Impact Brief: Bangladesh. Saving and Improving Lives through Increased Access to Contraceptives. 2014 Update

Publication date: 2015

I M PA C T B R I E F : BANGLADESH 2014 UPDATE Saving and Improving Lives through Increased Access to Contraceptives By helping women delay, space, and limit pregnancies, family planning is a cost-effective intervention that saves the lives of mothers and their children and also saves thousands of dollars in healthcare spending every year. Despite recent impressive gains in contraceptive use, 13.5 percent of married women in Bangladesh currently have an unmet need for family planning.1 In 2014, approximately 6 million Bangladeshi women wanted to avoid or delay pregnancy, but they were not using an effective method of contraception.1,2 As a result, more than 1.8 million women experienced an unintended pregnancy which can have serious consequences for mothers and children.3 In 2014 alone, out of those unintended pregnancies, an estimated— • 2,000 women died from pregnancy-related causes2,4 • 34,000 infants died in their first year of life5 • 9,800 children likely died before their fifth birthday due to below-optimal birth spacing.6 USAID Contraceptive Investment At the request of the Government of Bangladesh, the U.S. Government (USG) has provided assistance to improve the country’s health commodity supply chains and to better serve those who need family planning. From FY2009 to 2014, the USG has spent over $20.9 million to purchase more than— • 7.9 million doses of Depo-Provera® (DMPA) injectable • 37.7 million cycles of oral contraceptives • 30,500 implants (Jadelle®) • 194,000 Copper T-380A IUDs • 30 million condoms.7 27,800 1,800 $20.9MILLION From FY2009-2014 USAID invested infant deaths PREVENTED unintended pregnancies PREVENTED maternal deaths PREVENTED D EL IV ER 2 00 2 $70MILLION in direct healthcare spending SAVED 1.4MILLION in commodities   USAID Investment Impact From FY2009 to 2014, USAID-funded contraceptives had the potential to meet the needs of more than 5.6 million Bangladeshi couples.8 In the hands of women and men who need them, these contraceptives prevented approximately— • 1.4 million unintended pregnancies • 643,000 induced abortions • 27,800 infant (under the age of one) deaths • 7,200 child (under age five) deaths due to improved birth spacing • 1,800 maternal deaths. During this time, by avoiding the direct costs of unintended pregnancy and delivery care, and of treating complications from unsafe abortions, Bangladeshi families and the public health system saved an estimated U.S. $70 million in direct healthcare spending.9 Why Invest in Supply Chains? USAID has been a leader in efforts to meet the reproductive health needs of women in Bangladesh and other countries in the developing world. Improving access to modern methods of contraception is crucial to meeting these needs. As the Bangladeshi government expands its efforts to improve the health of its women and children, continued USAID investment in strengthening the national supply chain systems is essential to increasing access and reducing the unmet need for family planning. Through implementing partners, and in partnership with ministries of health and other organizations, USAID develops and strengthens reliable and sustainable public health supply chains by implementing robust logistics solutions, promoting supportive commodity security environments, procuring health commodities and building lasting local capacity, all to ensure that contraceptives make it into the hands of the women and men who need them. Table 1. Estimated Impact of USAID Contraceptive Commodity Support in Bangladesh, by Fiscal Year (FY)9 FY2009 FY2010 FY2011 FY2012 FY201310 FY2014 Totals CYP generated by commodities shipped 1,324,800 729,100 1,594,000 1,740,900 0 250,000 5,638,800 Unintended pregnancies averted 335,200 335,200 405,000 375,700 45,800 100,900 1,368,500 Unintended Live births averted 134,100 134,100 162,000 150,300 18,300 40,400 547,500 Abortions averted 157,500 157,500 190,400 176,600 21,500 47,400 643,200 Infant (U1) deaths averted 7,300 7,300 8,200 7,400 900 1,800 27,800 Child (U5) deaths averted due to improved birth spacing 1,800 1,800 2,100 2,000 200 500 7,200 Maternal deaths averted 500 500 500 500 100 100 1,800 Direct healthcare costs savings ($U.S. 2014) $ 17,106,300 $ 17,106,300 $ 20,669,100 $ 19,175,800 $ 2,336,100 $ 5,151,500 $ 69,843,000 This brief was prepared for USAID by the USAID | DELIVER PROJECT. For more details on the impact calculations, please contact askdeliver@jsi.com. 1 National Institute of Population Research and Training (NIPORT), Mitra and Associates, and ICF International. 2013. Bangladesh Demographic and Health Survey 2011. Dhaka, Bangladesh and Calverton, Maryland, USA: NIPORT, Mitra and Associates, and ICF International. http://dhsprogram.com/pubs/pdf/FR265/FR265.pdf (Accessed April 1, 2015) 2 United Nations, Department of Economic and Social Affairs, Population Division. 2013. World Population Prospects:The 2012 Revision. New York: United Nations. http://esa.un.org/wpp/ (Accessed April 1, 2015) 3 Figure calculated using conversion factor from Darroch, J. E., and S. Singh. 2011. Estimating unintended pregnancies averted by couple-years of protection (CYP). New York: Guttmacher Institute. http://www. guttmacher.org/pubs/2011/01/24/Guttmacher-CYP-Memo.pdf (Accessed April 1, 2015) 4 Country specific maternal deaths per unintended pregnancy rate applied to unintended pregnancies. See:Weinberger M, Fry K, and Hopkins K. 2015. Impact 2 v3:An innovative tool for estimating the impact of reproductive health programmes—methodology paper. London: Marie Stopes International. http://mariestopes.org/sites/default/files/Impact-2v3-Methodology-and-Assumptions.pdf (Accessed April 1, 2015) 5 U.S. Census Bureau International DataBase. http://www.census.gov/population/international/data/idb/region.php (Accessed March 1, 2015) 6 Marie Stopes International. 2015. Impact 2 (v3):An innovative tool for measuring the impact of reproductive health programmes. London: Marie Stopes International. http://www.mariestopes.org/impact-2 (Accessed April 1, 2015) 7 USAID | DELIVER PROJECT. 2014. My Commodities database from http://deliver.jsi.com/dhome/mycommodities 8 Coverage is calculated using couple-years of protection (CYP). USAID.“Couple Years of Protection (CYP)” from http://transition.usaid.gov/our_work/global_health/pop/techareas/cyp.html (Accessed March 1, 2015) 9 All figures were calculated using the Impact 2 (v3), Marie Stopes International, 2015 tool and data from the My Commodities database except for infant deaths adverted. For infant deaths averted, the figures were calculated using the Impact 2(v3) tool, My Commodities database, and the annual infant mortality rates (IMR) listed in the U.S. Census Bureau International DataBase. http://www.census. gov/population/international/data/idb/region.php (Accessed March 1, 2015) 10 No USAID-funded contraceptives were shipped in FY2013

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