C7.4: ICT Applications: e-health

Executive Summary: First Part

Sexual & reproductive health rights (SRHR) becomes an important issue especially for women & adolescents. In Bangladesh, adolescents represent more than one fourth of the total population and they are the healthiest members of the communities having survived infancy and early childhood diseases and health risks like early marriage & pregnancies, violence, inadequate nutrition etc. SRHR is defined as all health events related to reproduction in the life cycle that directly linked with family planning, post abortion care, safe pregnancy & safe motherhood, reproductive tract infections, sexually transmitted diseases, HIV/AIDS, maternal and infant nutrition, and cancer of the reproductive tract, infertility, female genital mutilation, and gender-based violence. This situation is reflected in the unacceptably high rates of maternal and child mortality and morbidity in the country.

Part 2: Project Information

Project Duration:  November 2016 to October 2021.

Implementing Partners:

Community Radio – Radio Lokobetar (Amtoli, Barguna), Radio Naf (Teknaf, Cox’s Bazar), Radio Meghna (Charfashion, Bhola), Radio Pollikontha (Moulovibazaar), Radio Padma (Rajshahi), Radio Mohananda (Chapainawabgonj), Radio Borendra (Naogaon), Radio Chilmari (Kurigram) and Radio Sarabela (Gaibandha).

Supported by: DFID-UKAid through Ipas Bangladesh.

Project’s description (Activity’s description)

Sexual and Reproductive Health Rights (SRHR) are basic human rights, and all people have to have the right for equal access to SRH education and services through ICT Applications: e-health. Now a days this services are available in online- Facebook, Facebook live, YouTube, Cell Phone SMS; and offline courtyard meeting, house visit etc. The issue of SRHR in Bangladesh still remains sensitive to discuss openly, particularly among the adolescents despite of its importance in their life; especially at this delicate stage. In Bangladesh, adolescents represent more than one fourth of the total population. Although adolescents are the healthiest members of the communities having survived infancy and early childhood diseases, they face a number of important health risks arising out of early pregnancies, violence, inadequate nutrition etc. Reproductive health (RH) is defined as all health events related to reproduction in the life cycle. Its components include family planning, post abortion care, safe pregnancy and safe motherhood, reproductive tract infections, sexually transmitted diseases like urinary tract infection, Syphilis, Gonorrhea, HIV/AIDS, RH services for adolescents, maternal and infant nutrition, and cancer of the reproductive tract, infertility, female genital mutilation, and gender-based violence. Despite improvements in some aspects of health, the RH situation in Bangladesh still remains unsatisfactory. This situation is reflected in the unacceptably high rates of maternal and child mortality and morbidity in the country.

Many young people in Bangladesh do not have access to adequate information about their SRHR because of strong social and cultural taboos around the issue which causes a pervasive silence. The current national school curriculum contains only minimum information about SRHR and often teachers are incapable & reluctant even, to teach the issues in the class rooms. It leaves a vacuum for the young people especially the adolescents to access fact information on SRHR.

As a result, most adolescents enter into unsafe relationships, marriage and pregnancy without any adequate preparation. Entering suddenly into such crucial life events, they even do not have access to the obvious necessary SRH information to manage such situations and ask for services as needed.

To address these crucial issues, it is high time to focus on young people, so they could be empowered by accessing accurate, friendly and age-appropriate information & services on SRHR issues. This will also support them to come up with the capacity of making ‘Informed Choices’ and to ask/utilize the available supports as well.

Community Radio Breaking the Silence on SRHR and Spreading Family Planning Message:

At present 18 Community radio stations are on ether in seven divisions that covers 16 districts with 6.8 million listeners.   It’s an art of infotainment for the voice of voiceless people living in rural areas.   In total each & everyday 147 hours programs are preparing and broadcasting community driven different programs including SDGs and safety nets through engagement of 1000 youth & youth women.

As Body rights are important part for any individual human being, based on that thoughts as well as analyzing of facts & figures Bangladesh NGOs Network for Radio & Communication (BNNRC) implies that this is the right times to address the very crucial & vital issues considering SDG 03 and 06. As community radio is one of the best tools to disseminate information and raising awareness of community people especially rural communities. Based on past experience of BNNRC it implies that comprehensive community radio programs like radio magazines, radio talk shows, public service announcement (PSA), awareness education sessions with educational institutions and courtyard meeting would be the tools for informing, educating, sensitizing and changing behavior & attitude of mass people through empowering communities, creating space and influencing power. The approach and implementation process of the programs is as follows.

Courtyard Meeting (CYM): Community radio stations are organizing CYMs with the members of radio listeners clubs considering age groups of women, newlyweds and adolescents on SRHR and long acting and permanent methods (LAPM), MR & PAC issues. The Union Family Welfare Assistant (FWA)/Family Welfare Volunteers (FWV) and trained volunteers act as resource persons for facilitating the sessions. At least 20/25 participants participate in each sessions and duration of the session were 1.5 hours including interactive discussion that followed questions & answers sessions.

Radio Talk Show: Community radio stations also organizing of talk show (Live) on SRHR and long acting and permanent methods (LAPM), MR & PAC issues in monthly basis involving of Doctors, DD Family Planning/Upazila Health & Family Planning Officer, Adolescents, Local Journalist and Teachers. The program duration is for 25/30 minutes including question & answer session.

Radio Magazine: Simultaneously, community radio stations are organizing and broadcasting radio magazine on SRHR and long acting & permanent methods (LAPM), MR & PAC issues.  A common format they have followed that comprises of radio Sting, news on SRHR & LAPM of local areas, Interview, PSA, Song, Drama, Voxpop etc. with a view to make the event lively and successful. Basically it is the recorded program that is views/voices of different stakeholders including govt. officials and method users. The duration of the magazine is for 20/25 minutes.

Public Service Announcement (PSA):  As a part of awareness education, CRSs has developed and broadcast PSAs on SRHR and LAPM in on regular basis. The duration of PSA is for 10 to 20 second each.

Features on SRHR: Community radio stations has engaged Local Journalist as fellow for preparing and publishing of features in local, regional and national newspapers considering local situation on SRHR and long acting & permanent methods (LAPM), MR & PAC issues. It is expected that this activity will add additional value to raise awareness of mass people and sensitizing them as well.

Expected Outcomes:

• Enhanced knowledge on SRHR and menstruation hygiene management (MHM) and LAPM,
• Reduced early marriage and sexually transmitted diseases, HIV/AIDS,
• Reduced child & maternal mortality rate,
• Improved reproductive choices and reduce unsafe abortion,
• Women are able to access effective FP, safe MR services, and high-quality PAC,
• Build capacity of the health system to provide safe services;
• An enabling regulatory and policy environment around sexual and reproductive health care.

Relation with SDG 03: Ensure healthy lives and promote well-being for all at all stages.

Adolescents and socio-cultural background although at the prime of their life, an estimated 1.7 million adolescents die every year mainly from exploitation and abuse violence takes many forms-physical, sexual and psychological. They are exposed to all prevalent forms of violence against women e.g. dowry related violence, marital rape, sexual harassment and intimidation at work, trafficking, forced prostitution, acid throwing, rape etc. Gender discrimination in the form of discrimination against girls has been identified as one of the prime adolescent reproductive health (ARH) issues in Bangladesh. The discrimination exists in most spheres of life including employment, marriage, social mobility, food allocation etc. A culture will be created to prevent unintended pregnancies and reducing adolescent childbearing through universal access to sexual and reproductive health care is crucial to the health and well-being of women, children and adolescents through …

• Increased capacity of the health sector in terms of service delivery centers, providers on quality SRHR and FP services.
• Institutionalized and sustainable attention at the national level to ensure access to women, young adolescents and newlyweds on SRHR, FP, MR, and PAC.

Highlights of the Project’s partnership activities

The aims of the partnership not only educating and empowering of the people but also to reduce mother & child mortality by contributing to improve access to SRHR and FP services through make inroads on a significant, but neglected areas of maternal health in Bangladesh in respect to death and injury from unwanted pregnancy and reducing the incidence of unsafe abortion by offering modern and high-quality FP and PAC services by trained persons.

A consistent route has been maintained based on social context and stakeholder analysis with specific functions such as information dissemination, interaction and integration of information resources, training, and monitoring and evaluation. The most outstanding feature is that it covers the entire health & family planning domain and offers free-of-charge, shared services.

It also plays a leading role in the social transformation and behavioral change through providing scientific and modern SRHR and FP health information system.

Challenges and project’s future perspectives

Considering the present situation and removing of misconception and myth about SRHR and family planning issues it is very important to aware and educate male counterpart/spouse and policy makers, social & religious leaders and educational institutions. Besides, need to introduce behavioral change communication (BCC) materials with a view to removing taboo on SRHR, family planning and technological development i.e. ICT through trained up service providers, availability of materials & equipment’s at grassroots level. It will continue to promote universal access to modern & scientific knowledge, and the creation and dissemination of scientific and technical information, taking account of open-access initiatives. The learning’s and social impact possibly to replicate in other community radio areas with the participation of multidisciplinary stakeholders.