Identifier
Created
Classification
Origin
09DHAKA768
2009-08-04 10:01:00
UNCLASSIFIED//FOR OFFICIAL USE ONLY
Embassy Dhaka
Cable title:  

BANGLADESH HEALTH MINISTER ENDORSES USG

Tags:  EAID ECON EINV PREL TBIOZK XD BG 
pdf how-to read a cable
VZCZCXRO4111
RR RUEHAST RUEHBI RUEHCI RUEHDBU RUEHLH RUEHNEH RUEHPW
DE RUEHKA #0768/01 2161001
ZNR UUUUU ZZH
R 041001Z AUG 09
FM AMEMBASSY DHAKA
TO RUEHC/SECSTATE WASHDC 9267
RUCNCLS/ALL SOUTH AND CENTRAL ASIA COLLECTIVE
RUEHPH/CDC ATLANTA GA USA
UNCLAS SECTION 01 OF 02 DHAKA 000768 

SENSITIVE
SIPDIS

DEPT FOR SCA/INSB
USAID FOR A/AID, ANE, GH, RENEE HOWELL DESK OFFICER

E.O. 12958: N/A
TAGS: EAID ECON EINV PREL TBIOZK XD BG
SUBJECT: BANGLADESH HEALTH MINISTER ENDORSES USG
SUPPORTED FAMILY PLANNING AND SAFE MOTHERHOOD PROGRAM

REF: Dhaka 000698

SUMMARY
-------
UNCLAS SECTION 01 OF 02 DHAKA 000768

SENSITIVE
SIPDIS

DEPT FOR SCA/INSB
USAID FOR A/AID, ANE, GH, RENEE HOWELL DESK OFFICER

E.O. 12958: N/A
TAGS: EAID ECON EINV PREL TBIOZK XD BG
SUBJECT: BANGLADESH HEALTH MINISTER ENDORSES USG
SUPPORTED FAMILY PLANNING AND SAFE MOTHERHOOD PROGRAM

REF: Dhaka 000698

SUMMARY
--------------

1. On July 23, 2009, Ambassador Moriarty and Bangladesh Minister
for Health and Family Welfare, Dr. A.F.M. Ruhal Haque, launched the
Mayer Hashi Family Planning and Safe Motherhood Project was launched
in Dhaka the start of a new era of USG assistance to the Government
of Bangladesh (GOB) in family planning and safe motherhood. The
Mayer Hashi Project - which means smiling mother in Bangla - is a
four year 12 million USD project. The objective of Mayer Hashi is
to reestablish the importance of long acting and permanent methods
(LAPMs) of clinical contraceptives. Mayer Hashi will train
government, NGO and private sector providers to give LAPMs,
resulting in 5 million couples receiving LAPMs by the end of the
project. The Mayer Hashi program will also promote maternal health
by providing interventions to prevent post-partum hemorrhage and
eclampsia (high blood pressure and seizures during pregnancy).

RESTARTING BANGLADESH'S FAMILY PLANNING PROGRAM
-------------- --

2. USG has been the largest single donor for family planning in
Bangladesh for decades. Over the last thirty years, USAID's
technical assistance, training, commodity support, advocacy and
strategic interventions have helped Bangladesh achieve remarkable
progress. Fertility has been reduced by half from 6.3 children per
woman in 1971 to 2.7 as reported in the most recent Bangladesh
Demographic and Health Survey (2007). Similarly contraceptive use
among couples has increased from 8% to 58% over the past 30 years.
The USAID-funded Social Marketing Company contributes over 34% of
contraceptives and makes commodities available through a network of
over 200,000 pharmacy outlets. In Bangladesh most women rely on
temporary method such as pills, injectables and condoms. However the
fact that nearly 62% of women want to space or delay subsequent
pregnancies, only 7% are using LAPMs. LAPMs use has reviewed
stagnant for over a decade

MINISTRY OF HEALTH'S RESPONSE
--------------


3. Minister Haque admitted that the government had not been

attentive over the past several years in addressing the lackluster
performance of its family planning program. The Minister urged USG,
other donors and NGOs to work together to help GOB reverse this
troubling trend. The Minister again echoed the previous call to
action for all levels of government to mobilize to address
Bangladesh's population problem and remarked that "every minister is
a Health Minister" because population affects all of the development
sectors. Historically, the bifurcation of the ministry with
vertical structures for implementing health and family planning
programs has been a continuing obstacle for the sector. However,
both senior officials - the Director General of Family Planning, Mr.
Qayyum and Director General of Health Services, Prof. Hossain - gave
impressive remarks regarding the need to work together on population
and health issues. Currently family planning and health services
are implemented vertically from the central level down to the
district level. Prof. Hossain came out strongly and indicated that
the "population is imbalanced by the growing numbers of illiterates
who are having more children than the literate population" whose
numbers cannot be sustained. He pledged that he and his Directorate
would work hand in hand with his counterpart in family planning to
resuscitate family planning through one health system, for which he
was applauded.

AMBASSADOR'S RESPONSE
--------------


4. Ambassador Moriarty reiterated the USG's long standing support
to the health sector contributing over 700 million USD since 1971,
and he confirmed continued support to Bangladesh's health sector.
Ambassador Moriarty compared Bangladesh, with a population of 150
million, to the state of Iowa. Iowa has a similar size land mass as
Bangladesh but only 5 million people - making Bangladesh 30 times
more populous than that tiny state. The Ambassador highlighted that
the Obama Administration's Global Health Initiative will focus on
maternal and child health and could support Bangladesh's efforts to
improve the health of women and children.

USAID MISSION DIRECTOR'S RESPONSE
--------------


5. Ms. Denise Rollins, USAID Mission Director, congratulated the
Minister and his staff on their commitment in addressing family
planning and protecting women's health. Specifically, Ms. Rollins
congratulated the GOB in reinstating Safe Motherhood Day, gathering
technical experts, medical providers and academia on June 17, 2009
to develop a National Action Plan for Maternal and Neonatal Health,

DHAKA 00000768 002 OF 002


and the current redrafting of the 2004 Population Policy. Ms.
Rollins informed the audience that in the last six months this
government has followed words with actions on its intent to restart
its family planning program and increase chances of meeting the
Millennium Development Goals for improving maternal health and
lowering fertility below two children per woman. Ms. Rollins
reminded participants of continued USAID support of the national
health program and announced that over 40 million USD is being
programmed for health activities in Bangladesh in 2009. She
highlighted that this year USAID will increase support to family
planning and population programs, and will increase its focus on
nutrition, food security and water and sanitation. Ms. Rollins
ended by thanking the Minister for accepting the invitation to join
the Ambassador in Sylhet (Northwestern Bangladesh) to see USAID
activities, including the launch of the 320th clinic in the
USAID-funded Smiling Sun Franchise.

THE MAYER HASHI PROGRAM
--------------


6. The Mayer Hashi Program will make long acting more available to
couples who voluntarily chose to space pregnancies or limit births.
Mayer Hashi, which means smiling mother in Bangla, conjures up the
images of a smiling mother who knows that she is free from unwanted
pregnancies and its risks; leading to a happy, healthy family. The
project will address high rates of maternal mortality due to
preventable causes, including high risk pregnancies and
complications. Mayer Hashi will train clinical service providers to
increase their skills in clinical contraceptive methods such as
inter-uterine devices, implants, vasectomies and tubal ligations.
The 12 million USD four-year project will provide services in 21 of
64 districts and target low performing areas such as Sylhet,
Chittagong and parts of the Barisal division. Mayer Hashi will work
with local officials, religious leaders, especially men, to mobilize
awareness and support for increasing availability and use of LAPMs.
Currently, LAPM is the least preferred method of contraception and
makes up only 7% of the method mix. By the end of the project, it
is envisioned that 5 million couples will use LAPMs. Mayer Hashi
will also target maternal health, by preventing maternal deaths.
The two leading causes of maternal death in Bangladesh are
post-partum hemorrhage and eclampsia at the community and facility
level. Mayer Hashi will provide training to service providers on
the Active Management of the Third Stage of Labor (AMSTL). The
program will also support the assessment and trial of Misoprostol (a
drug) to prevent post-partum hemorrhage.

LAUNCHING EVENT
--------------


7. Over 100 people attended the launching event for the Mayer Hashi
program, including senior government officials, USG, donors, NGOs,
civil society organizations. and the event also received extensive
coverage from major media sources. Following local tradition the
ceremony was laced with a series of cultural performances, including
a dance with song and lyrics related to family planning. The event
ended with a skit conveying messages that promote LAPM and address
problems of early marriage, which can put women at risk for early
pregnancy and related complications.

COMMENT
--------------


8. The Health Minister strongly supports the new USG supported
program to promote maternal health and safe motherhood. The
launching event of the Mayer Hashi Program was a turning point for
both GOB and USG in recognizing the opportunities that exist for
revamping Bangladesh's family program through the promotion of
LAPMs. Opportunities also exist to elevate population issues with
senior government officials, and USG will identify every possible
opportunity to raise awareness on the impact of population which
stands to slow Bangladesh's economic growth, over burden the
environment, and threaten the long term prospects for political
stability and democracy.

MORIARTY