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“After the menstrual regulations services I was prescribed a few medicines which I could not buy due to poor financial condition”

Shana Khatun decided to undergo menstrual regulation and received post-procedure care kit (Kit 8), that includes pain relief medicine. Alleviating the financial strain on her and her family.

Menstrual regulation, the method of establishing non-pregnancy for a woman at risk of unintended pregnancy, has been a part of Bangladesh’s family planning program since 1979. It is allowed up to 10 –12 weeks after a woman’s last menstrual period.

When Shana Khatun, a mother of three, became pregnant again she says she began to feel very weak and had issues with massive bleeding.Citing her age and the possibility of further medical complications, Khatun decided to undergo a menstrual regulation procedure.

“But if the hospital and services weren’t there then I would have had to have continued with my pregnancy, even when (I do) not want another child” she says.

Khatun says that the procedure went well, but that without the presence of medicine found in Kit 8 she would have lacked post-operation medicine.

“After the menstrual regulations services I was prescribed a few medicines which I could not buy due to poor financial condition,” she says. “But the hospital gave me a number of medicines that I could take.”

And while Khatun had talked with women about various family planning methods, she didn’t feel she could talk with anyone aside from her husband about getting the procedure.

“I feared they would treat me poorly (the hospital),” she says.

But Kahtun says she found the hospital trustworthy and helpful, even when she was suffering complications such as mass bleeding.

“I will be very cautious that I should not get pregnant again however in event if I get pregnant again then I will come to this hospital only,” she says.

Small scale innovation in Bangladesh during times of crisis: ensuring reproductive care to local communities

In times of humanitarian crises and disasters, the inability to access health care during floods can have serious repercussions on the local community.

As part of their Innovation Programme project, our South Asia office in collaboration with the University of Leicester and the Government of Bangladesh provides reproductive health kits to health centres located in areas most prone to seasonal flooding. Known as 'Kit 8' it contains three months’ worth of medicine and equipment for the management of miscarriage and complications of abortion and menstrual regulation in emergency situations, essential to minimize associated morbidity and mortality. Medical staff are trained to administer procedures and provide post-procedure care.

While abortion is considered illegal in Bangladesh, menstrual regulation, which has been a part of the country’s family planning program since 1979, is allowed up to 10–12 weeks after a woman’s last menstrual period.

Photography © IPPF/Victoria Milko

IPPF’s Innovation Programme supports small scale initiatives, which test new ways to tackle the biggest challenges in sexual and reproductive health and rights. Those challenges presented themselves in the region of Beluchi in Bangladesh where heavy flooding submerged local communities and roads under water.

The region of Belkuchi is very rural made up of agricultural land, which is prone to flooding in the monsoon season.

As part of their Innovation Programme project, our South Asia office provides reproductive health kits to health centres located in areas most prone to seasonal flooding.

Dkukuriabera Health and Family Welfare Centre experienced heavy flooding during the rainy season causing water damage to the building.

Kohinoor Begum, who has worked at the Daulatpur Family Health and Welfare Center for 18 years, says the seasonal flooding often means trouble for those seeking medical services. “During floods roads are blocked and so people have to use boats to reach the nearest usable road,” Begum says. “I have to visit homes of clients and clients, but during floods I cannot visit them and most people also cannot visit the centre. In such scenarios a miscarriage can sometimes happen.”

Mr. Binoy Kumar Sarkar, Ms. Salma Parvin and Ms. Khadija Khatun, say that around 20 villages and 100,000 people are covered by the facility. Recent flooding had a huge impact on the services and local community. “We had to stand on chairs. Very few patients came to access services.”

When Shana, 34, a mother of three, became pregnant again felt very weak and experienced heavy bleeding. To avoid medical complications, Shana decided to undergo menstrual regulation. “But if the hospital and services weren’t there then I would have had to have continued with my pregnancy, even when not wanting another child” she says. Although Shana had talked with women about various family planning methods, she didn’t feel she could talk with anyone aside from her husband about getting the procedure.

Poly, 32, explains how six months ago her period stopped. Assuming she was pregnant she showed no other symptoms or physical changes. “My husband, father, and mother-in-law thought that my pregnancy had been eaten by a bad spirit,” Khatun says. “But when I came to the hospital the [doctor] found that I was only 3 weeks pregnant.” Concerned about health complications she decided to undergo menstrual regulation.

Nurse, Lipara Khatun, has worked in Belkuchi Upzila Health and Family Planning Centre for 19 years. Recently she received training on the provision of menstrual regulation services. “I had done the procedures before but lacked courage and confidence,” she says. “After the training I gained courage, confidence and now I feel more efficient with the procedure. Now I have lot of satisfaction that I can do the job better and can apply the knowledge received during training.”

Auliya, 40, has three grown up children. When Auliya found out that she was pregnant she discussed the option of undergoing menstrual regulation with her husband. “My spouse was supportive and he gave me the freedom to come to this decision myself,” she says. “If this service was not available then I would have carried on with the pregnancy. It would have been embarrassing, though, to have another child at this age.”

Nursing Supervisor Ms. Lovely Yasmin is one of several staff members providing family planning, menstrual regulation, and post-procedure care services at Upzila Health Complex in Belkuchi. She has been a nurse practitioner for 16 years. “Before this training we used to sometimes advise people on such services and provided menstrual regulation but after the training I’ve become confident and efficient in providing services,” she says.

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country

Bangladesh

Subject

Emergencies

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country

Bangladesh

Subject

Emergencies