Toppling taboos

Improving sexual and reproductive health in Bangladesh.

Md. Sariful Islam

Development, Social policy, Health, Arts, culture & society | South Asia

15 May 2015

There is no policy covering women’s rights to sexual and reproductive health in Bangladesh. Is the country ready for it?

We often talk about women’s rights to sexual and reproductive health in Bangladesh, but there is no specific policy to cover this.

Some components, especially reproductive health issues, are mentioned in our National Health Policy, Population Policy and Adolescent Reproductive Health Policy, but Sexual and Reproductive Health Rights (SRHR) have no concrete status. They are bypassed, with the exception of Sexually Transmitted Diseases (STDs).

UNICEF reports that women are often subjected to early marriage, sexual abuse and violence in intimate and marital relationships in Bangladesh.

An increasing number of women are forced into prostitution as the only way to provide for their children. Men who buy sex from women are often reluctant to use condoms and women have little negotiating power. Even within their marriages, they may have spouses who are engaging in high-risk behaviours, and may be exposed to HIV.

The need for a comprehensive SRHR based policy is timely, but is Bangladesh prepared for it?

Bangladesh is much more dedicated to the improvement of the reproductive health sector, but not in sexual health and rights policy; we are comfortable discussing sexuality through health issues, especially STDs like HIV/AIDS.

The Bangladesh government is constitutionally obliged to ensure people’s fundamental human rights and improve public health, as outlined in Articles 11, 15 and 18 of the Constitution of the People’s Republic of Bangladesh, which assures basic democratic rights, the provision of medical care, and the right to proper nutrition.

Abortion is illegal, although there is provision for “termination of unwanted pregnancy or menstruation regulation’’, allowed up to 10 weeks from last menstruation. Homosexual acts are illegal and punishable according to Section 377 of the Penal Code of Bangladesh.

Bangladesh did not agree to the recommendations of the International Conference on Population and Development (ICPD) on homosexual rights. It also opposes the ICPD proposal to give children aged 12-13 years comprehensive sexuality education programs, and expressed its reservations on recommendations on sexual orientation and gender identity at the sixth Asian and Pacific Population Conference. In 2011 and 2013, Bangladesh was among 19 countries to vote against the resolution of the Human Rights Council of the UN Human Rights Body, that no discrimination or violence be brought against people based on their sexual orientation.

Open discussion with the women about SRHR on Safe Motherhood Day. Picture courtesy RHSTEP

Open discussion with the women about SRHR on Safe Motherhood Day. Picture courtesy RHSTEP

Policy laws are the framework for human welfare. But if the policy is influenced by conservative and restricted socio-cultural norms and values, then very often the policy fails. It is also possible that any initiative towards a SHRH policy in Bangladesh will create a backlash of criticism, and even exacerbate the current situation.

Reproductive health issues are included in several policies where sexual health issues are mentioned, but unfortunately do not have a well-defined implementation and monitoring system due to a lack of cohesion among different ministries responsible.

There are clear conflicts between universal or international human rights standards and time honoured socio-cultural practices. When rights and cultures collide, reaching a desirable conclusion is a serious challenge for policymakers.

In many cases, demand for a complete SRHR policy is reasonable and valid, but a universal SRHR policy becomes fragile when it varies from society to society.

Societies do not develop in parallel, rather every society has its own identity. Given different cultural characteristics, how we can suggest a single prescription for every society?

Trying to implement one solution for all may create a drastic breakdown in the existing social system, which may cause more human rights violations, and result in a more culturally restricted state. Sticking to traditional norms and values disregarding rights, or only asking for internationally recognised rights and ignoring the socio-cultural and political context, may create chaos.

Policy rhetoric will not ensure good SRHR policy, but policy formulation with effective and efficient implementation, and with proper monitoring, can make a real difference.

Good and effective policy can reduce SRHR-related sexual and reproductive stigma, gender inequality, violation of rights, and sexually transmitted diseases.

If we want to create a new framework for SRHR, we have to go through a lot of groundwork first. It is not possible to change the whole cultural edifice overnight. But a rights-based approach and sound policy can start bringing change. Achieving a confluence between the socio-cultural fabric and human rights would possibly be the most challenging task.

Also, if we do not have the appropriate data and information, it is not possible to design an effective policy framework. Government must collate research and data on different sexual and reproductive health issues in Bangladesh to pave the way forward. This will also identify priorities for policy formulation and revision.

Reproductive health issues are primarily concerned with women, and different policies and laws are largely focused on women too. But not much emphasis has been placed on the active involvement of men, who have a very important role to play in the success of any new policies. Without including men in the policy design, there would not be a positive outcome.

Despite difficulties and challenges, Bangladesh has set an excellent example in providing SRHR services through Government-NGO collaboration, but these are not sufficient. In addition, international politics is very complex and we need to keep different agendas in mind, and consider whose interests are being served. Careful analysis is a must, to identify the underlying motivations behind international political pressure, and the specific interests of development partners.

There is no denying that ensuring human rights must be at the core of any SRHR policy, but not at the cost of uprooting the socio-cultural system.

We cannot overlook the existing situation, nor isolate ourselves from our socio-cultural beliefs and values, and we cannot ignore the human rights factors. We must focus on both in any new policy design. A modest adjustment of rights and cultural agendas, to create a comprehensive SRHR-based policy, will be the best outcome for Bangladesh.

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