The International Planned Parenthood Federation (IPPF) is a global network of member associations in 149 countries and the world’s foremost non-governmental provider and advocate of sexual and reproductive health and rights.

IPPF believes that sexual and reproductive rights are internationally recognized human rights and, as such, should be guaranteed for everyone.

IPPF is committed to gender equity and to eliminating the discrimination which threatens individual well-being and leads to the widespread violation of health and human rights, particularly of young women.

IPPF values diversity and strives to achieve this in its governance and in its programmes – with a special emphasis on the participation of young people and people living with HIV/AIDS.

IPPF considers the spirit of volunteerism to be central to achieving its mandate and advancing its cause.

IPPF envisages a world in which every women, man and young person has access to the information and services they need; in which sexuality is recognized both as a natural and precious aspect of all our lives and as a fundamental human right; a world in which choices are fully respected and where stigma and discrimination have no place.

PROBLEM ANALYSIS

Situation Analysis

SRH is still a taboo in the community. As a signatory of the international charters including the ICPD Program of Action, the government of Bangladesh is committed to address the SRH issues. But these commitments are not properly translated into actions. Level of awareness on SRH and rights is still very low. Rate of literacy is below 50%. Superstition and religious misconception prevail large. Incidence of gender-based violence is highly prevalent and related laws are hardly enacted.

Problem Analysis Lack of education and awareness among general mass on SRH & Rights issues. Lack of concern and involvement of policy makers and community gate keepers in reproductive rights issues. The issues of SRHR is not properly conceptualised and recognised by beneficiaries and stake holders.

STRATEGIC DIRECTION

Mobilise support for SRHR promotion by involving policy makers, activists and the media.

GOAL

To increase public and financial commitment to and support for sexual and reproductive health and rights at the community and national levels.

OBJECTIVES

Objectives 1:

To strengthen support for promotion of SRHR with special focus on preventing gender based violence among government and non-government activists and leading print and electronic media organizations which promote, respect and protect these rights.

Activities

1. Conduct needs assessment survey on SRHR.
2. Conduct orientation program for FPAB policy makers and management staff on SRHR/GBV.
3. Organise sensitisation seminar with community gatekeepers including religious leaders on reproductive rights and their role.
4. Organise mass media campaign for sensitisation and support for promoting reproductive rights and preventing gender based violence.
5. Develop BCC materials on GBV discrimination and RR.
6. Organise round table meeting, dialogue, TV talk show with government, donor and NGO officials on SRHR.
7. Organise conference with media personnel for more coverage of the issues on RR/GBV.
8. Organise seminar with legal support organizations and law enforcing agencies.
9. Conduct a mid-term survey to assess the impact of advocacy efforts and redesign action plan accordingly.
10. Undertake media monitoring through a working group at the NHQ.
11. Conduct impact evaluation on attitudinal changes on SRHR.
12. Document best practices and lessons learnt and disseminate the same among development partners and donor community for mobilizing resources.

OUTCOME
1. Policy makers and media professionals become more committed to critical issues related to SRHR and GBV.
2. Government, donor agencies and development partners become supportive to promote SRHR issues.

INDICATORS

Indicators for outcomes 1

• Policy makers oriented and sensitised on SRHR.
• Media coverage of SRHR/GBV increased by 30%.
• Enlisted legal support organizations, religious leaders and law enforcing agencies become more active in extending legal and moral support to victims of violence.

Indicators for outcomes 2

•Indicators relating to SRHR included in the monitoring and evaluation tools.
•Level of participation of identified ministries/directorates of government, donors and development partners in the SRHR program increased.
• 30% more funds generated in the SRHR field.

PROBLEM ANALYSIS

Situation Analysis
In Bangladesh, adolescents constitute about 23% of the total population. Many adolescents exposed to sex before marriage and thus are vulnerable to unwanted pregnancy. Adolescents are practically vulnerable to STI/HIV/AIDS, as most of them know little about STI/HIV/AIDS. Child sexual abuse and exploitation are becoming everyday affair in Bangladesh. A vast majority of adolescents lack in adequate knowledge about sexuality and reproductive health needs, limited access to health and family planning services. Literacy rate is 48% where as female adolescent rate is only 42%. Female adolescent literacy rate in rural areas are deplorable. Involvement of adolescents/youths in policy management, adolescent friendly clinical services and supply of BCC materials are negligible to meet their needs and requirements.

Problem Analysis

• In Bangladesh 60% of the girls are married before 18 years of age. Median age of first marriage for women 17.5 years and men 25 years. Child birth among the adolescents is (15-19) 177 per 1000. Median age at first birth is between 17 and 19 years, adolescent fertility is one of the highest in the world. And, pre-marital sex is substantially high amongst the male adolescents. • Vast majority of Bangladeshi adolescents never heard of HIV/AIDS, only 17% of adolescent married women had heard of HIV/AIDS and knowledge of STI is lower compared to knowledge of HIV/AIDS and adolescents perceived of limited access to reproductive health services.

STRATEGIC DIRECTION

Strengthening partnership between FPAB and other organizations / institutions / clubs / groups working with adolescents and young people.

GOAL
Adolescents and young people are aware and empowered to make informed choices and decisions to improve their sexual and reproductive health & rights.

OBJECTIVES

Objective 1
To strengthen commitment and support of the 50% of community gatekeepers in project areas for sexual and reproductive health needs and rights and of adolescent/young people by the year 2003.

Activities
1. Conduct KAP survey.
2. Develop tools on the basis of KAP survey to train gatekeepers.
3. Organize advocacy meeting/orientation and seminars with gatekeepers along with local elected representatives.
4. Orient club board members on the needs of ASRHR.
5. Organize mass campaign through rally, TV talk show on ASRHR.
6. Form local level network on ASRHR with GO and NGO.
7. Undertake post intervention.

Objective 2
To increase access of 70% adolescents and young people to comprehensive youth friendly, gender sensitive and sexuality education by the year 2009.

Activities
1. Conduct base line survey in project areas.
2. Conduct group meeting on SRH in schools, out of school and madrasha.
3. Organize debates in schools, colleges and madrashas.
4. Develop and use BCC materials on early marriage, early pregnancy and health seeking behavior on SRHR.
5. Review & update curriculum & teaching aids.
6. Organize capacity building and life skills, training for the peer educators.
7. Organize TOT on SRH for school teachers.
8. Develop curriculum, module and handouts for TOT of school teachers.
9. Observance of national & international days & events e.g. National Youth Day, International AIDS Day.
10. Promote condom as a dual protection method among the young people.
11. Conduct mid-term and final evaluation at the end of 2009.

Objective 3
To increase access to adolescent friendly services of 50% adolescents and young people in 38 clinics within 5 years.

Activity for objective 3
Introduce and develop youth friendly services in clinics.

OUTCOMES
1. Increased commitment of community gatekeepers on ASRHR.
2. Reduction of early marriage and pregnancy and increase in the number of adolescent health seeking behaviour.
3. Designed 20 model Adolescent Friendly Clinics.

INDICATORS

Indicators for outcomes 1
• 50% community gatekeepers played proactive role on ASRHR.
• Reduced opposition against sexuality education to young people in the community.
• Increased change of attitudinal behaviour among the young people

Indicators for outcomes 2
• Decreased number of early marriage.
• Decreased number of early and repeated pregnancy.
• Increased number of young people visiting clinics and interacting with each others.
• Reviewed and updated all existing gender sensitive materials.
• Developed and distributed booklets, posters and displayed video film on ASRHR.
• Institutionalized 20 model adolescent friendly clinics.
• Increased number of young people visiting clinics for counselling and services.
• Developed guidelines/protocol on adolescent friendly clinics and replicated the guidelines/protocol and mode of operation to government clinics.

PROBLEM ANALYSIS

Situation Analysis
AIDS is a global problem and it is also a development crisis. In Bangladesh 386 HIV positive cases have been detected so far. Out of them 57 AIDS cases were detected of whom 30 have already died. The situation in Bangladesh is characterized by low prevalence but high risk of HIV, high prevalence of STI, unsafe sex practice and low level of awareness among general mass.
Lessons leaned from other affected countries advise that early action is essential to stop the spread of HIV at large. Service integration and partnership with other organizations would be essential and most cost effective option for a country like ours with limited resources to stop the virus from spread, before the economic burden becomes too large to endure.

Problem Analysis

Prevention is critical
• Low level of awareness still prevails in Bangladesh. It is difficult to generate awareness about the risk associated with HIV transmission due to conservative social environment that restrict free and open discussion of sexual issues, to reach more vulnerable group is made difficult by the atmosphere of stigma, denial and discrimination.
• National behavioural surveillance found that large number of men continued to buy sex at higher percent than anywhere else in Asia. Majority of men still do not use condoms in commercial sex encounters and female sex workers reported the lowest condom usage in the region which is around 4%. Evaluation study of FPAB also found that consistent condom use among the CSW is 8%.
• The fourth round of serological surveillance has detected 4% HIV infection among high-risk behaviour group in Bangladesh just short of the 5% mark of a concentrated epidemic. The syphilis rate is also high; studies reveal that among female sex workers the rate is as high as 40%.
• Studies also found that increasing trend of premarital and extramarital sexual behaviour also exist in Bangladesh.

Poor Access to quality STI/HIV/AIDS related services
• The 1999 to 2000 BDHS found that only 33% married women and 50% married men have knowledge on prevention of HIV-AIDS. Very high numbers of respondents from different groups in the third surveillance are not knowledgeable about the basic modes of HIV transmission, which is 93.97%.
• Study found that service-seeking behaviour related to RTI/STI/HIV/AIDS is not satisfactory. It is also found that some service provides still have negative attitude towards STI/HIV/AIDS, which hinders in providing quality STIs/HIV/AIDS related services and the dual role of condom is not well discussed in the counselling sessions. Women status in family, community and society at large is not satisfactory and majority of women are not empowered in decision-making.
• Integration of gender sensitive STIs/HIV-AIDS related preventive services with other projects of FPAB and partnership among different organizations working in the field of HIV-AIDS is still inadequate.

STRATEGIC DIRECTION
By creating an enabling environment for reducing vulnerability to HIV-AIDS and integrating gender sensitive STI/HIV/AIDS information and clinical services in the existing project activities of FPAB.

GOAL
Reduction in the incidence of HIV-AIDS and protection of the rights of people infected and affected by HIV-AIDS in Bangladesh.

OBJECTIVES

Objective 1
To strengthen support of 50% of the different stake holders in project areas of 7 branches of FPAB in reducing social, religious, cultural barriers that make people vulnerable to HIV-AIDS within 5 years.

Activities
1. Conduct situational assessment studies on existing socio-cultural and religious barriers to HIV-AIDS prevention and use information for designing project activities.
2. Conduct workshop for policy level volunteers for sensitisation and to get support from them in the prevention programme of STI/HIV/AIDS.
3. Develop, distribute and display need based BCC materials including pictorial leaflet, bill board, organize folk song and street drama and telecast TV serials to reduce stigma associated with HIV/AIDS.
4. Organize advocacy seminar with youth/women organizers and religious/teachers and community influential leaders in order to overcome barriers and ensuring support from them in reducing barriers related to STI/HIV/AIDS.
5. Organise orientation for school, college and madrasa teachers on Gender and STI/HIV/AIDS to teach the subject in respective institutions.
6. Organise round table meetings with different bodies/committees of government, development partners, NGOs/CBOs working in the field of SRH, HIV/AIDS to get their support.
7. Conduct post intervention survey to assess reduction of barriers to HIV/AIDS prevention programme.

Objective 2
to increase access of beneficiaries to information and clinical services for the prevention and control of STIs/HIV-AIDS by 25% through integrated gender sensitive STI/HIV/AIDS program in the selected project areas by the year 2009.

Activities
1. Conduct baseline survey with clients visiting 7 SDPs to assess the STI/HIV/AIDS related information and service seeking behaviour of beneficiaries.
2. Review, update and develop modules, manuals and curriculum on gender and HIV/AIDS for clinical and community level service providers.
3. Conduct training for clinical and community level service providers of FPAB and other NGOs on Gender and STI/HIV/AIDS.
4. Conduct group and individual counselling session at community and clinic level to increase knowledge among beneficiaries on gender and STI/HIV/AIDS and empower them to be able to protect themselves.
5. Provide quality gender friendly STI/HIV/AIDS services, promote condom and introduce VCT for increasing availability through static and mobile clinics.
6. Establish proper referral services with government and other clinics for PLWA.
7. Conduct post intervention survey to measure STD/HIV/AIDS related service seeking behaviour of men and women in project areas.
8. Document lessons learnt and disseminate the same among development partners, Government, NGOs and community.

OUTCOMES
1. Socio-cultural and religious barriers to HIV/AIDS reduced.
2. Gender sensitive SRH services utilized by beneficiaries.

INDICATORS
Indicators for outcomes 1
• Reports/survey findings disseminated and used.
• Stakeholders of 7 selected branches informed on HIV-AIDS and became supportive in reducing STD/HIV/AIDS.

Indicators for outcomes 2
• Reports/survey findings disseminated and used.
• 7 SDPs of FPAB became gender and STI/HIV friendly.
• Service providers attitude towards STD/HIV/AIDS become positive.

PROBLEM ANALYSIS

Situation Analysis
Government policy in Bangladesh does not recognize abortion; but there exits a policy on menstruation regulation (MR), which permits termination of unwanted pregnancy up to 10 weeks from the last menstrual period. The policy regarding MR is not very clear. Unskilled and untrained providers mostly conduct termination of pregnancy. Access to safe abortion services is very limited. Huge BCC gap exists, religious and procuring funds for promotion of safe abortion service is difficult. Internally MR facilities are not available at peripheral level. Service providers are not adequately trained and post abortion care facilities are insufficient. Unsafe abortion-female foeticide-gender discrimination may raise as a problem in Bangladesh near future.

Problem Analysis

• About 3.9 million pregnancies occur in Bangladesh annually out of which 1.3 million is unwanted. Due to this high-unwanted pregnancy rate 0.8 million women terminate their pregnancy either by MR or abortion. High rate of unsafe abortion • Most abortions are done by the unskilled health professionals. At least 8.000 women die from complication of unsafe abortion. Bedsides this around 100.00 women suffers from long run morbidity from the complications of unsafe abortion. • Though from the Government side there is no opposition to provide abortion through menstruation regulation (MR) program but there is some form of religious and socio-cultural opposition/barrier against it. • Some International Donor Agencies have some reservation to provide financial support for promotion of MR/Safe abortion services. • In comparison to the need of the abortion/MR services there are wide gap in providing services, post abortion care and follow up care services with maintaining its quality aspects. • Some negative attitude of service providers in providing Abortion/MR services.

STRATEGIC DIRECTION
By advocating and creating awareness among the policy level and community level people for the universal abortion rights of women and ensuring access to safe abortion by providing MR services.

GOAL
Recognition of the universal right of women to choose and have safe abortion.

OBJECTIVES

Objective 1
To raise awareness of 60% target people of project areas, policy makers, politicians, religious leaders and National level high officials of Government and other Agencies about consequence of unsafe abortion on public health within the next five years.

Activities
1. Conduct base line survey on attitude of people on abortions.
2. Intervention of awareness generation and mobilization program among the community on safe abortion issues through focus group discussion courtyard discussion/meetings, film shows.
3. Advocacy seminar with government agencies, politicians, religious leaders, health professionals and media personnel to recognize, protect and fulfill these rights through advocacy meeting, seminars, symposiums, workshops, rallies and campaigns.
4. Organize national, International seminar/workshop to affect the rights of safe abortion CEDOW ICPD.
5. Develop appropriate and need based BCC and advocacy materials.
6. A study on the impact of safe abortion on the morbidity of the house holds.

Objective 2
To increase access to safe abortion for 80% of the beneficiaries of the program operation areas of FPA Bangladesh.

Activities
1. Mobilize human and financial resources to improve the quality of existing facilities for safe abortion post abortion and follow up care.
2. Setting up of sensitive, non-judgmental, affordable and quality MR/post abortion services in all clinics of FPAB.
3. Interim and project end survey.
4. Provision of treatment of complications of septic abortion, post abortion contraceptive services, creation of functional referral mechanism and referral of high risk abortion and post abortion cases to higher centers.

OUTCOMES
1. Public dialogue about safe abortion is initiated in Bangladesh.
2. Enhanced access of the community to safe abortion services and post abortion care.

INDICATORS

Indicators for outcomes 1
• Media articles/support on abortion related issues.
• Statements in support of safe abortion as a women’s rights made by influential persons and leaders.
• Abortion rights are acknowledged in the Govt./NGO policy books.

Indicators for outcomes 2
• Demand for safe abortion service increased.
• Use of all kind of contraceptive increased.

PROBLEM ANALYSIS

Situation Analysis
Bangladesh family planning program has achieved remarkable success during last two decades in spite of its endemic poverty, high incidence of maternal and infant mortality and morbidity, low literacy and poor women empowerment. The country achieved a commendable progress in raising its contraceptive prevalence rate (CPR) but there is still high unmet need for reproductive health services at the remote and underserved areas. In spite of attaining satisfactory level of CPR, the TFR has remained almost static during last few years. Poor antenatal and postnatal care, very low rate of child delivery at institutional facilities, high prevalence of early age pregnancy, low status of women and incidences of gender-based violence are important challenges. The internal weaknesses of FPAB are less facilities for males in clinics, weak referral network, inadequate training for service providers and inadequate counselling on gender, nutrition and SRHR.

Problem Analysis

Inadequate access to SRH Services, Poor socio-economic conditions, Low per-capita income (US$ 386), low literacy (47.3%) and religious barrier, low rate of women employment (9.7%), high unmet need for family planning services (15%), inadequate access to Antenatal care (26%) and Postnatal care, High prevalence of early age pregnancy (34.7%), physical violation against women (47%), lack of awareness and knowledge on legal rights of women, adolescent girls and women are victim of violence, Limited services and lack of quality outlets to reach the remote and underserved areas, the existing service centres are not well equipped, inadequate and irregular supply of logistics and high turnover oft rained staff.

STRATEGIC DIRECTION
FPAB will work to increase access to quality SRHR information and services by reducing social, cultural, religious and infrastructural barriers that impede access of men and women to essential services.

GOAL
Increase access of poor marginalized and underserved people and exercise their rights to SRHR information and services.

OBJECTIVES

Objective 1
To increase by 50% the existing coverage on SRHR information, education and services for all beneficiaries in the project areas.

Activities
1. Conduct a gender sensitive/adolescent friendly baseline survey/operations research on factors influencing lack of access to SRH services.
2. Based on the findings of the survey providing SRH services and organise satellite clinics.
3. Organise group/community meeting, seminar and health education session on SRHR issues for gatekeepers in the project areas.
4. Introduce counselling and services on SRHR issues, clinical contraception and nutrition.
5. Strengthen quality integrated SRHR services along with MR/abortion, nutrition, safe motherhood, child health through static and satellite clinics for the underserved and marginalized groups.
6. Use BCC materials for behavioural change in the health seeking behaviour of the communities being served by FPAB project areas.
7. Establish functional linkage with GO and NGOs for SRH services, Clinical contraception, Emergency Obstetrics Care, nutrition rehabilitation.
8. Document and use findings of operations research in order to bring qualitative and quantitative improvements in SRHR.

Objective 2
To reduce the gender based socio-cultural barriers that prevent men and women from access to SRH services in 7 branches (same as HIV/AIDS).

Activities
1. Redesign the women forum by involving men and women activists for sharing experience, ideas and resources by formation of a Technical cell composing organisational planning and Gender issues attaining gender equality and equity by setting short term goals.
2. Women forum will advocate and hold dialogue with the policy makers to create environment on SRH Rights empowerment.
3. Organize group meeting/seminar with husbands, gatekeepers and religious leaders on SRHR, early marriage, early pregnancy, divorce etc. to reduce violence against women.
4. Establish networking with GO and NGOs.
5. Observe national and international days/events involving women to increase awareness and also to improve their moral courage.
6. Organize rally involving community people to sensitise the consequences of gender-based violence.

OUTCOMES
1. Increase involvement of target groups and strengthened project activities.
2. Involved community people, established linkage with GO-NGOs and sensitised consequences of gender-based violence.

INDICATORS

Indicators for outcomes 1
• 7 SDPs base line surveys conducted.
• 7 SDPs survey findings documented.
• 27,150 meeting/health education sessions and 155 seminars organised.
• 750,000 counselling sessions conducted.
• 2,570,000 beneficiaries SRH services received. • 300,000 need based BCC materials. Collected and distributed.
• 850 functional linkage with GO and NGOs established.
• 7 survey findings documented and used.

Indicators for outcomes 2
• 33 women forum redesigned.
• 620 dialogue hold.
• 35,000 group meetings and 355 seminars organized.
• 10,000 networking established.
• 930 national and international days/events observed.
• 930 rallies organized.


LEADERSHIP AND GOVERNANCE

PROBLEM ANALYSIS
Volunteers have played a pioneering role from the inception of FPAB in conceptualizing and advocating Family Planning, supplementing the government policy towards reproductive health and small family norms. Since 1953, FPAB has exposed a new horizon to the mass, popularizing the philosophy of a small family model. FPA took a hold and controversial anti traditional programme for the benefit of community towards introducing qualitative reproductive health progammes.

More focus on strategic priorities on 5 “A”s by IPPF from 2005-2009 onwards will substantiate on diverse skills and expertise from volunteers from branch and national level. The new challenge for FPAB is to recruit volunteers capable of providing the necessary leadership and expertise i the field of SRH.

FPAB encourages active participation and support of volunteers in the areas of :
• Advocacy role
• Resource mobilisation
• Policy formulation
• Stewardship of FPAB
• Image building

The Volunteers are further required to develop in-depth knowledge on organisational constitution, rules, roles and responsibilities. They are further encouraged to create an environment to increase the membership of youth and women in the governing bodies both at national and branch level.

STRATEGIC DIRECTION
FPAB will work towards developing the capacity of the volunteers at every level to advocate strongly for increased commitment and resources for SRHR and to strengthen their ability to provide leadership.

GOAL
To increase public, political and financial support for ensuring sexual and reproductive health and rights in the communities and at the national level.

OBJECTIVES
Objective 1
Improve the capacity of the volunteers to enhance the image of FPAB through effective advocacy and resource mobilization.

Activities
1. Recruit committed, quality volunteers from all sectors of society to serve FPAB objectives and develop effective mechanisms of sharing and communication.
2. Revise the constitution of FPAB focusing mandates of the IPPF for involvement of women, client groups, youth, disadvantaged and minorities/ethnic group on volunteer boards and committees thereby increasing participation of women in leadership/management positions mandatory.
3. Provide the volunteers with training in relevant leadership skills and orientation on the respective responsibilities and obligation of both volunteers and staff regarding good governance and management.
4. Establish a continuing programme of orientation and consultation for key influential groups such as parliamentarians, community leaders and the media etc. in order to mobilise more resources.
5. Provide assistance to the FPA’s in all aspects of their work relating to governance, management, supervision, accountability and transparency.

OUTCOMES
1. Image of FPAB enhanced at national, regional and global level.
2. Establish FPAB leadership by volunteers with expertise in development, specifically in the field of SRHR. Increased commitment of the community leaders and parliamentarians to resolve SRHR related issues supplementing national policy.
3. Increased participation of marginalised groups, particularly young people and women in the governance structures of FPAB.

INDICATORS
Indicators for outcomes 1
• Increased financial resources made available to FPAB for programme excellence and image.
Indicators for outcomes 2
•Increase in the percentage of women, youth and marginalised groups in the FPAB governing bodies.
Indicators for outcomes 3
• Better staff and governance relations.