How Bangladesh’s female health workers boosted family planning
Contraception delivered through female community health workers has helped to reduce birthrates and infant mortality
Wearing sandals and draped in a dark-blue sari, Aparajita Chakraborty glides into the cluster of hilltop homes with the self-assurance of someone who has long been making house calls.
She has. For more than 30 years, Chakraborty has been visiting this extended family, doing checkups and dispensing advice. But she is no doctor, she’s a community health worker who has been dispatched by the local hospital. Yet she has won the trust and gratitude of the surrounding villages by saving lives – mainly from cholera and other deadly diarrhoeal diseases.
With all the men away, either working in the rice fields or having migrated to the city, Chakraborty quickly gets down to business in the family compound of half a dozen homes. She and a colleague conduct a group interview, asking four women personal questions such as: when did they last menstruate? Are they taking the pill, or using another method of family planning?
One woman explains that she stopped taking the pill when her husband began working in Chittagong, a day’s journey away. She resumed her use of contraceptives immediately after his surprise visit. By then it was too late, and she is now expecting their third child.
Another woman says she is not using any form of contraception. The woman’s husband, it transpires, had a vasectomy after their fourth child. But he doesn’t want his brothers to know for fear they will think him impotent. So it’s a secret, albeit one that has been documented by hospital staff, along with every birth, death, marriage, divorce and other vital statistic of 225,000 people in the region.
Chakraborty knows more intimate details about the community than they know about one another. But discretion is paramount, she says: “I keep what I hear to myself. I feel like I’m part of the family.”
She is part of an all-female cadre of community health workers who span this portion of Bangladesh‘s low-lying delta, carefully maintaining one of the longest-running and most detailed health and population data sets in the developing world.
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