SRH and HIV/AIDS Linkages at Policies, Programmes and Service ...

BANGLADESHCAMBODIANEPALPHILIPPINESBackgroundBangladesh is situated in northeasternsouth Asia and covers an areaof 147,570 square kilometres. It isentirely surrounded by India, on thesouth-eastern frontier with Myanmar,and the Bay of Bengal in the south. Itis the world’s largest delta, formed bythree major river systems, the Ganges(Padma), the Brahmaputra ( Jamuna),and the Meghna.Except for the hills in the east and thehighlands in the north, it is largely a low,flat, fertile land, criss-crossed by aboutseven hundred minor rivers, canals, andstreams.Bangladesh is the most denselypopulated country in the world with apopulation of 150 million people anda corresponding population densityof more than 920 persons per squarekilometre. During the first half of thelast century, the population increased by45 per cent (BDHS, 2007). This slowincrease resulted from a combination ofhigh birth rates and high death rates. Inthe second half of the twentieth centurypopulation growth was rapid and thepopulation tripled during this period.The relatively young age structure of thepopulation indicates continued rapidpopulation growth in the future. Sinceindependence in 1971 there have beenlaudable efforts by successive electedgovernments to control the populationgrowth (contraceptive prevalence rate isnow 53 per cent9), a reduction in infantand child mortality rates (IMR of 66per 1000 live births10), and genderparity achieved in primary schoolenrolment (76 per cent and 81 per centnet primary enrolment for girls andboys, respectively11) (BDHS, 2007).According to the Human DevelopmentIndex (HDI) Bangladesh ranks 140thamong nations as presented in the2007-2008 Human DevelopmentReport. The county’s HDI valueis 0.547, placing it in the categoryof medium human developmentcountries. However Bangladesh is stillstruggling to emerge from poverty.The country is ethnically homogenous,except for a small tribal population ofabout 1.2 million. The religion of themajority population is Islam with atraditional context of culture wheremen have dominant roles. Polygamyis common, but sexual relationshipsoutside marriage meets with strongsocial disapproval. However theserelationships are not totally absent andare a threat to exposure to AIDS.Bangladesh is one of the poorestcountries in the world. Nevertheless,the large population (translated intomanpower) is one of the country’sbiggest assets for foreign remittance.International and internal migration foremployment is common, particularlyamongst younger people. Thesemigrations pose a threat to the spreadof HIV, particularly among the low riskpopulation of Bangladesh.Bangladesh has a low-incomeagricultural economy. GDP per capitafor 2008 was US$431, with the percapita GDP growth about 6 per centper annum. The sectoral contributionsto GDP for 2000-2001 were 24.87 percent from agriculture, 26.89 per centfrom industry, and 49.24 per cent fromservices. In the manufacturing sector theready-made garment industry generates4