In Bangladesh’s urban slums, nearly two-thirds of female garment workers were married before turning 18, with 65% experiencing their first pregnancy before adulthood, according to ICDDR,B’S just-published two-year cohort study. Conducted with 778 workers across Dhaka and Gazipur, the research exposes adolescent vulnerabilities combined with limited workplace support and rising violence, highlighting urgent gaps in protection and services for the ready-made garment workforce.
- One in three workers reported at least one unintended pregnancy during the study period. One in four respondents underwent an abortion or menstrual regulation procedure.
- Reports of spousal violence remained very high, with most forms increasing during the study.
- The study Sexual and Reproductive Health and Rights among Female Garment Workers Living in Urban Slums of Bangladesh, conducted by ICDDR.B with support from Global Affairs Canada, ran from August 2022 to December 2024.
INSIDE THE STUDY: ICDDR.B’s AdSearch programme carried out a 24-month cohort study in Dhaka and Gazipur slums, surveying 778 female garment workers aged 15–27 every six months. This was the first such research in Bangladesh, designed to track reproductive health, violence, and factory service access, generating evidence for future worker-centred policies.
- The study spanned from August 2022 to December 2024.
- Data was collected under ICDDR.B’s Urban Health and Demographic Surveillance System.
ADOLESCENT PREGNANCY RISKS: The study pinpointed adolescent pregnancy as a major concern. Risks rose with early marriage and exposure to violence, while education, later marriage, contraceptive use before first pregnancy, and entry into garment work before pregnancy helped reduce vulnerability. These patterns underline the need for interventions aimed at delaying marriage and increasing access to contraception.
- Women with nine years of education and later marriage faced lower adolescent pregnancy risk.
- Contraceptive use before first pregnancy cut adolescent pregnancy risk by 47%.
- Starting garment work before first pregnancy was linked to reduced adolescent pregnancy.
- Violence by husbands increased adolescent pregnancy risk by 26%.
ESCALATING VIOLENCE: Violence emerged as a persistent and worsening issue across home and workplace contexts. All forms of spousal violence, except sexual violence, rose over two years. Workplace psychological abuse also increased, yet formal and informal support mechanisms were barely used, showing the isolation faced by many workers experiencing abuse.
- Psychological violence at work rose from 48% at baseline to 55% after two years.
- Only one in five workers reported workplace harassment to authorities, with no improvement over time.
- Informal help-seeking for domestic abuse dropped from 35% to 21%.
- Almost none of the women who faced violence sought formal support.
FACTORIES FALLING SHORT: Factory-based services were found to be inadequate. While some counselling existed, essential supplies such as sanitary pads and contraceptives were scarcely provided. This shortfall shows the disconnect between growing worker awareness of family planning methods and the limited practical support available in workplaces, leaving health needs largely unmet.
- Only 22% of surveyed factories provided sanitary pads to workers.
- Just 14% supplied family planning materials.
- Some counselling services were present, though coverage was limited.
- The shortage of factory-based provision left workers dependent on external and often inaccessible services.
EXPERT VOICES: A seminar following the study presentation earlier this week featured commentary from health and industry experts. Speakers stressed the urgency of addressing patriarchal barriers, contraceptive access, workplace support, and systemic reforms. Their remarks underscored the role of government, development partners, and factories in tackling the interconnected issues revealed by the study.
- Dr Ruchira Tabassum Naved called for joint action by government, development organisations, and partners to improve workers’ health.
- Farzana Sharmin emphasised patriarchal barriers and urged easier contraceptive access alongside more flexible government clinic hours.
- Yasmin H Ahmed pointed to contraceptive stigma, highlighting the importance of factory-based provision and counselling.
- Dr Ubaidur Rob urged prioritisation of worker knowledge to prevent unwanted pregnancies.
WHAT THEY SAID:
Despite being relatively economically advanced, the sexual and reproductive health status of female workers in Bangladesh's garment industry is worse than that of other women. Detailed research on the determinants for improving the situation is needed. The government, development organisations, and partners must take collective initiative.
— Dr Ruchira Tabassum Naved
Emeritus Scientist
ICDDR.B
Since the social system is patriarchal, it is very difficult for women to maintain a 'work-life balance'. Their opinions on matters like pregnancy are not given much importance. In this situation, creating awareness among workers is imperative. The government can play a far-reaching role here. Contraceptive methods need to be made easily accessible to the workers, and their knowledge on this subject needs to be increased. On the other hand, the fixed working hours of government clinics from 9 AM to 5 PM prevent working women from accessing services, which should be reconsidered.
— Farzana Sharmin
Joint Secretary
BKMEA
Negative perceptions still prevent women from openly buying contraceptives from shops, underscoring the need to ensure common contraceptive materials and counselling within garment factories.
— Yasmin H Ahmed
Former Executive Director
Marie Stopes Bangladesh
While women's workplaces are expanding, reducing unwanted pregnancies must be a priority through increasing the workers' knowledge.
— Dr Ubaidur Rob
Former Director
Population Council Bangladesh
