FPAB Believes That Sexual and Reproductive Rights Are Internationally Recognized Human

FPAB profile

Family Planning Association of Bangladesh (FPAB) CORE VALUES

FPAB believes that sexual and reproductive rights are internationally recognized human rights and, as such, should be guaranteed for everyone.

FPAB is committed to gender equity and to eliminating the discrimination which threatens individual well-being and leads to the widespread violation of health and human rights, particularly of young women.

FPAB values diversity and strives to achieve this in its governance and in its programmes - with a special emphasis on the participation of young people and people living with HIV/AIDS.

FPAB considers the spirit of volunteerism to be central to achieving its mandate and advancing its cause. FPAB

Annual Report 2011

Family Planning Association of Bangladesh (FPAB)

2 Naya Paltan, Dhaka - 1000

Phone: 9354238, 9354213, 8311423, 8319343, 8351006-7

Fax: 88-02-8317385

Email: [email protected]

Website: www.fpab.org Printers Line Contents 5A’s

FPAB Protects Sexual and Reproductive Health Rights M E S S A G E

I am pleased to see that once again FPAB has completed another successive year and putting forward its annual report for 2011. This report consist not only the collection of its success stories but also challenges that were overcome in a cooperative manner. For decades FPAB has been working for the better health of marginalized population of the country through its pioneering approach.

Both family planning and reproductive health issues, has been a great challenge for organizations working throughout the country. Our dedicated volunteers have shown their commitment from time to time in overcoming these challenges. They have kept their ongoing support at the policy and advocacy level. Committed staffs throughout the organization have proven themselves as assets. At the service delivery points they have gained applause by development partners, media and other stakeholders for their role in sexual and reproductive health services. FPAB’s participation towards providing services to the young and adolescent people has been a unique one. It is significant for building a healthy nation that the youth are made aware of their rights.

International Planned Parenthood Federation (IPPF) of which FPAB is a Member Association (MA), have always kept their support towards innovative programs. This will keep encouraging FPAB to be one of the best among IPPF’s MA’s in the South Asian Region.

I am certain that this report will reflect all the hard work that has been put behind the programs. This will be an important document for future endeavours. I would like to congratulate all those who have worked hard to complete this document.

Meher Afroze Chumki, MP President, FPAB F O R E W A R D

FPAB publishes its annual report every year aiming to have a documented piece available, in accordance to the work done in different programs and projects that we have. The year 2011 is no exception. We are in the second year of implementing our Strategic Plan for 2010-2015.

We provide sexual and reproductive health services and advocate for sexual and reproductive rights. In a developing country like Bangladesh there are many challenges that we need to face and overcome in a regular basis. Their have been limitations in various sectors. Never the less, our working mechanism has helped us to succeed in providing sexual and reproductive health including family planning support.

Services were provided directly from the clinics and outreach sessions. And emphasis was given in building strong referral linkages. Youth participation was ensured through different activities. Capacity building was ensured as an ongoing progress throughout the organization, so that their work mirrors the vision and mission of FPAB. There has been significant level of involvement at the advocacy level by our honourable volunteers. Continuous efforts are made to achieve the pick of quality service.

I believe, this will be a hand on resource for anyone interested to have a concise idea of the work done by us. I am thankful to my colleagues who contributed in the successful publication of this report.

A F M Matiur Rahman PhD Executive Director, FPAB A C R O N Y M S

ABS Advocacy for Breaking the Silence MISP Minimum Initial Service Package AIDS Acquired Immune Deficiency MoU Memorandum of Syndrome Understanding ANC Antenatal Care MR Menstrual Regulation APR Annual Project Review M & E Monitoring and Evaluation ART Anti-retroviral Treatment NEC National Executive Committee ASRH Adolescent Sexual and NGO Non-government &R Reproductive Health and Rights Organization AVIZAN Acceptance, Valuing, information, NHQ National Headquarters Zero tolerance, Advocacy, Networking BCC Behaviour Change Communication OP Oral Pill BSMMU Bangabandhu Sheikh Mujib Medical PLHIV People Living with HIV University CBO Community Based Organization PMTCT Prevention of Mother-to- Child Transmission CBD Community Based Distribution PMC Project Management Committee CMIS Clinical MIS PNC Postnatal Care CSG Community Support Group PRMA Project Resource Mobilization Awareness DO District Officer QoC Quality of Care ECP Emergency Contraceptive Pill RHP Reproductive Health Promoter EOC Emergency Obstetric Care RTI Reproductive Tract Infection FDC Family Development Centre SARO South Asia Regional Office

FPAB Family Planning Association of SMT Senior Management Team Bangladesh GBV Gender Based Violence SRH Sexual and Reproductive Health GCACP Global Comprehensive Abortion SRHR Sexual and Reproductive care Project Health and Rights HIV Human Immunodeficiency Virus STI Sexually Transmitted Infection HQ Headquarters SRID Sexual Right: An IPPF Declaration ICPD International Conference on SWU Special Work Unit Population and Development IEC Information, Education and ToT Training of Trainers Communication IPPF International Planned Parenthood VAT Value Added Tax Federation LCF Logistics Coordination Forum VCT Voluntary Counselling & Testing MCWC Maternal and Child Welfare Centre VSC Voluntary Surgical Contraception MDG Millennium Development Goal WHO World Health Organization

MIS Management Information System YIF Youth Incentive Fund INTRODUCTION

Family Planning Association of Bangladesh (FPAB) started at 1953 with the objective to improve the quality of life of the underprivileged section of the society. Since then it has been working towards promoting basic human rights for all. As an affiliated member of International Planned Parenthood Federation (IPPF), FPAB is the oldest and largest family planning non- government organization in Bangladesh.

The founding president of the association was renowned Dr. Humaira Sayeed, following by prominent personalities like late Alamgir M. A. Kabir, late Professor Dr. Md. Ibrahim, late Dr. (Captain) Abul Kashem, late Dr. Syed A K M Hafizur Rahman, M Shamsul Islam, Shaheed Md. Maizuddin, Kazi Anisur Rahman and so others.

The organization has pioneered family planning movement in the country. It advocates family planning as a basic human right and motivates people towards the concept of small family. FPAB played an important role in formulating national family planning programme introduced by the then government of Pakistan in 1965. With the span of more than 57 years of its emergence, FPAB has made a significant achievement in creating awareness among the eligible couples about family planning and annually contributes 7% of the total national family planning performance. In conformity with the global and national needs, FPAB shifted its thrust from lone family planning interventions to the holistic approach of reproductive health in mid 90s of the last century. Instead of targeting fertile couples, interventions of FPAB now involve men and women of all ages with special focus on the disadvantaged segment of the population. Beneficiaries of FPAB have now exceeded ten million people.

FPAB works to improve the life of the individual in a right based way and works in five priority areas: Adolescent, HIV/AIDS, Abortion, Access & Advocacy. In compliance with the changed global and national needs, FPAB developed its five year strategic plan for 2011-2015, with focus on these thematic areas. At present FPAB has its service network from 32 districts out of 64 districts of Bangladesh. Sexual and Reproductive Health services are priority interventions and has been providing from 21 comprehensive clinics, 11 special work unit clinics and 3 Unit clinics. 1420 Reproductive Health promoters (RHPs) are working at the community to provide doorstep services. Fifty-five outreach satellite sessions are operating from clinics to reach out the poor, underserved and marginalized people of rural areas of Bangladesh at project locations of FPAB. VISION

FPAB envisage a world in which every woman, man and young person has access to the information and services they need; in which sexuality is recognized both as a natural and precious aspect of all our lives and as a fundamental human right; a world in which choices are fully respected and where stigma and discrimination have no place.

FPAB Mission

FPAB aims to improve the quality of lives of individuals, by campaigning for sexual health and reproductive right through advocacy and services, especially for poor and vulnerable people.

FPAB defends the right of all young people to enjoy their sexual lives free from ill-health, unwanted pregnancy, violence and discrimination.

FPAB supports a woman's right to choose to termite her pregnancy legally and safely.

FPAB strives to eliminate Sexually Transmitted Infections and to eradicate HIV-AIDS.

FPAB carries its work in partnership with other organizations and donors to achieve our goals more efficiently and effectively. Core Programmes:

• SRH Education for Adolescent and Youth

• HIV-AIDS Education through Awareness and Training

• Enhanced Access to Comprehensive FP and RH Services

• Prevention of Unsafe Abortion: Rights to Services and Women Empowerment

• Advocacy for Breaking the Silence

• Assistance for Organizational Development

Restricted Projects:

• Unite for Body Rights Program

• MR-WHO Project

• Project Resource Mobilization Awareness (PRMA)

• Global Comprehensive Abortion Care Initiative (GCACI)

• IF-Climate Change Project

• P-SAFE Project

• DANIDA A+ International Affiliation of FPAB

The Family Planning Association of Bangladesh (FPAB) is a full member of the International Planned Parenthood Federation (IPPF) London. The IPPF is a non-profit international organization of voluntary national Family Planning Associations of 170 countries of the world, dedicated to the belief that knowledge of sexual and reproductive health is a basic human right and gender equity has to be maintained by eliminating the discrimination which threatens individual well-being and leads to the widespread violation of health and human rights, particularly of young women. The IPPF world has been divided into six regions: 1. Africa Region 2.Arab World Region 3.East and South-East Asia and Oceania Region 4.Europe Region 5.South Asia Region 6.Western Hemisphere Region The FPAB is one of the Member Associations in its South Asia Region, which also includes FPA of India, Nepal, Pakistan, Sri Lanka, Iran, Afghanistan, Society for Health Education (SHE) of Maldives and RENEW Bhutan. The IPPF is financed by contributions from Governments, Foundations and private individuals all over the world.

GOVERNANACE AND MANAGEMENT

The National Council comprised of the elected representatives of 21 branches is the highest governing body of FPAB. The representatives are volunteers from the respected branches. The 22 member National Executive Committee (NEC) elected by the councillors and headed by its President. NEC performs governance functions including policy formulation, resource generation and image building of the organization. Branches and special work units have their own committees. Currently the organization has about 5000 active members. Programmes of FPAB are managed and implemented by its staff members at the national office, branches and special work units. The staff hierarchy is headed by an Executive Director. Programme, focal points and other officials stationed at the national office. They perform the management and supervision functions. Branches and special work units (SWU) implement the programmes under the guidance of their respective committees and supervised by the national office. Performance 2011

Advocacy for Breaking the Silence (ABS) program:

Advocacy program for Breaking the Silence (ABS) is linked to FPAB’s advocacy strategy for mobilizing support for the promotion of Sexual and Reproductive Health and Rights (SRHR) by involving policy makers, activists and the media. The strategy aims to increase public and financial commitment at the national and community levels, towards sexual and reproductive health and rights of women, men and young people. In the year 2011, “Stopping child marriage” was the advocacy issue for FPAB. Early marriage has been a great public health concern in the country. Its consequences are violation of sexual and reproductive health rights of women and girls.

The activities included developing fact sheets on child marriage, dialogue with parliamentarians and policy makers targeting effective implementation of child marriage related laws. We have developed partnership at the national level with organizations working towards ensuring child rights, woman rights, SRHR rights and human rights. We were involved in media campaigns to build awareness so that child marriage related laws are successfully implemented. In order to organize fellowship activities on child marriage we have developed partnership with Women Journalist Centre. Orientation program was organized for FPAB’s national level volunteers and staff on the SRHR issues and their role in advocacy level.

The ABS project aims to increase understanding and commitment of FPAB volunteers and staffs on the gender and rights based approach. It also aims to strengthen support for promoting SRH rights among the activities of the government, non-government organizations, and leading print and electronic media.

Strategic goal Increasing public and financial commitment to and support for sexual and reproductive health and rights at the national and community levels In order to attain its objectives, FPAB organized advocacy events, produced and published advocacy materials in the year 2011.

Advocacy Events & Activities

 Developed advocacy fact sheet on child marriage to use in different advocacy events;

 Organized Partners meeting with Plan-Bangladesh, CARE Bangladesh, BNWLA, Women Journalist Centre and other organizations on Child Marriage;

 Developed working partnerships with Health Reporters Forum and Women Journalist Centre. Fellowship activity was also organised with them on child marriage. MoU was signed with Women Journalist Centre;

 Facilitated orientation session with Hon. Volunteers on SRHR and advocacy issues at Branch levels. This was held at Cox’s Bazaar, Bogra and Pabna;

 An issue of Shukhi Paribar magazine was published;

 3500 copies of note books were produced;

 Honorary Secretary General Report of FPAB was published for Annual General meeting of FPAB. All program activities and policy level issues of FPAB, were highlighted in the report;

 Published Honorary Treasurer Report for Annual General meeting of FPAB;

 Published APR Workshop Report;

 Published FPAB Annual Report of 2010. This report is a reflection of the performances and achievements of FPAB. The document is used by volunteers and staff of FPAB and the partner organizations;

 Developed FPAB’s strategic plan for the period of 2011-2015;

 Organized Meeting-workshops on Political Mapping, started process, selected consultant for political Mapping for new Advocacy strategy. It is now in the final stage. Limitations / Challenges

This year, some planned activities could not be accomplished due to socio-political situation & other relevant causes. Some of which included:

 Identification of new issues of Advocacy;

 Attitude of Policy makers in FPAB towards new concept of advocacy strategy;

 Budget constrain;

 Adjusting time schedule to work with policy makers;

 Political instability;

 Lack of manpower.

A D O L E S C E N T

Aiming to provide comprehensive sexuality education (CSE) and youth friendly services (YFS) to young people, FPAB has made specific working areas and defined major activities under each of its different programs and projects. These were done in accordance to the credentials of individual donors and included the followings:

AVIZAN project (core fund): Active participation of youth at the program, management and governance level.

Unite for body rights (Dutch alliance): Comprehensive Sexuality Education and Youth friendly services. P-SAFE (RFSU/SIDA fund): Comprehensive Sexuality Education and Youth friendly services.

DANIDA A+: Youth friendly services.

AVIZAN project:

AVIZAN (Acceptance, Valuing, Information, Zero tolerance, Advocacy, and Networking) to promote adolescent sexual and reproductive health and rights.

Strategic goal Adolescents and young people are empowered to make informed choices and decisions to enjoy mutually satisfying & safe relationship, free from coercion or violence without fear of infection or pregnancy.

Events & Activities  FPAB Youth Parliament: Speaker and Leader of the House of Parliament were elected as a member of SARYN (South Asia Regional Youth Network). Leader of the House Ms. Syefa Ahmed was elected as a President of SARYN. She was also elected as a RC member, REC member of SAR/IPPF and Governing Council member-GC of IPPF. At the country level Two Youth Parliament sessions were organized.  Youth Friendly Sexual Reproductive Health services : FPAB service statistics shows that 47,619 young people from 9 branches and 11SWUs of FPAB have received counselling services on life skills, sexuality, HIV/AIDS prevention, SRH and other issues. In the same reporting period 17,501 young people have visited the Tarar Mela’s (FPAB service centres) for education, counselling and services. The peer educators have distributed 90,629 pcs of condoms, 15226 cyl of oral pill, 369 cyl of ECP among the young people in educational institutions and communities.  Advocacy and training on SRH of young people: In 2011 young people’s capacity for advocating on sexual and reproductive rights was built through several initiatives. At the Regional level, there was capacity building training on ‘monitoring tools for achieving the Millennium Development Goals: Young Peoples perspectives’ and ‘Regional Youth Workshop on SRH HIV integration and Advocacy.’  AVIZAN Program organized training for PMC, PE and Youth Parliament member on ASRHR, leadership, communication and CSE.  Organised orientation program with 26 school and 13 madrasha teachers on ASRHR.  Organized talent competition like drawing, quiz, story writing, debate etc.  Young people were involved in National and International level conference through out the year.  Comprehensive Sexuality Education CSE: FPAB’s Youth participated in Regional workshop on CSE and Training program for Adolescent and Young People. 368 sessions were conducted with adolescent boy at branch level with 9114 participants. 248 sessions were conducted with adolescent boy at SWU level with 6235 participants. 376 sessions were conducted with adolescent girls at branch level with 9051 participants. 248 sessions were conducted with adolescent boy at SWU level with 6228 participants

Need to put photos here Unite for Body Rights (UBR) Project:

Unite for Body Rights programme, is focused to upgrade existing clinics into prominent youth friendly one throughout 12 Upazilas of Bangladesh with an alliance of five NGOs. It aims to assure quality integrated SRHR services in combination of clinical and community activities. A special approach to Madrashas (religiously oriented schools) was part of the programme, because of the importance to reach these adolescents with information on SRHR. Rights based approach has been used to teach democratic principles and personal relations. The SRHR Alliance strives to increase acceptance of sexual rights by governments, policy makers, societies, communities and civil society organizations. Working together gave the opportunity to learn from each other‘s best practices on reaching poor people, and improving participation. This also included an innovative approach to engage citizens, especially better engagement of young people and creating further space for them.

Unite for Body Rights (UBR) Project was initiated by Dutch SRHR alliance; Government of Netherlands has funded the program. In Bangladesh FPAB, PSTC, DSK, CHC and RHSTEP these five non government organizations (NGOs) are the member of this alliance. As part of this alliance, FPAB implemented the program aiming to strengthen service delivery systems; empowering adolescents, youth and marginal people through the means of youth friendly services and education on sexual reproductive health and rights. The UBR project of FPAB has been implemented in Mymensingh Sadar, Noakahali Sadar, Pabna Sadar, Bogra Sadar, Poba Upazila including Shah Makhdum Thana of Rajshahi district.

Strategic Goal Strengthening the Bangladeshi health systems in multiple ways, depending on the local realities, as well as strengthening people‘s capacity to demand comprehensive SRHR services and advocacy for supportive laws and legislation. Events & Activities

 Youth Participation: In 2011 total 97,871 clients received 154,595 services including counseling from FPAB static clinics, 71,245 people of reproductive age received different family planning services from 150 RHPs and total 80,283 young people visited FPAB Youth Friendly Service centre named Tarar Mela.

 Capacity Building: FPAB also initiated some comprehensive training under UBR program for service providers keeping the output ‘Increased capacity of service providers on SRHR issues and increase delivery of comprehensive sexually education’ in mind and trained Doctors, Nurses, Paramedic, Counselors, Youth Trainer, Peer Educator, PMC member under this program.

 Advocacy and BCC: - Considering the importance of the role of teachers, teacher’s orientation programs were organized in different schools and colleges and 672 teachers were oriented.

- Printed Brochure for young people centering the topics on Rights of Sexual and Reproductive Health, Changes in Puberty, Menstruation, Wet-dream and Child Marriage.

- FPAB published 2,000 copies Sandhi, a News Letter and distributed to the madras’s, schools, colleges and all stakeholders among the partner organizations.

 Upgraded Youth Friendly Service Centre:

- Five Tarar Melas (youth friendly centres) of FPAB have been equipped with books, leaflets, interactive games on SRH, Gender, Sexual Abuse, Contraceptives, Sexual Rights and Relationships.

- Offered various skill development courses and free internet browsing facilities to increase the acceptability of Tarar Mela among parents and teachers. - Have clear signs displaying hotline number at Tarar Mela for complaints regarding sexual harassment. Promoting SRHR and Adolescent Friendly Environment (P-SAFE) Project:

FPAB implemented this project in Tangail, Rangpur, and Comilla branches. Through this project Youth Friendly Corner (Tarar Mela) was established. Tarar mela consisted of a room with computers, indoor sports materials, BCC materials, TV & DVD player. There is another room for counselling.

This project was able to articulate and pioneer in creating friendly environment for increasing access to sexual and reproductive health information and care for adolescents. As well as enabling them to enjoy their rights and entitlements.

Strategic Goal

Young People enjoy sexuality health and rights.

Events & Activities

 Youth Participation:

- Organized 3 day long training for 18 PMC members on how to monitor adolescent program, their roles in gender- and rights-based approaches. - Organized 5-day long TOT for 18 peer educators on how to conduct SRHR session in out of school, in school and tarar mela. - Organized 3 day long training for 20 branch level managers on how to monitor adolescent program, their roles in gender- and rights-based approaches.

 Advocacy and BCC:

- Organized daylong orientation for 45 teachers, government officials, public representatives and religious leaders from three branches. - Organized 432 SRH sessions and a total number of 7944 boys and 8436 girls attended these sessions. - Five types of BCC materials printed to motivate young people on SRHR issues.

 Youth Friendly Corner

- Three Tarar Mela were decorated with furniture, computers, TV/DVD etc. And these centres now offer various skill development courses such as computer course, spoken English course and internet browsing facilities. The centres also have a reading corner and game facilities. - Organize 142 talent competitions on essay, debate, drawing, hand writing, rime at three branches Tarar Mela. - Provide 1730 telephonic counselling on SRHR issues through male and female youth counsellors.

Need to add two photos that was given

Improve Youth Friendly Services (DANIDA A+) Project

The DANIDA A+ project continued to build on the work done under SALIN plus in four branches (Jessore, Khulna, Dinajpur, Faridpur).

Events & Activities

 Renovated FPAB clinics, by improving outlook and created better spaces for service providers/recipients and managerial staffs. This helped increase quality and quantity of services. Satellite services changed the notion of thought and number of service recipients among young people increasing highly and first time service recipients in A+ project area are 4332 young peoples.  Developing and finalization of Child and Youth Protection Policy.  Capacity building trainings were organized to increase institutional commitment towards young people’s SRHR and positive sexuality. District Officer, Coordinator Program/Finance, clinical staff, youth counsellors, youth trainers, PMC members, and peer educators participated in different training program.  Concept Clarification training was conducted for all the staffs in A+ Project areas.  Developed a Youth Film Maker pool (8 young people) through training and then created a documentary “Behind the Dream”.

Limitations / Challenges Addressing adolescent health is a challenge and opportunity for health care providers, parents, and educators who frequently are unwilling or unable to provide complete, accurate, age appropriate reproductive health information to young people.

 SRHR issues are sensitive and not something that is openly talked about in the country.  Most of the time parents were reluctant to talk about these issues and didn’t want to send their children to the sessions.  Many young people did not feel comfortable as well, discussing sexuality issues with their parents or other adults.  Frequent turnover of Young People.  Developing ASRH positive attitude among community gatekeepers.  Develop positive sexuality/attitude for youth friendly environment among adult volunteers and staff members.  Frequent changes among the young people.  Lack of sustainable plan for young people. HIV AND AIDS

HIV and AIDS Prevention Program

This project is linked to IPPF’s strategic goal of reducing the incidence of HIV and protection of the rights of people infected and affected by HIV in project area. The project aims to reduce social, religious, cultural, economic, legal and political barriers those make people vulnerable to HIV/AIDS and increase access to interventions for the prevention of STIs and HIV/AIDS through integrated, gender-sensitive sexual and reproductive health programmes.

Strategic goal Reducing the incidence of HIV and protection of the rights of people infected and affected by HIV in project area

In order to accomplish its mission of eliminating Sexually Transmitted Infections and eradicating HIV and AIDS, every year FPAB works towards building and improving its HIV and AIDS program. This year HIV and AIDS project was implemented in 21branches and 13 Special Work Units with at least one of the five components of HIV continuum of care, i.e. (i) Behaviour Change Communication (ii) Condom promotion (iii) STI management (diagnosis & treatment) (iv) Voluntary Counselling & Testing and (v) Psychosocial support were given directly. Other components of the continuum of care including (vi) Opportunistic infections (vii) Anti-retroviral treatment (viii) Prevention of mother-to-child transmission (PMTCT) and (ix) Palliative care to support PLHIV was given by building partnership with allied organizations to strengthen referral linkage.

Events & Activities  Increased VCT service and Condom promotion. VCT services: There has been a 4% increase in VCT service over 2010. 7137 clients have taken VCT service. This has been possible because of staff commitment. Capacity building training of Staff on VCT has increased the quality of service. New MOU and Strengthening existing MOU have increased service for MARP of HIV and AIDS  VCT service was introduced to two districts, in Kushtia and Rangpur. Inauguration programs were held where members from different organizations, health care givers, government officials, journalists and representatives from the key population were present. Need for VCT service in those districts were pointed out and problems faced by caregivers in its absence were also mentioned. It was a highly praised and much needed step taken by FPAB.

 Counsellors from the following branches received training on VCT counselling from HIV/AIDS and STD Alliance Bangladesh (HASAB): Bogra, Jamalpur (2), Khulna, Noakhali, Jessore, Chittagong, Sylhet, Tangail, Dhaka, Dinajpur, Faridpur, Kushtia, Patuakhali, Rajshahi, Rangpur, Barisal, Comilla. Executive clinic from the following branches received training on STI Investigations, Management and Universal Precautions from HIV/AIDS and STD Alliance Bangladesh (HASAB): Barisal, Jhalakathi, Comilla, Ghorasal, Manikgonj, Panchagarh, Magura, Dhaka, Laxmipur, Rajshahi, Rangamati, Khagrachari, Rangpur, Saidpur

 Condom Promotion: There has been a 5% increase in condom distribution over 2010. Condom was available at the clinic and with RHPs for distribution. 667810 pieces of condom distributed, which exceeded the expected result. This may be the result of increased level of awareness among clients in regards to the use of condom as preventive measure for STIs and HIV and AIDS.

 Reproductive Health Promoters (RHPs) went from door to door and provide domiciliary Service. A total number of 75370 participants attended awareness sessions regarding HIV and AIDS transmission and prevention, STIs, stigma and discrimination, VCT and so on.  FPAB has observed World AIDS day in their 32 SDPs based in 32 districts in Bangladesh. Activities were planned keeping in mind this year’s theme “Getting to Zero- Zero New HIV Infections. Zero Discrimination and Zero AIDS Related Deaths”, in collaboration with Government of Bangladesh and NGOs including UNFPA, Light House, Marie Stopes, HELP, Podokhep, BRAC, Smiling Sun etc . SDPs have taken separate programs including Rally, stalls, seminar and discussion meetings on various topics including AIDS prevention, stigma reduction, STDs; Street theatre, film show; Posters, festoon, leaflet and banners were made, and youth from FPAB also participated in the activities. Some of the branches received certificate for participating in different activities on this day.

 Referral services: Expected result was 15% increase in referral services. We have achieved a 13.47 % increase. 5071 referrals were taken in and given out to organization with whom MOUs were built.  Syndromic management for STI: 120624 clients received services related to STI/RTI syndromic management.  Staff received training on “Training of trainers on SRH- HIV integration module” in Bangkok, Thailand by IPPF.

Limitations / Challenges  Capacity building of staff in regards to dealing with MARP of HIV and AIDS. Arranging training for technical persons. i.e. Lack of master trainer  Special arrangements at the clinics to provide services for key population (i.e. separate timing, staff attitude towards clients). This is because of Stigma and discrimination related to HIV and AIDS among the general population in the country. Concept clarification among the staff of FPAB is needed  Keeping trained staff seems to be one of the major challenges in giving quality service. Work burden on counselling staff need to be lessen. In order to build awareness of clients on HIV and AIDS and to do a risk assessment a good portion of time is spent per client.  Reporting to NHQ. There needs to be more accurate reporting from branch and SWUs level to NHQ. ABORTION

This program is linked to IPPF’s strategic goal of providing universal recognition of a woman’s right to choose and have access to safe abortion, and a reduction in the incidence of unsafe abortion. The project aims to strengthen public, volunteer and staff commitment for the right to choose and have access to safe abortion and also to increase access of women to safe abortion.

Strategic goal Providing universal recognition of a woman’s right to choose and have access to safe abortion, and a reduction in the incidence of unsafe abortion.

During the year 2011, services related to Abortion was implemented in four divided clusters in terms of funding support like restricted project Global Comprehensive Abortion Care Initiative (GCACI) (7clinics) Unite For Body Rights (5clinics) &World Health Organization(WHO) supported 6 clinics up to October & rest of clinics are operating safe abortion services from core fund.

In order to achieve the objectives the project implemented in capacity building, Awareness/networking programmes, service delivery during the reporting period.

Events & Activities  All the clinics are providing MR / safe abortion or abortion related services to the fullest extent permitted by law  All the clinical outlets served on MR and remain obliged to serve mostly the underserved population in right-based approach, have reached the clients who want to prevent unwanted pregnancies and seek relief from the curses of unsafe and complicated abortions. Moreover, FPAB is addressing other RH needs of women and adolescents-youths.  Increased number of clients on MR: In 2010 the numbers of MR clients were 4,358 and in the year 2011 the number is 5,216 i.e. 19.68% increase. Global Comprehensive Abortion Care Initiative (GCACI) project The Global Comprehensive Abortion Care Initiative (GCACI) covered 7 SDPs in providing increased access to comprehensive MR services, increased the uptake of post-MR contraceptive services, and Increased access to family planning services. The GCACI clinics are centrally located and enjoy a good reputation among the communities they serve. They are fully operational with trained staff and adhere to IPPF quality of care standards. Both SWUs have shown positive trends in MR Service delivery and, with continued support, are expected to further improve quality of care and access to long-term contraceptive methods. Aim of the project is to increase access to comprehensive MR services as an integral component of sexual and reproductive health. To reduce unsafe abortion and its complication and increase access to family planning service.

Events & Activities  Providing comprehensive MR services: 2023 clients received safe MR services by trained providers, 97% of the clients adopted post MR contraception among them 4328 clients adopted long-term and 27657 clients adopted short-term methods by the end of 2011.

 Clinical Management Information System: In all service delivery points a client-based manual record system has been put in place. In addition, the electronic clinic management information system (CMIS) has been implemented in the 13 clinics of FPAB. All 13 service providers including 7 GCACI clinics got training in CMIS, manual record system & smart filing where client cards kept for the client who leave clinic without taking Post abortion contraception and follow up for referred client.

Limitations / Challenges  Up till now the women segment of our project locations are not receiving MR services from the clinics up to the expected numbers; most of the women terminate their unwanted pregnancies through clandestine type of abortion; which in most cases are unsafe leading to maternal morbidity and mortality.  RHPs are not well aware on what need to be done in case of incomplete abortion and primary management of unsafe abortion. To strengthen the capacity of the RHP more awareness and training is needed. ACCESS

Access: Increasing access to SRHR information & services for poor & marginalized people program:

In 2011 seven comprehensive clinics were focused on its work particularly to increase client flow on various SRH services. Special emphasis was given to increase male family planning methods, screening services by increasing number of clients on screening for cervical cancer by VIA (visual inspection of cervix after applying acetic acid) and support services to Gender Based Violence (GBV) clients.

Strategic Goal

All people, particularly the poor, marginalized, the socially- excluded and under-served are able to exercise their rights, to make free and informed choices about their sexual and reproductive health and have access to sexual and reproductive health information, sexuality education and high quality services including family planning.

Events & Activities  On the basis of data of service statistics 2009 the projection of No Scalpel Vasectomy (NSV) was 1425 from 7 clinics against which achievement was 1825 in 2011.  For women empowerment, gender equality and reduction of GBV, 72 Family Development centres (FDCs) continue their activities. 6 clinics provided services on safe Delivery and 2 clinics provided services on EOC in the year 2009. But due to end of the project SMP, initiative was taken to mainstream safe delivery & EOC services from 5 clinics.  Services for the madrasha teachers and students were continued through 20 madrashas of 5 branches by the funding support of Dutch Alliance. The lessons learning of madrasha project were continued through all madrasa’s of 5 branches and SRH services were provided from madrasha health posts.  In the year 2011 some services like safe delivery, services for madrasha students, male SRH, Youth –friendly services were implemented in an integrated and comprehensive way with trained and skilled service providers with adequate facilities to make 5 branch clinics as “one stop service centre”. This was done to bring more focus and credibility to them “a point of reference” in the community.  Upgraded Safe Motherhood clinics and started safe delivery & EOC services from 5 clinics by the funding support of DFID-GPAF.  To prevent unsafe abortion, MR and contraceptive service provision was made at all clinics particularly from mini clinics which are located at peri-urban areas.  To ensure quality of care of services, professional trainings provided to new service providers.  All the clinics provided a wide range of SRH services to young people. Including contraceptives, Emergency Contraceptive (EC), pregnancy test, menstrual regulation service (MR), sexually transmitted infection services, gynaecological services and other services.  Awareness session on SRHR: Women of the community were empowered of the following: - Rights to decision making - Rights to health care utilization - Control over income - Control over land resources

 Increased service seeking behaviour of community people.

Limitations/challenges

 Retention of trained staff in the organization.  High turnover of technical staff.  Inadequate supervisory staff at NHQ.  Access to services by young people.  Service provision of Long acting and permanent method of Family Planning from mini clinics.  Crisis of govt impress fund interrupted regular services on LA/PM (Long acting and permanent method) from clinics.  Limited awareness session to build awareness among men and boys regarding benefit of male involvement in SRH and to reduce gender based violence.  Budget constraint for concept clarification training of all FDC Organizers and all field level staffs. Meeting Sexual and Reproductive Health and Rights of Climate Change Survivors in Bangladesh Project

The goal of the project is to increase access to sexual and reproductive health information and services for populations surviving crisis and living in post-crisis situations in Bangladesh. This project aimed to enhance emergency preparedness for sexual and reproductive health needs of women and children; increase access to comprehensive SRH information and services for climate change survivors and their families. It also aimed to generate support for a coordinated response to SRHR in crisis among stakeholders and partner organizations in 6 districts of Bangladesh. The project was implemented in 24 unions of 6 Branches (Noakhali, Barisal, Khulna, Patuakhali, Pabna and Tangail & 2 SWU Jhalakathi and Laxmipur), some of which are located at the coastal belts while others are situated at the banks of rivers, hence highly prone to climate change disasters.

Events & Activities  A total of 103 Community support group (CSG) meetings were organized involving 425 members. This group acts as watchdog to observe and monitor the performance and at the same time play the role of a pressure group to highlight the needs and concerns for the climate change survivors and their families at union level forums. This support group established linkage with the existing women’s group at village level.

 24 Emergency Preparedness Plans were developed for 24 unions of the project locations.

 Social Audit on socio-economic and health situation of the climate change impact area was conducted at 3 locations ie Noakhali, Pabna & Tangail. Follow up action on social audit recommendations will be taken to recovery the gaps with the help of GO/ NGO of that area.

 Arranged day long refresher training on Minimum Initial Service Package (MISP) for reproductive health in crises for Managers, Medical Officers, Paramedics, Community Mobilizers & representatives of partner organizations. Another 4 days long Training on counselling skills (based on counselling manual on Trauma, Guilt , Shame and Low self esteem) was organized for counsellors

 15000 leaf-lets highlighting some important message on how to protect & face emergency situation like Cyclone, Flood & River erosion was designed and printed.

 A Documentary film was developed on the climate change project activities by FPAB Khulna Branch.  MOUs were signed with 47 partner organizations.

 11 consultative meeting were held with the partner organizations. These meetings were also reviewed the progress of the integration of MISP/ SRHR in crisis into the district emergency preparedness plan.

 Organised 821 satellite sessions through mobile medical team.

 To save the life of pregnant mother and their children, financial support for transportation was provided from the project. In the past year a total amount of r\taka 72,800/= was distributed among the pregnant mothers.

 Capacity building of different stakeholders including partner organizations on MISP (Minimum Initial Service Package) and BEP (Birth Emergency Preparedness Plan).

 Integration of emergency preparedness plan to other partner organizations.

 Creating awareness on institutional delivery instead of home delivery especially in the remote locations where delivery centres do not exist. DFID-GPAF–Project Title: Global Poverty Action Fund Project (GPAF)

The Fund for DFID –GPAF was used to improve Sexual and Reproductive, Maternal and newborn health of vulnerable people. Emphasis was given on the health needs of women, youth and children particularly the poor and marginalized group. The project aim was to achieve the following to contribute to the MDGs:

1. Enhance maternal and child health services. 2. Provision of comprehensive abortion services. 3. Increase awareness of community people. 4. Increase contraceptive prevalence rate of modern methods of family planning. 5. Increase capacity and quality of service providers, volunteers and community agents on safe motherhood and maternal and child health.

Events & Activities  Funding support of DFID-GPAF project helped to upgrade clinic infrastructure of four clinics to provide safe delivery and safe motherhood services.

 Essential equipments and instruments for safe delivery and EOC services were procured.

 Manual Vacuum Aspirator (MVA) single valve and MVA plus were purchased for MR services.

 Besides contraceptives and medicine were also procured for those clinics to prevent unwanted pregnancy.

 Support was provided to procure commodities for clinical services.

 Emergency drugs for MR complication management, other Medicines and contraceptives were also procured to ensure post MR contraceptives (Oral pill, condom, ECP and Inject able) and medicine for clients.

 Instruments like BP machine and stethoscope were procured and supplied to RHP’s to detect early pre-eclamplie conditions of a pregnant mother. They were also supplied apron, bag and BCC materials to make them visible in the community as a service provider of FPAB.

 Turnover of trained clinical service providers.  Interruption of flow of govt. impress funds usually create obstacle in providing continuous LA/PM services from clinics.

 Short project period with lot of activities. Building Momentum for SRHR-HIV Integration in Bangladesh project FPAB implemented the project titled “Building Momentum for SRHR/HIV Integration in Bangladesh”. This is a three years project funded by European Union. The aim of this project is to sensitize and increase commitment of Country Coordination Mechanism (CCM) to integrate SRH HIV in the Global Fund Process. The objectives of the project are:

1. Increased commitment of Country Coordinating Mechanisms (CCM) in the project countries to SRH and HIV Integration; 2. Capacity of CSOs in integration, proposal writing, gender, budgeting and financial management for Global Fund enhanced and integrated SRH/HIV proposals submitted to the CCMs in project countries 3. Increased funding from the Global Fund for SRH and HIV integration in the 8 project countries 4. Increased uptake of SRH and HIV services by young people.

In the first 6 months of the project awareness was built among the key stakeholders on the importance of SRH HIV Integration. Bilateral discussion with key stakeholders helped to find out the right track to advance with the activities, which helped to establish ownership and commitment of stakeholders to the issue of SRH HIV integration.

Events & Activities  FPAB is a member of CCM-Technical Sub-Committee: FPAB is now the member of the CCM Technical sub Committee of HIV/AIDS, CCM. This membership will help FPAB to come close to CCM members and stakeholders for continuous interaction and dialogue on the issue of integration. Moreover, it will be easier to organize meeting of the CCM for sensitization. All these opportunities will help FPAB to way forward the advocacy initiative of sensitization of CCM. The members included:

1. UNFPA Bangladesh

2. Ashar Alo Society ( Working on HIV/AIDS + People)

3. Mukto Akash Bangldesh ( Working with HIV/AIDS + People)

4. Speaker, FPAB Youth Parliament 5. Duty Bearer, South Asia Regional Youth Network and Leader of Position, FPAB Youth Parliament.

6. Line Director, National AIDS/STD Program (NASP)- subject to approval of authority ( Needs endorsement from the higher authority).

7. NEARS (Network of Adolescent Sexual and Reproductive Health- Bangladesh)

8. STD/AIDS Network- Bangladesh

 Bilateral Meeting with Partners: Through bi-lateral meeting, FPAB shared the project to 7 CCM members, National AIDS /STD Program (NASP), and other CSOs who are using Global Fund (i.e. Ghashful, Durjoy Nari Sanga, and Women Health Coalition).

 Consultation Meeting on SRH HIV Integration: A consultation meeting was held with the participation of development partners, CSO representatives and Government officials of NASP on SRH HIV Integration. In the meeting a country team was formed to way forward advocacy of SRH HIV Integration.  UNFPA-BD commits to provide technical support in SRH HIV Integration: A capacity Building Training on SRH HIV Integrating was organized for the representatives of CSOs working on SRH and HIV. UNFPA provided technical support in the capacity building training of SRH HIV Integration voluntarily. CSOs representatives attended the training committed to integrate SRH HIV in their programs.

No limitations and challenges Accreditation and Governance program

IPPF Strategic Plan Frame work Goal: Accreditation and Governance

During the year 2011, FPAB focused on ‘Stewardship and Image building’. With this target FPAB took a lead role in SRHR issues among the allied agencies; create new avenues to embrace new partners particularly with GOB, enrolling the youths, adults and more female members under its membership umbrella. This would help to create an enabling environment in the governing bodies both at national, branch and Special Work Unit (SWU) level. Mainstreaming ‘gender and establishing equity and equality’ was integrated at all components of Five A’s. Dissemination of acquired knowledge with targeted audience and effective linkages with the Branches and Special Work Units have been established in this year. Increase of financial resources with innovative ideas and self generated local level approaches were also the prime focus of FPAB in 2011.

Events & Activities  Organized Annual Project Review (APR) Workshop 2011, in March involving Volunteers and Staff of SWUs, Branches and National Head Quarter.

 Annual Program & Budget, Annual Report and APR Workshop Report 2011 have been printed.

 Workshop on Governance issues: This program started in 2011 and will continue in 2012. 91 Members were oriented during 2011 through 3 Orientation programs.

 Field visits were arranged for NEC members for sharing of lessons learnt and best practices of programs.

 Developed a strategy to include committed youth, women and diverse professional groups as members of FPAB to uphold equal rights.

 Recruited committed youth, women and diverse professional groups as members of FPAB.

 Facilitated process so that youth, women and diverse professional groups are included in the EC, BEC, NEC and National Council.

 Organized SWU-EC, BEC, NEC and Council meetings to review, develop and amend policies related to different issues and perform various duties as per constitution. Limitations/challenges

No limitations and challenges Monitoring and Evaluation

This project is linked to IPPF’s strategic goal for effective program management and improved performance.

The department carries out two vital roles, monitoring & evaluation; and recording & reporting of service statistics. M&E Department coordinates evaluation and other studies and provides support for awarding external consultants for researches planned in the restricted projects. The department also support restricted projects and supervises the evaluation staff in restricted projects (e.g GCACI, AusAID), supports Focal Points of the thematic A’s.

M&E Department is responsible to post the Service Statistics in eMIS. For this purpose M&E department collects service statistics data on a monthly basis from 21 Branches and 11 SWUs and compile them annually. As service statistics reflects the performance of FPAB, hence to ensure accurate service statistics data, M&E Department considered different measurements for 2011.

Strategic Goal

To ensure effective program management and improved performance

There were five specific objectives to achieve the strategic Goal.

1. To monitor and evaluate five thematic areas (A’s) 2. To ensure efficient and robust MIS to capture data and generate reports including service statistics 3. To develop M&E Strategy for FPAB 4. To develop capacity of the M&E staff field staff for ensuring data quality 5. To assess the prevalence of poverty among FPAB clients

Events & Activities 1. To monitor and evaluate five thematic areas (A’s), this year M&E department has conducted five evaluation / impact assessment of the core programs.

 Impact assessment of knowledge attitude and practice among the service providers to wards HIV/AIDs care: This impact assessment conducted in 11 Branches. The respondents of the study were service providers of FPAB. The findings revealed that majority of the service providers have good knowledge about HIV transmission. However some of the service providers have wrong perception about prevention and stigma & discrimination related issues.

 End line evaluation of the project “Working with men and boys for gender equality and SRHR in Bangladesh.” The project steered with a hope to establish a good service and create knowledge for male and youth. In a nutshell, the project performed well in some areas but there are some areas which need to be improved. A huge demand has been created for this project. Considering the overall issues of male reproductive health, the project needs to go further with new designing.

 Baseline survey and Annual Assessment of youth participation in planning, implementation and monitoring in the decision making body. (AVIZAN): The findings revealed that during the baseline survey the PMC members were more confined to the Branch office level activities. Their main recommendations were within those activities of Tarar Mela which could be done. Whereas in the annual assessment the findings suggested that at this stage they were thinking in broader aspect linkage/association rather than confining within Tarar Mela. They now think of working with partner organizations, involving parents, and through satellite sessions want to involve the community people. The findings showed that during the baseline survey and also in the annual evaluation majority of the PMC members received SRHR training. More than half of the PMC members (57%) reported that they received some specific training as PMC members. Whereas the percentage was only one-third (27%) during the baseline, these PMC members received training on planning, monitoring and implementation.

 Baseline survey and Impact assessment of “Comprehensive information and service for prevention of unsafe abortion and Access to MR services as right of women (core funded Abortion project 2011)”: A comparative analysis has been prepared on the basis of the baseline findings and the end-line assessment findings. The results suggested that the Reproductive Health Promoters’ (RHP’s) knowledge have been increased after the intervention of the project. In the end- line assessment 80% RHPs correctly answered that a doctor can perform MR up to 10 months pregnancy. Whereas, in the baseline survey 62% RHPs answered this. In the end-line assessment 71% RHPs mentioned that before performing MR blood grouping is necessary. But in the baseline only 48% RHPs reported this. However the findings suggested that the level of value regarding MR services as right of women have not changed much. 2. To ensure efficient and robust MIS: to capture data and generate reports including service statistics the following activities have been carried out

 Daily Service Statistics record keeping system Computerized in all Branches/SWUs.

 Prepared Quarterly MIS report and send regularly to the Branches/SWUs. Which contend Branches/SWUs wise data.  Client base manual filing system implemented in 15 Branches/SWUs.

3. M&E strategy plan was included in FPAB’s five years strategy plan.

4. Developed capacity of the M&E staff and field staff for ensuring data quality: An Orientation training on Service Statistics was held at National Head Quarters to develop the capacity of the field staff members. The participants of the training were 11 Assistant District Officers, 8 Counsellors, 12 Clinical services, and 1 Coordinator program from Branches and SWUs.

5. To assess the prevalence of poverty among FPAB clients M& E Department used the “Quick poverty score toolkit” with the assistance of SARO, IPPF. The findings from all branches revealed that 67% of the clients coming to the clinics were poor (i.e. per person income less than 1.75 US $)

Apart from these M&E department also performed some other activities which included:

 Most Significant Cases (MSC): In climate change project to understand the changes among the clients MSC evaluation was conducted. M&E department worked throughout the process and final selection of the stories.

 PEER review method was conducted to review SALIN project in Jessore branch with the financial and technical support of SARO, IPPF. This participatory method was used to capture the voice of the beneficiaries.

Achievements:  Computerized Daily Service Statistics record keeping system was introduced to all Branches and SWUs.  Branch wise quarterly report was Prepared, which helped to monitor the programs. Limitations /Challenges

 Lack of manpower in M&E department.

 Turnover of trained staff at Branches/SWUs.

The graphs below are showing the services statistics of 2011

Graph:1 Method Mixed (New users): 2011

Graph : 2 Reproductive Health Services (FP excluded) :2011 Donors & Partners

Kingdom of the Netherlands

Rutgerswpf

SIMAVI

Bangladesh NGO Foundation

FPAB Summary of Annual Program Budget 2011

Publication of FPAB in 2011

1. Report on Annual Report 2010

2. GdwcGweÕi A‰eZwbK gnvmwP‡ei cÖwZ‡e`b-2011 (Report of

the Honorary Secretary General of FPAB-2011)

3. GdwcGwe ev‡RU-2012 (FPAB Budget-2012)

4. myLxcwievi- el© 39, msL¨v 1 (Sukhi Paribar-issue 39, Number 1) 5. evj¨weevn : evsjv‡`k ‡cÖw¶Z (Folder on Child Marriage)

6. FPAB Strategic Plan-2011-2015

8. Stories of Most Significant Change : Project `Meeting Sexual & Reproductive Health and Rights of Climate Change Survivors in Bangladesh 9. Folder : Climate Change Project : Project `Meeting Sexual & Reproductive Health and Rights of Climate Change Survivors in Bangladesh

10. Report on Social Audit Report 2011: Project `Meeting Sexual & Reproductive Health and Rights of Climate Change Survivors in Bangladesh

11. Avgvi eqtmwÜKvj (My Puberty)

12. I DECIDE : wm×vš— Avgvi ,Mf©cvZ cwiPh©vi A‡š^l‡Y Zi“Yx‡`i c_ cwiµgv 13. GBWm I †hŠb‡ivM Z_¨ mnvwqKv (Information Guide on AIDS and Sexual Disease )

14. AviGBPwc mnvwqKv (Guide for RHPs)

15. Annual Program Budget 2011

16. AvBwcwcGd bxwZgvjv : cyi“l Ges †hŠb I cÖRbb ¯^v¯’¨ (leaflet on IPPF Policy : Male and Sex and Sexual Health)

Yellow marked, did not understand.