Although population growth and net fertility rates have not gone down in the past seven years, family planning officials believe the stagnation is itself a sign of success.
Issues however remain in terms controlling population in specific areas and a fear that the government, riding on its earlier success, has become complacent about population growth.
For the last seven years, the population growth rate in the country has been 1.37% and the net fertility rate has been 2.3, according to Bangladesh Demographic and Health Survey 2014.
The target is to bring the fertility rate down to 1.
Compared to the rest of the country, however, the use of contraceptives is not as popular in the Dhaka division. In fact, over the last few years it has fallen by a few percentage points.
According to UN Population Division, the population of Dhaka is 18.2 million, which is the eighth highest in the world.
In January 2015, the contraceptive acceptance rate (CAR) in Dhaka division was 78% among couples, in January 2016 it had dropped to 77.4% and in January 2017, it was 77.5%.
The highest CAR is in the Rajshahi division where currently 80.6% of couples use contraceptives.
“Thousands of people migrate to Dhaka every day. A lot of them become part of the floating population who are very difficult to track,” Ferdous Alam, director of Information, Education and Motivation Unit at the Directorate General of Family Planning said.
He said the city corporations had a major role to play in this and there was a lack of coordination between the two agencies.
“Given our socio-economic situation, the CAR rate is actually satisfactory. However, there are issues with reaching people in remote areas and slums,” said Dr AKM Nurunnabi, professor of population sciences at University of Dhaka. “We need to find innovative measures to reach out to these people.”
Ferdous Alam told the Dhaka Tribune: Our older initiatives and programmes are still in place and we are taking up more programmes.
One problem is that our last five-year project ended in January this year, which slowed down our work in the last five or
six months. Now that we have received a new budget, we have been able to speed up our work since June.
Ferdous said the directorate asked the population science department at Dhaka University to conduct a survey on population control.
The survey report recommended that instead of sticking to the usual methods of promoting birth control, the directorate needed to take a more area-specific and innovative approach, he said.
Outreach was still difficult in a few areas, the director said.
In remote places such as the Haor region, it takes a field worker an entire day to cover maybe four or five families, whereas in easily accessible places we can reach up to 50 families in a day, he said.
Khandker Mahbubur Rahman, deputy programme manager at the directorate, claimed some of the tools that the directorate used to promote family planning and birth control were folk songs, billboard ads, street dramas and road shows in local languages.
This year we will also start campaigning through ads in local cable channels and cinema halls, he said.
In 32 districts, the directorate has sent out 'audio-visual vans' that campaign on the road and within five years there will be a nationwide coverage, he said.
Our budget has doubled. A new programme called the Health, Population, Nutrition Sector Programme has been introduced, he added.
A visit to Surjer Hashi clinic
Rozina Akhter, a school teacher, who was visiting the Surjer Hashi Clinic in Mouchak with her 16-month-old son, said after her marriage she received counseling about family planning from the clinic. Her sister had told her about the clinic.
“I really like how they explained everything to me here”, she said.
“They helped us decide that we would not take more than two children. Even if we do, we will wait another four or five years, for the sake of my health and my children’s.”
Rozina thinks that she sought out the clinic by herself because she comes from an educated background.
“People in less educated neighbourhoods are still in need of the door-to-door approach,” she remarked.
Lekha Akhter, 35, a mother of six, works at homes during the day and sells balloons and toys on the street in the evening, in the Panthapath area.
Like many of Dhaka’s residents engaged in manual labour, she has no time to think about family planning.
She has four daughters and two sons. Her eldest is 10 years old. Asked what family planning was, Lekha appeared baffled.
She said she had no idea what the Surjer Hashi Clinic was and was never approached by anyone about such things.
Her health had broken down after the birth of the second child, she said.
Nasima Akhter, who is the manager of the clinic, said the number of people who came to the clinic to take service had dropped slightly.
“A lot of people are more aware now. They go to doctors or pharmacies to talk about their birth control options,” she said.
“We have kept up our campaigns but our door-to-door campaigns are not as regular as before.”
One of the reasons why outreach is failing in Dhaka was that people here are busy with employment, said Bilkis Akhter, a paramedic at the clinic.
“People like labourers, garment workers - they are so busy with work that they do not have the time to listen to us,” she said.
The ads on the state television channel are no longer visible because nobody watches BTV, she added. The clinics were also facing a crisis of volunteers because the pay was too low.