Married as a child, Chandana Bala did not have agency over when she got pregnant. But today, as the mother of four children, Chandana has taken ownership over her reproductive future, using a contraceptive method she learned about from Pathfinder’s Shukhi Jibon project.
But what if we had reached Chandana earlier? That’s what Pathfinder’s latest intervention aims to do—reach newlyweds on the day of their wedding, aiming to help young brides like Chandana plan for families when they are ready.
Despite improvements in reproductive health over the last three decades, Bangladesh still suffers from high rates of unintended and early pregnancies, and more than half of Bangladeshi girls are married before their 18th birthday. Seeing this ongoing challenge, four years ago, in 2017, the Directorate General of Family Planning in Bangladesh (DGFP) piloted a small program in the Brahmanbaria district, where information boxes on family planning methods were given to newlywed couples. The pilot was a real success—73% of the young couples who received the information chose to delay their first pregnancy as a result.
Today, Pathfinder is ramping up the intervention, in collaboration with the Government of Bangladesh, to reach newlywed couples in 10 different upazilas (regions) with diverse demographics. And the intervention has made a huge buzz in those communities.
On the day of their wedding, newlywed couples receive a surprise box from a local representative, in the presence of a community health worker known to the couple, or at other times, a local religious leader or government official. The box is filled with information for the newlyweds. It comes with a congratulatory letter from the DGFP, a booklet on reproductive wellbeing, leaflets on oral contraception and condoms, samples for the couple to use, a wall clock with the national family planning call center number, and reminder stickers to promote the call center number so couples can seek information and guidance from local health workers.
But the box doesn’t work on its own. It’s part of a much larger effort from USAID’s Shukhi Jibon Project to meet young people where they are, collaborating with local leaders, trusted community members, family members, and religious leaders, all who are involved to ensure the message is taken seriously.
The work takes time and effort to create buy-in. But Pathfinder has a 360 degree approach to getting it. “When we looked at the data from the pilot program,” says Tania Jahan, Shukhi Jibon’s Community Engagement & Social and Behavior Change Manager, “we found that there was some resistance from local imams and marriage registrars. We saw this, so immediately started our coordination efforts with local Islamic foundations with permission from the National Level Authority of the Islamic Foundation, under the Ministry of Religious Affairs in Bangladesh. Pathfinder worked with the local imams, community decision makers, and health workers, creating communications channels between the service providers and the local community leaders, to create more knowledge around sexual and reproductive health. The more these two groups coordinate, the easier our work is. Our work is to develop an environment that enables this discussion, so community members are more likely to participate actively in the intervention.”
FIRST SIX MONTHS:
- 500 newlywed information boxes distributed in 9 upazilas, 367 frontline health workers and 600 community leaders received orientation in 10 upazilas.
- 240 frontline service providers received a four-day training on adolescent and youth-friendly health services.
- 640 former trainees had follow-up sessions on adolescent and youth- friendly services.