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Expanding Choice for Young Couples in Bangladesh

Two years ago, Sathi Akter and her husband, Saydur Rahman, were married in the Khalishakhali village of southern Bangladesh where they live. Still students at the time, the young couple decided to postpone having children so they could focus on finishing their education, which was still two years away.

With limited options, Sathi and Saydur resorted to various temporary methods of contraception, including condoms and oral contraceptives. But after some time, these methods grew expensive and cumbersome. The couple sought a solution that would save them more money and time and that would give them greater flexibility and peace of mind. The option they sought was a long-acting method of contraception, such as hormonal implants, which can last up to three years when inserted beneath the skin.

But Sathi and Saydur could not obtain the implant, because for several years the Bangladesh government only permitted couples with at least one child to use this method. Sathi and Saydur were among millions of young couples in Bangladesh who could not access implants because they had not yet given birth to their first child. Each year, 1.2 million new couples get married in Bangladesh, creating a growing demand for these services.

Life for Sathi and Saydur changed for the better in spring 2011, however, when—following years of persistent advocacy by EngenderHealth—the Bangladesh Directorate General of Family Planning reversed its policy, allowing newlywed couples and childless couples to use implants.

Sathi and Saydur seized the opportunity as soon as they learned about it from a Family Welfare Assistant in their village. In April 2011, Sathi visited the Maternal and Child Welfare Center in her upazilla to receive an implant. At last, the young couple could do away with the daily stress of temporary contraception and could relax, save money, and focus their energies on their education.

“We are finally so happy and worry-free,” Sathi said. “The implant has eased our lives tremendously. Now we can both focus on our studies.”

Through the Mayer Hashi (“Smiling Mother”) program, EngenderHealth works to expand access to long-acting and permanent methods of contraception, which are safe, cost-effective, and easy to use and which have the highest success rates (greater than 99%) among contraceptive options. The program seeks to educate young married couples about family planning services and engage the community through peer education programs. The program also works to improve maternal health care by distributing misoprostol pills throughout the community to prevent postpartum hemorrhage, a leading cause of maternal death in Bangladesh.

Today, Sathi is a role model in her neighborhood, sharing her experience and encouraging other couples to consider using implants. “I am proud that I was able to access implants,” she said. “Now I enjoy telling others what a great opportunity this is and that they should try it.”

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