A prolonged shortage of government-supplied birth control materials, coupled with staff vacancies and funding delays, are reversing hard-won gains in reproductive health across Bangladesh.
An acute shortage of government-supplied contraceptive commodities-persisting for more than a year and worsening sharply over the past six months-has put women at serious risk of unintended pregnancies, disrupted sexual and reproductive health, and threatened to undo decades of progress in family planning.
Stakeholders say the crisis has hit hardest among married women from low-income communities, for whom the government-supplied oral contraceptive pill, popularly known as Sukhi Bori, is the most widely used method.
Injectables and intrauterine devices (IUDs) are the next preferred options, while condoms remain the primary method for men. These contraceptives are normally distributed free of cost through the Directorate General of Family Planning and partner non-governmental organisations, particularly in remote and underserved areas.
However, following administrative changes after August, stocks in most upazilas have nearly run dry. Women who have long relied on free contraceptives now face heightened anxiety over unintended pregnancies, as financial constraints and unfamiliarity with private brands prevent them from turning to the market for alternatives.
The impact of the shortage is beginning to show in national data. According to the Multiple Indicator Cluster Survey (MICS) 2025, Bangladesh's total fertility rate rose to 2.4 in 2025 from 2.3 in 2019-its first increase in more than a decade-raising concerns among public health experts.
Field-level health workers typically distribute five contraceptive methods: condoms, oral pills, IUDs, injectables and implants. Official figures show that, under normal conditions, workers distribute more than five million condoms and nearly four million cycles of oral pills every month. But data from the DGFP website reveal a stark reality: as of November 2025, second-generation Sukhi Bori pills were unavailable in 491 of 493 upazilas, condoms were out of stock in 398 upazilas, and injectables were unavailable in 63.
Family welfare assistants say regular service recipients are increasingly distressed, fearing unintended pregnancies and health complications. The crisis is compounded by a severe staffing shortage, with nearly 40 percent of field-level posts vacant, further weakening service delivery in marginalised communities.
DGFP officials acknowledge that contraceptive shortages have persisted for nearly two years, driven by funding constraints and administrative delays. Md Manjur Hossain, Programme Manager (A & RH) of the MCH-S Unit at the DGFP, said contraceptives were previously procured under a five-year sector programme that has since been discontinued.
"Activities are now being carried out under a new Development Project Proposal (DPP), but final approval for the July 2024-June 2026 period has not yet been granted," he said, adding that procurement stalled during the transition, leaving warehouses empty and posts unfilled. He expressed hope that swift approval of the DPP would help restore supplies and services.
Public health experts warn that prolonged delays could deepen inequality. Zakia Ferdausi Khanam noted that only 30-35 percent of family planning services come from the private sector. "Urban women may still manage to buy contraceptives, but for marginalised women, travel costs and access barriers make that impossible," she said, urging the government to prioritise resolving the crisis before vulnerable women are pushed further to the margins.
