particularly the hard-to-reach chars of the Jamuna and Brahmaputra rivers. In these remote areas, it is women who primarily avail contraceptives from health centres, as men often remain indifferent. In fact, a Samakal report, citing the Bangladesh Demographic and Health Survey 2022-23 (BDHS), stated that 91 percent of contraceptive users are women, with only nine percent being men. This shows that, men unjustly and implicitly place the burden of family planning on their female partner. Therefore, when the free service stops, the less affluent and less aware families are undoubtedly at higher risk of unintended pregnancies.

The situation is worsened by a significant rise in the price of birth control related products in the private market, as reported in several media. Therefore, residents of these chars, who are mostly underprivileged, cannot even afford to buy contraceptives from the market. Besides, the women of these char areas told me that they felt discouraged about family planning as their male partners were very reluctant to engage in this matter.

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Meanwhile, health workers in remote community clinics informed that following the disruption of contraceptive supplies and the complete halt of iron-folic acid tablets, fewer adolescents and women were visiting the clinics. This break of contact severely hampers efforts to provide vital maternal health services and create awareness—which, they believe, will negatively impact the overall maternal health care services and population trends.

As a journalist covering remote areas for years, particularly the char areas of northern Bangladesh, I have witnessed that women face significant barriers in relation to maternal and reproductive health care issues. Their male partners are often uninterested in taking them to the doctor in town, even when severely ill, as travelling from a remote char to an upazila or district town for treatment is costly and difficult. Every char I visited in the last nine years has a high incidence of child birth and maternal mortality compared to urban areas.

Bangladesh has achieved a remarkable feat in family planning, moving from just eight percent of families using contraceptive methods in 1975 to a high of 64 percent in 2022. This success saw the average number of children born to a woman drop dramatically from six at the time of independence to only two today. This achievement was the result of concerted efforts by government initiatives, extensive public awareness campaigns, and the dedicated work of NGOs. However, the recent severe and countrywide shortage of contraceptives threatens to reverse decades of progress in population control and public health.

Now, the core question remains: how could we allow such a crisis of birth control or contraceptives to happen in a densely populated country like Bangladesh? Why are there no contingent plans to avert the crisis? Furthermore, why is the government no longer prioritising birth control as a matter of national importance? The government cannot abruptly, and without any prior warning, trim the free contraceptive services it has provided to marginalised communities for years. There is no evidence that the government is even considering a way to mitigate the enormous health risk that has been created.

The bottom line is that the government should swiftly restore normal contraceptive supplies and treat this matter as a national priority. It should also commission an independent survey on the contraceptive crisis of the past year to determine the extent of the increase in unintended pregnancies, abortions, and maternal mortality. The research findings can then guide the next government to ensure such a crisis never happens again.

Globally, every populous country considers contraception as a national imperative, not just for population control or economic development, but as a life-saving strategy and a legitimate medical procedure. Bangladesh should be no different.

Mostafa Shabuj is a journalist at The Daily Star. He can be reached at mostafashabujstar@gmail.com.

Views expressed in this article are the author's own.

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