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. 2023 Apr 8;9(4):e15349.
doi: 10.1016/j.heliyon.2023.e15349. eCollection 2023 Apr.

Disparities in readiness of health facilities to provide long-acting reversible contraceptives (LARCs) and permanent methods (PMs) in Bangladesh

Gaylan Peyari Tarannum Dana  1 , Tasmiah Sad Sutopa  2 , Sawkia Afroz  1
Affiliations

Disparities in readiness of health facilities to provide long-acting reversible contraceptives (LARCs) and permanent methods (PMs) in Bangladesh

Gaylan Peyari Tarannum Dana et al. Heliyon. .

Abstract

The considerable success of Bangladesh's family planning programs Slowed in recent years due to the low utilization of long-acting reversible contraceptives (LARCs) and permanent methods (PMs). The low uptake persists despite the fact that these methods are proven to be highly effective in preventing unplanned pregnancies and lowering maternal deaths. This situation causes a daunting challenge for the country to attain sustainable development goals (SDGs) by 2030. The current study provides new insights into the status of LARCs and PMs availability in Bangladesh from the supply-side perspective. The main objective of this study was to assess the readiness of health facilities to provide all LARCs and all PMs in Bangladesh. To assess service readiness, we examined variations in facility types and regions, using data from the Bangladesh Health facility Survey (BHFS) 2017. Out of a total of 1054 health facilities assessed, government health facilities manifested higher availability of items of general service readiness for LARCs and PMs compared to private health facilities. Service readiness included domains including staff and guidelines, equipment, and medicine. Logistic regression models of readiness of LARCs, PMs, and combined LARCs-PMs showed significant variations by facility types and regions. Moreover, the findings of this study highlighted that, Bangladesh government facilities, irrespective of region, were more likely to be ready to provide combined LARCs-PMs, LARCs, and PMs individually than private health facilities. Looking more closely at the overall readiness within private health facilities, we found that it was better in rural areas than in urban areas. The findings of this study provide a basis to develop recommend strategic approaches to family planning programs, investment priorities in family planning services and, training for service providers to reduce regional inequality and disparities by facility types in Bangladesh.

Keywords: Bangladesh Health facility survey; Long-acting reversible contraceptives (LARCs); Modern contraceptives; Permanent methods (PMs); Sustainable development goals.

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Figures

Fig. 1
Fig. 1
a Odds ratio of readiness of providing LARCs for private facility vs. govt. facility by location of facility. b. Odds ratio of readiness of health facilities for providing LARCs for urban vs. rural by facility type.
Fig. 2
Fig. 2
a Odds ratio of readiness of health facilities for providing PMs for private facility vs. govt. facility by region. b. Odds ratio readiness of health facilities for providing PMs for urban vs. rural by facility type.
Fig. 3
Fig. 3
a Odds ratio of readiness of health facilities for providing LARCs-PMs for private facility vs. govt. facility by region. b. Odds ratio readiness of health facilities for providing LARCs-PMs for urban vs rural by facility type.
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