The government's Family Planning Programme is in terminal decline unless serious measures are taken, said officials in the Directorate General of Family Planning, pointing to over 10,500 posts, including 185 posts at the deputy and assistant director level, which are lying vacant.
The lack of staff, the indifferent attitude of the government towards family planning, and the withdrawal of family welfare assistants from their regular door-to-door campaigning are the main reasons why the programme can no longer achieve anything like the success it did in the 1980s, said officials.
All 72 posts of deputy director, 113 of the 134 posts of assistant director, 168 of the 480 posts of upazila family planning officer and 535 of 1,055 posts of medical officer are vacant, creating significant obstacles in the running of the programme.
Though all the posts of 15 directors have been filled, the officers have been appointed on deputation from the administration and health cadres, bypassing experienced staff within the DGFP.
Moreover, since the directors are appointed on deputation, they have little motivation to do the required work.
Another significant problem is that the family welfare assistants, who used to be the driving force of the Family Planning Programme through their door-to-door counselling, are now engaged in other work.
'When the programme was designed, every FWA had to counsel 600 couples in a locality. Now the number of couples has risen to 1,800 as the population has soared, but the empty posts have not been filled,' said MM Nizamuddin, director general of the Directorate General of Health Services.
Fully 2,280 posts of FWA are now vacant, according to directorate's own documents.
Painting a dismal picture of the DGFP, Nizamuddin said that for over 30 years there has been no recruitment of FWAs at the field level and many of them have now retired, resulting in the stagnation of the programme.
'Recently we have taken some steps to recruit people at the field level. The process is going on and hopefully we can recruit nearly 800 field-level workers by the end of July,' he said.
Rashid-e-Mahbub, former president of the Bangladesh Medical Association, blamed the government for the total failure of the programme.
'The government actually has no clear vision of the programme. It has not taken any steps to ensure that the programme runs smoothly,' he said.
Another concern is that family planning workers also have to provide various other services for the government, including participation in immunisation programmes and community clinics, which hinder them from fulfilling their principal responsibilities, said family planning officials.
They said that workers employed in about 190 non-government organisations are also supposed to work alongside the government workers as part of the programme.
The NGOs, in city corporations and municipalities, mainly provide services in clinics to people for a fee, said the officials, complaining that although sometimes the NGO workers go door to door, they do not distribute contraceptive products.
Rashid-e-Mahbub criticised this approach and said it was another reason for the failure of the programme.
'It is very necessary to give the contraceptives directly to the people, especially the poor. It should not be expected that poor people have to purchase the products for planning a family because they simply cannot afford it,' he said.
The experts said the target of achieving a fertility rate of 2.2 per family by the end of 2011 is almost impossible if the family planning activities are conducted at the current speed.
Only around 57 per cent of couples are using contraceptives whereas the number of users should exceed 70 per cent to achieve the target, they said.
Professor AKM Nur un Nabi, of the Department of Population Sciences of the University of Dhaka, said that the government needs to address the family planning needs of slum-dwellers as they constitute 40 per cent of the total population of a city.
He also said the government should consider what special measures need to be taken in each division after considering its fertility rate.
'The nation is going to face a disaster if the government does not take immediate measures to improve family planning,' Nabi warned.
Source : New Age
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