The Bangladesh Directorate of Family Planning in collaboration with the Population Council, Pathfinder International, and John Snow, Inc. is conducting an operations research project to test the feasibility of introducing emergency contraceptive pills (ECP) in the national family planning (FP) program and to answer operational questions on implementing the use of ECP efficiently. In Bangladesh, 1.2 million births are unplanned and the number of menstrual regulation/abortions is increasing. ECP could be a good reproductive health intervention for women since it gives them a chance to avoid unwanted pregnancy. ECP does not induce abortion. In fact, it helps in reducing the number of abortions. In Bangladesh, emergency contraception is relatively new and there is general lack of knowledge even among doctors. Thus, training providers will be a critical element for the introduction of ECP. The present feasibility study, detailed in this research update, has been undertaken to answer operational questions that need to be addressed while introducing ECP in the national FP program. The study has been carried out in two districts, Tangail and Mymensingh.

Approximately 28,000 maternal deaths occur every year in Bangladesh due to pregnancy and delivery-related complications, while many more women suffer major physical and psychological injuries. Available statistics indicate an increase in menstrual regulation (MR) and abortions, most performed by untrained practitioners under unhygienic conditions. Introducing emergency contraception (EC) in the national family planning (FP) program in Bangladesh could substantially reduce unwanted pregnancies and as result MR/abortions should also decrease. Because MR/abortions in Bangladesh significantly contribute to high maternal morbidity/mortality, introducing EC could be an important reproductive health intervention to provide couples with a back-up support to prevent unwanted pregnancy. EC could also reduce the psychological worries and health risks associated with unwanted pregnancies, MR, and abortions. The Directorate of Family Planning in collaboration with the Population Council’s Frontiers in Reproductive Health Project, Pathfinder International, and John Snow Inc., is conducting this feasibility study to develop, test, and document operational details for introducing EC as a back-up support for existing FP methods. This report is an interim update of the study’s accomplishments so far.