Comprehensive Initiatives of Ipas for Promoting Reproductive Health and Rights in Bangladesh
Ipas, founded in 1973 in North Carolina, USA, operates globally to promote reproductive justice by expanding access to abortion (referred to as menstrual regulation (MR) in Bangladesh) and contraception. In 2011, Ipas began operations in Bangladesh, collaborating with the Ministry of Health and Family Welfare (MoHFW), Directorate General of Family Planning (DGFP), Directorate General of Health Services (DGHS), Directorate General of Nursing and Midwifery (DGNM), NGOs, donors, and stakeholders for strengthening the health system. Initially focusing on menstrual regulation (MR), postabortion care (PAC), and family planning (FP) services, our efforts have evolved to advocate for institutionalized sexual and reproductive health and rights (SRHR) services.
Our Core Values and Strategic Priorities
We support access to sexual and reproductive health and rights through these fundamental pillars:
- Innovation
- Health System Strengthening
- Advocacy
- Technical Assistance
- Community Awareness and Social Support
- Humanitarian Support
- Research and Evidence Generation
Assessment of Ipas Initiatives: The QFP Project
Ipas implemented a project titled “Family Planning in Bangladesh: Improving Quality and Access” briefly called QFP (Quality Family Planning) Project. The project activities were implemented during October 2016 – July 2021. With an aim to reduce the unmet need for contraceptives in Bangladesh and to deliver PPFP and PAFP services to women with a special focus on promoting LARC and PM, Ipas implemented QFP project from October 2016 to July 2021.
This study assessed the contribution of QFP project to promote LARC and PM in Ipas intervention facilities in Bangladesh to identify the enablers and/or hinders in uptake of LARC and PM. Furthermore, this study aimed to assess the QFP project initiatives to strengthen family planning (FP), menstrual regulations (MR), and postabortion care (PAC) services and to assess the progress towards institutionalization of FP, MR and PAC services in Director General Health Service (DGHS) system.
Innovation in Digital Health and Humanitarian Settings
The ISRHR’D project has introduced the OGSB Call Center, launched in May 2023, as a step forward in digital health services. Offering free consultations, this initiative aims to bridge the socio-economic divide and ensure equitable access to SRHR services for underserved urban populations.
In addition to urban efforts, Ipas Bangladesh led an innovative study in the sprawling Rohingya refugee camps located in Cox’s Bazar, Bangladesh in collaboration with the Center on Gender Equity and Health at the University of California, San Diego (UCSD). This evaluation report details the 2022 performance evaluation of the “Humanitarian Response Program” implemented in the Rohingya refugee camps in Cox’s Bazar, Bangladesh by Ipas.
Understanding Menstrual Regulation and Vacuum Aspiration
According to the Government of Bangladesh (GoB), Menstrual Regulation (MR) is a procedure to regulate the menstrual cycle when menstruation is absent for a short duration; it is performed in a health care facility by a trained service provider within a set number of weeks since a woman’s last menstrual period.
A key procedure used is Vacuum or suction aspiration, which uses a vacuum source to remove an embryo or fetus through the cervix. The procedure is performed to induce abortion, as a treatment for incomplete spontaneous abortion (otherwise commonly known as miscarriage) or retained fetal and placental tissue, or to obtain a sample of uterine lining (endometrial biopsy). It is now known to be one of the safest obstetric procedures, and has saved countless women's lives. Suction can be created with either an electric pump (electric vacuum aspiration or EVA) or a manual pump (manual vacuum aspiration or MVA).
Key Facts and Historical Data of Vacuum Aspiration
The following data highlights the background and usage of the procedure:
- First use: China 1958 and UK 1967.
- Gestation: 3-13+6 weeks.
- Procedure time: Typically takes less than 15 minutes.
- Usage in Sweden (2005): 42.7%.
- Usage in UK (2006): 64%.
- Usage in United States (2016): 59.9%.
- Complication rate: Achieved as low as 0.48% in certain historical studies.
Clinical Benefits
A study found use of Karman vacuum aspiration to be a safer option for endometrial biopsy when compared to the alternatives such as conventional endometrial curettage. Vacuum aspiration is the surgical procedure used for almost all first-trimester abortions in many countries, if medication abortion is not a viable option.