Skip to content

Story and Perspective

Stickers, Planning Prompts, and a Hotline

Mahbub Alam

Bangladesh
Responding to the Reproductive Health Needs of Ready-Made Garment Workers in Bangladesh

Approximately 3 million women in Bangladesh work in the ready-made garment industry. They are an economic force in their country, communities, and families—and they have imminent reproductive health needs that must be addressed.

Pathfinder International works with the Government of Bangladesh to address reproductive health needs, particularly the unmet need for contraception. As part of this effort, our (re)solve project developed tailored solutions to ensure female garment workers can prevent unintended pregnancies through voluntary use of contraception. Pathfinder International is now working with the government to scale up these solutions across the country.

According to the 2017 Bangladesh Demographic and Health Survey, more than 50 percent of women using contraception in Bangladesh prefer using oral contraceptive pills, and this is true among garment workers as well. Despite their intention to use pills, around 40 percent of women discontinue use for myriad reasons, putting them at risk of conceiving when they are not ready.

(re)solve found that garment workers have extensive workdays and typically continue housework when arriving home. Their lack of leisure time makes it easy for them to miss taking the pill every day. Side-effects and lack of time to visit health facilities for refills were also challenges.

(re)solve developed a set of solutions to address these specific challenges:

  • Planning prompt for pill users: Allows health providers to help pill users create a plan for using and continuing oral contraceptives. This comes in the form of a card that identifies when she plans to take the pill every day, who she assigns to remind her, and what she will do if she experiences side effects.
  • Enhanced pill pack and supportive communication for side-effect management: Available at clinics and neighboring pharmacies, this includes reminder stickers; a visual instruction sheet to help women remember to take the pill; and a phone number for a government hotline, run by the Directorate General of Family Planning, to enroll in free supportive communication services using integrated voice response. The hotline allows women to receive a reminder to take the pill or information on how to correctly adhere to the pill and strategies to manage side effects.

The solutions are unique because they are based on a comprehensive study determining the reasons why women were dropping out of their pill regimens and their patterns of behavior. They also come at a time when the government has been heavily focused on transitioning women to long-acting reversible contraceptives (LARCs). In addition to this focus on LARCs, we looked at women’s real needs, desires, and contraceptive choices and devised solutions to allow them to exercise their contraceptive choice, while making those choices as effective as possible.

We shared the solutions with the national family planning program, and the government was very excited about our solutions. Although work under our (re)solve program ended in November, we have been able to work with the government on scaling up the solutions through Shukhi Jibon, our national USAID-funded family planning program. Shukhi Jibon provides support to the Ministry of Health and Family Welfare to strengthen health systems for increased accessibility of family planning. So far, the government has supported family planning initiatives in 400 factories, and we have a scale-up plan in place to reach an additional 50 factories with (re)solve solutions.

These 50 urban factories will provide a test case for further expanding the solutions across the country. Through a six- to nine-month testing phase, we will reach approximately 50,000 workers with the (re)solve solutions, 20,000 who currently use oral contraceptive pills, and evaluate the effect on discontinuation. The government has already incorporated the (re)solve solutions into training curricula used at factory health clinics and will apply evidence from the testing phase to develop a national scale-up plan that includes factories in rural areas.

Healthy workers are productive workers, and reproductive health is the most significant area of ready-made garment factory health we need to take care of. If someone stops taking pills because of side effects or for other reasons, that heightens the chance of unintended pregnancies, poor health, and job loss. If these solutions are effective in reducing the drop-out rate and helping women to continue using oral pills, there will be ripple effects on health and well-being in Bangladesh.

Learn more about (re)solve’s work in Bangladesh.

More Stories

Workshop on preventing cervical cancer in Kano State, Nigeria.

Inside Kano State’s Bold Effort to Prevent Cervical Cancer

“This topic touches me deeply, as I lost my wife to cervical cancer. That painful experience has shown me how…

Read More
Community Health Worker counsels maternal health client.

Celebrating High-Impact Maternal Health Innovations

On this International Day of Action for Women’s Health, let’s listen to women and invest in health care that they…

Read More
Religious leaders in Boboye, Niger.

When a Religious Leader Becomes an Ambassador for Family Planning

“A few years ago, in the space of just 25 days, I lost two children; it’s something that I will…

Read More

10 actions pour promouvoir l’inclusion linguistique dans le secteur DSSR / 10 Actions for Advancing Language Inclusivity in SRHR

Récap, réflexions et ressources de « Qui n’a pas la parole ? Briser les barrières linguistiques dans le domaine des…

Read More
Supervision visit with community health extension worker at New Era Hospital in Kaduna state. Photo by: Bayo Ewuola

Task-sharing: A High-impact Solution for Improving Health Equity in an era of Dwindling Foreign Assistance

A fresh look at how task-sharing can be optimized in Nigeria By Amina Dorayi, Country Director, and Fanna Mairami, Senior…

Read More

Pathfinder Annual Report 2024

Amplifying Local Partnerships for a Sustainable Future Almost 70 years ago, Pathfinder started as a family planning organization—and we have…

Read More

Mobilizing Civil Society to Save Women’s Lives

By Amina Dorayi, Country Director, Pathfinder International Nigeria In Nigeria’s Kano state, maternal mortality rates are higher than the national…

Read More

International Women’s Day: In Their Words

Across Pathfinder, we are opening doors for women and girls to forge their own path ahead, live the lives they…

Read More

A wedding invitation you can’t accept: Pathfinder’s campaign against child marriage in Pakistan

By Ali Asghar, Senior Communication Manager, SA-MENA and Sarah Peck, Development Communications Advisor “Please join us in this grand celebration…

Read More

Reaching Young People through Edutainment: Reflection from the GAMIVAL Experience!

As the world grapples with the challenges of engaging young people in critical conversations about their health and wellbeing, innovative…

Read More
Pathfinder Placeholder

Pathways December 2024: Women Lead on Climate and Health

The urgency of our mission is underscored by stark realities. In 2022 alone, over 110 million people in Africa were…

Read More

Contributing to Global Health Security and Protecting Women’s Health

By: Madiha Latif As the world looks to the end of 2024—which has seen COVID-19 and destructive weather become part…

Read More