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Role of Marie Stopes Bangladesh in Social Development challenges and way forward

Dr. Reena YasminSr. Director Programmes

Marie Stopes was founded in 1988 as a not

for profit organization

Affiliated with Marie Stopes International,

London, UK

Is one of the foremost SRH service delivery

organization

We are contributing towards two important

Social Development Goals

NO ONE SHOULD BE LEFT BEHIND

Extensive Network of Clinics and Outreach Services

MS Referral Clinic

MS Clinic

LAPM RT & IUD RSP

Public Sector Support

MS Maternity Clinics

Our Spread

Network of Clinics:

Marie Stopes Clinics : 41

Marie Stopes Referral Clinics : 60

Maternity Clinics (DFID) : 15

Extensive Network of Outreach:

LAPM Roving Teams : 11

IUD Roving Service Providers : 28

Strengthening GoB health facilities for LAPM services : 25

FP Service (Cafeteria approach)ANC/PNCRTI/STISafe MR ServicePost Abortion CareNeonatal & Child HealthPost Abortion contraceptionLimited General Health

Satellite

Once per weekServices including• FPANC/PNCCHSTI/RTIPost Abortion Care follow-upLimited GH

FP ANC/PNC; Safe Delivery Breast-feeding Unsafe abortion Post Abortion Care Post abortion FP VAW Nutrition• Newly-wed counseling

Women-based community support groupMale involvement Participation of local formal/informal leadersParticipation of GoB field workersParticipation of local NGOsLinking with UPPR

Community participation BCCG

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Safe Delivery servicesManagement of minor OBG/GYN operationsFP Service (Cafeteria approach)ANC/PNCRTI/STISafe MR ServicePost Abortion CareNeonatal & Child HealthPost Abortion contraceptionLimited General HealthSelective Male RH services (NSV)Primary management of Infertility &Referral linkage

MCH Post

Urban Area -

VSC Roving Team

IUD Roving Team

Maternal & Child Health Referral

Centre

NG

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sPeri-Urban Area

Urban Area- Close to community

Satellite

Access: Multi Tier Service Delivery Model

Affordability: Pro-poor Targeting

no one is denied services for want of money

At least 40% of services to be ensued free of cost

to the poor

Baseline Survey

(Based on SES)

Opportunity Carddistribution based on

poverty

grading criteria

Annual Review

PROVIDER % of

Failed MR

% of

Incomplete

Quality

Score

Client

Satisfaction

Doctors 0.02 0.16 Both types

of clinics

scored

equally in

quality

indicators

97%

satisfied

with the

serviceParamedics 0.004 0.05

Comparative outcome of MR services

Cost of Providers do have a significant impact on service costing

Where ever possible task shifting//sharing

Getting and retaining doctors in small towns and remote locations

Or they do not want to work in slums

Availability of Service Providers: Para-medicalization

more than 1.1 million unsafeabortions/MRs every year

Decision Making: MR & Post MR FP

384,000 Women suffered from Abortions complications in 2014

48% of all pregnancies are unintended

Total MR conducted 52,000

Post MR FP (%) 97%

Short term FP acceptors 71%

LARC acceptors 26%

Permanent method 0%

MSB: Up to Quarter 3 (2017)

Only 14% of women can take decisions alone on their health issues

Collective initiative of men and women in

awareness activities on family planning

Male Involvement

Jahanara, is 30, was married at 12 & had the first of seven children shortly after

“I say to my daughter, I was a child when I gave birth to a child; have only two kids.I do not want you to go through the same miserable life as mine.”

TFR Stagnated: Low uptake of LAPM

A unique collaboration with DGFP

Mostly in remote and hard to reach locations,where there are –

Lack of trained and skilled service providers

Low performances

Inadequate demand creation

Low Uptake of LAPM: Collaboration

17 Teams (each team consisting of 1 Doctor and 1 Field Worker): based regionally.

Move to GoB health facilities to provideLAPM services

TFD show in a school to prevent child marriage

Adolescent SRHR

A large cohort of adolescents (10 - 19 years) entering the RH life every year

Adolescent Birth Rate

is 113 per 1000

teenage pregnancy is the number one causes of mortality for girls aged 15 –19 years

1 in 3 (36.84%) married Bangladeshi men reported physically and/or sexually

abusing their wives in the past year

About 48% of workers report

current illness/symptoms

Female Factory Workers

Annually around 1.8 million clients walk through Marie Stopes blue door

Thank You

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