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In Their Own Words: Stories from Garment Factory Workers in Bangladesh

Inside the Versatile Apparel garment factory in the bustling capital city of Dhaka, Bangladesh, hundreds of sewing machines hum under the fluorescent lights. More than 1,400 women work in this factory, part of Bangladesh’s $23 billion garment industry. Their average age is 26; most of them are married.

Fatema Begum has worked here for five years. In addition to her regular duties, she now has a special role: She is a peer educator teaching other garment workers about family planning. It is part of a pioneering program from EngenderHealth to provide family planning services onsite at garment factories.

Bangladesh’s garment industry employs some 4 million people; three-quarters of them are women. The nature of the work—often long hours on factory premises—can make accessing health services a challenge. Regular government-run health clinics, for example, have limited business hours and long waiting lines. Most factory workers cannot afford to take a whole day off just to get contraception.

EngenderHealth is filling the gap by bringing family planning information and services directly to the factory floor. Through a public-private partnership with the Bangladesh Garment Manufacturers and Exporters Association (BGMEA)—the trade body that represents garment manufacturers and exporters in the country—health clinics are being established right on the factory premises. EngenderHealth trains the providers and helps to identify and train the peer educators in participating factories.

Fatema was chosen to be a peer educator because she has the trust and respect of her colleagues. Her own history gives her a keen understanding of how contraception—or the lack of it—can affect a woman’s life. She got married when she was 10, and had her first child, a son, at age 13. Six years later, she gave birth to a daughter. Now 29, Fatema has no desire to be pregnant again. “Two children are enough,” she laughs.

Some of the female employees at Versatile Apparel were hesitant at first about discussing family planning in the workplace, especially in front of men. At the initial family planning orientation seminar, several young women were so embarrassed that they stood up and left. “It’s a cultural issue,” Fatema explains. “Women aren’t accustomed to talking about these things openly. But they want to avoid pregnancy, because having children can hamper their earnings.”

The trainers and peer educators dispelled the awkwardness by treating contraception as a matter-of-fact health issue. Family planning is part of life, and health care is a benefit for workers. “There’s no problem talking about it now,” Fatema says. “Workers are seeing this as a basic health need.”

The clinic on the premises is staffed by a doctor and nurse who are available every day during factory hours. Services are free for employees, and confidentiality is guaranteed. Workers who come to the clinic are counseled on a wide variety of family planning methods, including long-acting reversible contraception and permanent methods.

Nupur, 24, is one of the workers who is taking advantage of the clinic’s services. She has two children, a 5-year-old and a 9-month-old, and she does not want any more. She used to take oral contraceptives, but now she gets the three-month contraceptive injection at the factory clinic. She finds it much more convenient. Nupur considered other methods, like the hormonal implant, and she talked them over with her husband, but eventually she decided that the injection suited her best.

“Everyone has been very supportive and respectful,” Nupur says. “This program is really good for us.”

It is good for the factory owners too. From a business standpoint, the case for family planning is compelling. Workers who do not have access to contraception are more likely to get pregnant and need maternity leave (at full pay, per federal law); they are also more likely to experience ill health and complications. And if a worker chooses to leave her job entirely after giving birth, the factory has to hire and train her replacement. Making family planning freely available results in a workforce that is healthier, more stable, and more productive.

Fatema is proud to work at a factory where the focus is on workers’ health. And she is proud of her role as a peer educator and family planning champion. “I feel good about providing services that help the workers,” she says. “I’m contributing to the betterment of the community.”

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