VZCZCXRO4111
RR RUEHAST RUEHBI RUEHCI RUEHDBU RUEHLH RUEHNEH RUEHPW
DE RUEHKA #0768/01 2161001
ZNR UUUUU ZZH
R 041001Z AUG 09
FM AMEMBASSY DHAKA
TO RUEHC/SECSTATE WASHDC 9267
RUCNCLS/ALL SOUTH AND CENTRAL ASIA COLLECTIVE
RUEHPH/CDC ATLANTA GA USA

UNCLAS SECTION 01 OF 02 DHAKA 000768 
 
SENSITIVE 
SIPDIS 
 
DEPT FOR SCA/INSB 
USAID FOR A/AID, ANE, GH, RENEE HOWELL DESK OFFICER 
 
E.O. 12958: N/A 
TAGS: EAID ECON EINV PREL TBIOZK XD BG
SUBJECT: BANGLADESH HEALTH MINISTER ENDORSES USG 
SUPPORTED FAMILY PLANNING AND SAFE MOTHERHOOD PROGRAM 
 
REF: Dhaka 000698 
 
SUMMARY 
------- 
¶1.  On July 23, 2009, Ambassador Moriarty and Bangladesh Minister 
for Health and Family Welfare, Dr. A.F.M. Ruhal Haque, launched the 
Mayer Hashi Family Planning and Safe Motherhood Project was launched 
in Dhaka the start of a new era of USG assistance to the Government 
of Bangladesh (GOB) in family planning and safe motherhood.  The 
Mayer Hashi Project - which means smiling mother in Bangla - is a 
four year 12 million USD project.  The objective of Mayer Hashi is 
to reestablish the importance of long acting and permanent methods 
(LAPMs) of clinical contraceptives.  Mayer Hashi will train 
government, NGO and private sector providers to give LAPMs, 
resulting in 5 million couples receiving LAPMs by the end of the 
project.  The Mayer Hashi program will also promote maternal health 
by providing interventions to prevent post-partum hemorrhage and 
eclampsia (high blood pressure and seizures during pregnancy). 
 
RESTARTING BANGLADESH'S FAMILY PLANNING PROGRAM 
--------------------------------------------- -- 
¶2.  USG has been the largest single donor for family planning in 
Bangladesh for decades.  Over the last thirty years, USAID's 
technical assistance, training, commodity support, advocacy and 
strategic interventions have helped Bangladesh achieve remarkable 
progress.  Fertility has been reduced by half from 6.3 children per 
woman in 1971 to 2.7 as reported in the most recent Bangladesh 
Demographic and Health Survey (2007).  Similarly contraceptive use 
among couples has increased from 8% to 58% over the past 30 years. 
The USAID-funded Social Marketing Company contributes over 34% of 
contraceptives and makes commodities available through a network of 
over 200,000 pharmacy outlets.  In Bangladesh most women rely on 
temporary method such as pills, injectables and condoms. However the 
fact that nearly 62% of women want to space or delay subsequent 
pregnancies, only 7% are using LAPMs. LAPMs use has reviewed 
stagnant for over a decade 
 
MINISTRY OF HEALTH'S RESPONSE 
----------------------------- 
 
¶3.  Minister Haque admitted that the government had not been 
attentive over the past several years in addressing the lackluster 
performance of its family planning program.  The Minister urged USG, 
other donors and NGOs to work together to help GOB reverse this 
troubling trend.  The Minister again echoed the previous call to 
action for all levels of government to mobilize to address 
Bangladesh's population problem and remarked that "every minister is 
a Health Minister" because population affects all of the development 
sectors.  Historically, the bifurcation of the ministry with 
vertical structures for implementing health and family planning 
programs has been a continuing obstacle for the sector.  However, 
both senior officials - the Director General of Family Planning, Mr. 
Qayyum and Director General of Health Services, Prof. Hossain - gave 
impressive remarks regarding the need to work together on population 
and health issues.  Currently family planning and health services 
are implemented vertically from the central level down to the 
district level.  Prof. Hossain came out strongly and indicated that 
the "population is imbalanced by the growing numbers of illiterates 
who are having more children than the literate population" whose 
numbers cannot be sustained.  He pledged that he and his Directorate 
would work hand in hand with his counterpart in family planning to 
resuscitate family planning through one health system, for which he 
was applauded. 
 
AMBASSADOR'S RESPONSE 
--------------------- 
 
¶4.  Ambassador Moriarty reiterated the USG's long standing support 
to the health sector contributing over 700 million USD since 1971, 
and he confirmed continued support to Bangladesh's health sector. 
Ambassador Moriarty compared Bangladesh, with a population of 150 
million, to the state of Iowa.  Iowa has a similar size land mass as 
Bangladesh but only 5 million people - making Bangladesh 30 times 
more populous than that tiny state.  The Ambassador highlighted that 
the Obama Administration's Global Health Initiative will focus on 
maternal and child health and could support Bangladesh's efforts to 
improve the health of women and children. 
 
USAID MISSION DIRECTOR'S RESPONSE 
--------------------------------- 
 
¶5.  Ms. Denise Rollins, USAID Mission Director, congratulated the 
Minister and his staff on their commitment in addressing family 
planning and protecting women's health.  Specifically, Ms. Rollins 
congratulated the GOB in reinstating Safe Motherhood Day, gathering 
technical experts, medical providers and academia on June 17, 2009 
to develop a National Action Plan for Maternal and Neonatal Health, 
 
DHAKA 00000768  002 OF 002 
 
 
and the current redrafting of the 2004 Population Policy.  Ms. 
Rollins informed the audience that in the last six months this 
government has followed words with actions on its intent to restart 
its family planning program and increase chances of meeting the 
Millennium Development Goals for improving maternal health and 
lowering fertility below two children per woman.  Ms. Rollins 
reminded participants of continued USAID support of the national 
health program and announced that over 40 million USD is being 
programmed for health activities in Bangladesh in 2009.  She 
highlighted that this year USAID will increase support to family 
planning and population programs, and will increase its focus on 
nutrition, food security and water and sanitation.  Ms. Rollins 
ended by thanking the Minister for accepting the invitation to join 
the Ambassador in Sylhet (Northwestern Bangladesh) to see USAID 
activities, including the launch of the 320th clinic in the 
USAID-funded Smiling Sun Franchise. 
 
THE MAYER HASHI PROGRAM 
----------------------- 
 
¶6.  The Mayer Hashi Program will make long acting more available to 
couples who voluntarily chose to space pregnancies or limit births. 
Mayer Hashi, which means smiling mother in Bangla, conjures up the 
images of a smiling mother who knows that she is free from unwanted 
pregnancies and its risks; leading to a happy, healthy family.  The 
project will address high rates of maternal mortality due to 
preventable causes, including high risk pregnancies and 
complications. Mayer Hashi will train clinical service providers to 
increase their skills in clinical contraceptive methods such as 
inter-uterine devices, implants, vasectomies and tubal ligations. 
The 12 million USD four-year project will provide services in 21 of 
64 districts and target low performing areas such as Sylhet, 
Chittagong and parts of the Barisal division.  Mayer Hashi will work 
with local officials, religious leaders, especially men, to mobilize 
awareness and support for increasing availability and use of LAPMs. 
Currently, LAPM is the least preferred method of contraception and 
makes up only 7% of the method mix.  By the end of the project, it 
is envisioned that 5 million couples will use LAPMs.  Mayer Hashi 
will also target maternal health, by preventing maternal deaths. 
The two leading causes of maternal death in Bangladesh are 
post-partum hemorrhage and eclampsia at the community and facility 
level.  Mayer Hashi will provide training to service providers on 
the Active Management of the Third Stage of Labor (AMSTL).  The 
program will also support the assessment and trial of Misoprostol (a 
drug) to prevent post-partum hemorrhage. 
 
LAUNCHING EVENT 
--------------- 
 
¶7.  Over 100 people attended the launching event for the Mayer Hashi 
program, including senior government officials, USG, donors, NGOs, 
civil society organizations. and the event also received extensive 
coverage from major media sources. Following local tradition the 
ceremony was laced with a series of cultural performances, including 
a dance with song and lyrics related to family planning.  The event 
ended with a skit conveying messages that promote LAPM and address 
problems of early marriage, which can put women at risk for early 
pregnancy and related complications. 
 
COMMENT 
------- 
 
¶8.  The Health Minister strongly supports the new USG supported 
program to promote maternal health and safe motherhood.  The 
launching event of the Mayer Hashi Program was a turning point for 
both GOB and USG in recognizing the opportunities that exist for 
revamping Bangladesh's family program through the promotion of 
LAPMs.  Opportunities also exist to elevate population issues with 
senior government officials, and USG will identify every possible 
opportunity to raise awareness on the impact of population which 
stands to slow Bangladesh's economic growth, over burden the 
environment, and threaten the long term prospects for political 
stability and democracy. 
 
MORIARTY