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Download PDF The Maternal Mortality Rate (MMR) in the country stands at an alarming 3.2 per thousand births as around 87 percent of pregnant women still depend on unskilled birth attendants, with three expecting mothers dying every hour due to complications from pregnancy and childbirth.
Although to fulfil the Millennium Development Goal (MDG), the MMR should have been 2.75 per thousand by 2000 under the Emergency Obstetric Care (EOC) project taken in 1994.
“The MMR is still high as medical facilities have not reached the rural areas as it should have been. Of the total maternal mortality across the country, 80 percent takes place in rural areas,” Prof Sabera Khatun of Bangabandhu Medical College and University (BSMMU) said.
She also said that while the rate is 7-40 per lakh in developed countries, it is 320 in Bangladesh.
To reduce it, it is necessary to ensure medical services in every upazila, poverty reduction and recruitment of more doctors and nurses as well as building awareness, she added.
Directorate of Family Planning sources said a total of 16,000 mothers die due to causes related to pregnancy and childbirth every year and skilled birth attendants conduct only13 percent of the deliveries.
While the government officials point out lack of awareness about maternal and reproductive health in addition to lack of education and skilled manpower in the society, the experts draw attention to another dimension related to the picture.
Noted economist Prof Abul Barakat of the Dhaka University holds responsible the meagre allocation for women’s health in the national budget as the main obstacle for ensuring maternal health, adding that the Safe Delivery Services make up for only 9.5 percent of the health budget.
Terming the rate of maternal mortality due to pregnancy related causes as ‘alarming’, Barakat said that in 2004-2005 total health budget was Tk 31,203 million, of which just Tk 2,964.30 million was spent for Safe Delivery Services.
“To meet the demand, two to three time increase in budget is required for delivery care components,” he said adding that the number of service providers in EOC, especially doctors and nurses, should be increased with a three-shift working hours in the places providing comprehensive EOC.
Anwarul Islam, Deputy Programme Manager of government’s Reproductive Health Programme, said that only 80 upazila health complexes among 402 in the country are brought under the system of comprehensive maternal health care since 1998. He stressed the need for human resources development to ensure maternal health.
A study conducted by Bangladesh Mahila Parishad in May 2005 revealed that social awareness is very low when it comes to maternal health while around 70 percent of the expecting mothers’ families do not allot any funds in the family budget for dealing with emergencies arising from pregnancy related complexities.
“Though it is found that in district towns near the capital, like Manikganj, women are seeking health services more and more, the society lacks responsibility towards women’s health, especially maternal health,” Dr Laila Anjuman Banu, secretary of Health and Environment of Bangladesh Mahila Parishad, said.
Budget allocation for maternal health should be increased in public and private sectors and at the same time men should be made aware of it and their involvement is also important, she said.
Major causes of maternal death include haemorrhage, abortion, eclampsia (involves high blood pressure and convulsions), puerperal sepsis (blood poisoning following childbirth, caused by infection of the placental site) and obstructed labour.
Though maternal and child health is one of the government’s priority sectors in recent years, while the health care services flourished much in the urban areas, it could not attain the same standard in case of rural and remote areas of the country, the experts said.
Even though a total of 56 percent women come to the hospitals and clinics for antenatal care, the rate is only 18 percent for postnatal care, that might cause bleeding problem, infection and malnutrition, they added.
Besides lack of awareness among people, it is to be noticed that only six percent of the total national budget is provided for health sector, which is quite negligible comparing to that of the people’s necessity, they said.
Per capita health expenditure in the country is Tk 314 and only one percent of the Gross Domestic Product (GDP) is spent in the health sector.
The economists said the health sector could be taken into a better position if 20 percent of the GDP is allocated persistently for ten years.
A study carried out by Bangladesh Institute of Development Studies (BIDS) in cooperation with the Chronic Poverty Research Centre (CPRC) of UK styled ‘The State of the Poorest 2005-2006–Chronic Poverty in Bangladesh: Tales of Ascent, Descent, Marginality and Persistence’ said overall Bangladesh is well on its way to achieve most of the MDGs except income poverty reduction (goal 1/target 1), reduction in maternal mortality rate, and perhaps reduction in under-five mortality rate.
April 16th, 2007 at 10:43 am
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