Behavior Change Communication (BCC) Campaign on Long-acting Permanent Method (LAPM) Program in urban slum of Dhaka City: An evidence-based result for program intervention

According to the Bangladesh Demographic and Health Survey 2014 and the Urban Health Survey 2010, the use of modern method is higher at urban slums than the national figure. However, the use of Long Acting and Permanent Methods (LAPM) are low among the urban slum people than other areas. The use of LAPM in the last 10 years remained almost stagnant and increased only from 7.2% to 8.1%. On the other hand, majority of the women complete their family size at an early age and continue to rely on temporary methods for the rest of their reproductive life cycle, which is causing unintended pregnancies in many cases.

SMC operated a BCC related pilot program in 2016 using own resources at Korail Slum in the capital, Dhaka with an aim to increase knowledge and use of LAPM on a pilot basis. The result of this pilot initiative was quite satisfactory and therefore, the SMC Board decided to expand this initiative in untapped area of Korail Slum and Sattola Slum, which started from January 2018. The campaign was successfully ended in December 2018.

At the end of the intervention, SMC conducted an End line survey in 2019. According to survey findings, the knowledge on different Family Planning methods and services of LAPM increased significantly. Out of 888 potential users 222 clients (25%) accepted Long Acting Reversible Contraceptives (LARC) and out of 693 potential users 37 clients (5.3%) accepted Permanent Method. Only 36 LARC users (16%) discontinued their method which is lower than national figure.

Considering the above significant performance and effects of the program and following directives from SMC Board of Directors (191st meeting held on February 17, 2020), Program Division has come up with a proposal to initiate the BCC Campaign Program in the following areas & slums under Dhaka City Corporation (DCC) as considered the location of SMC Clinic and SMC Niltara Clinic. Initially the project will implement at Kollayanpur Pora Bostee and then gradually it will be expanded at Dhaka Uddan area. A total of four Community Mobilizers, two LARC Counselors and one Community Mobilization Officer are engaged to conduct interpersonal communication through household visit and refer clients for long term and permanent methods to the nearest GOB and NGO service delivery points. 

In order to increase knowledge and demand for family planning methods following mobilization activities were performed during the period from July 2023 to March 2024:

  • 719 Married Women of Reproductive Age (MWRA) were contacted through 76 group meetings
  • 13,173 clients/households were contacted through Inter Personal Communication (IPC)

 

Referral of potential permanent method users to the nearest GO and NGO health centers:

  • 252 LAPM clients referred to SMC Clinic and nearest service delivery centers
  • 240 clients received LARC services (I-Plant-234 and IUD-6) from SMC and SMC Niltara Clinic
  • 12 clients received LAPM (NSV-9, Tubectomy-3) services from Mohammadpur Fertility Center

BCC Campaign Activities on LAPM: