Priorities and issues of reproductive health in policies and programs in Bangladesh: a result based post ICPD analysis

Kabita R. Bhadra, Independent Researcher
Sadananda Mitra, Independent Consultant

There was serious concern of low performance of reproductive health indicators in Bangladesh including maternal mortality ratio which was almost plateau over last decades. There was no success story in other areas of reproductive health except family planning before ICPD. After the paradigm shift of ICPD-94, there were radical changes of priorities agendas of reproductive health in the policy and program level. As a result, there was substantial improvement in the arena of reproductive health in recent years. The maternal mortality ratio has been reduced sixty six percent in 2010 from 1991. There was also significant progress in the health system of the country including wider service delivery up to the doorstep at the community level, quality of care, public private partnership, demand side intervention etc. The aim of the paper is to dissect the policy documents of the country to show how the changed priority agendas, adopted in reproductive health after ICPD, accelerated the progress in this arena. This will ultimately help to achieve the MDG-5 targets by 2015. The policy issues in reproductive health also focused here that could retard some components to achieve the millennium targets. The top down policy planning in health in the country failed to capture some regional/micro level issues that will lag uniform performance of reproductive health services. As a result, a section of population will be marginalized and remain vulnerable even if national average is on the track. There needs demand driven bottom-up policy formulation in reproductive health in Bangladesh pertaining to penetrate the benefits to every corner irrespective of regions and backward communities.