Editorial

Premature birth: Ensure prenatal care of mothers 

Child health protection in any country is inextricably linked to socio-economic status and the development of the health system. If a child is malnourished and born prematurely, various health risks are created for later stages of life. 

The picture of child health in Bangladesh, which emerged during the press conference organised by the International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b) last Tuesday, is very alarming.

According to the information presented at the press conference, 3 to 3.2 million children are born every year in Bangladesh, out of which 600,000 are preterm births.

This constitutes 19.4 per cent of the total live births. Babies born prematurely or with low birth weight suffer from complications, and a significant proportion of these infants have a low chance of survival.

The global situation is also far from satisfactory. Out of the 135 million babies born in 2020, approximately 35.3 million were born underweight or prematurely. Of the 2.24 million newborn deaths that occurred that year, half, or 55.4 per cent, were due to premature birth or low birth weight complications. 

During the conference, Samina Chowdhury, former president of the Obstetrical and Gynecological Society of Bangladesh (OGSB), highlighted that mothers should ideally visit a physician or a trained health worker at least eight times for proper prenatal health care.

However, in Bangladesh, only 80 per cent of mothers visit a healthcare provider once, and merely 41 per cent visit twice. 

High-quality antenatal care entails the involvement of a trained physician seeing the pregnant woman at least once. Furthermore, it's important to monitor five crucial aspects: checking the woman's weight, assessing her blood pressure, conducting urine tests, performing blood tests, and providing pregnancy counseling. 

In 2017, the United Nations children's agency UNICEF reported that 446,900 babies are born prematurely in Bangladesh every year. Among these, 23,600 children die before reaching the age of five. Maternal malnutrition and early marriage are among the causes of these premature births.

This underscores the link between the health and age of the mother and the likelihood of giving birth to a premature and malnourished child. When a mother is married at a young age, the risk of the child being born prematurely and undernourished increases. Notably, Bangladesh holds the highest rate of child marriage in South Asia. 

Expenditure within the health sector also holds immense importance for child health protection. Merely 1 per cent of the country's GDP is allocated to healthcare, whereas in Europe, 9 per cent and in the United States, 18 per cent of the GDP is dedicated to health spending. Among South Asian countries, Bangladesh's allocation rate for the health sector remains comparatively low.  

Regardless of our claims to enhanced healthcare, Bangladesh holds the seventh position among the ten most underdeveloped countries globally in terms of premature births.

Not all mothers have the opportunity to access proper antenatal care given their circumstances. Simultaneously, it is imperative to foster social awareness alongside implementing legal measures to curb child marriages.

It is our hope that policymakers will shift away from the 'everything is fine' mindset and instead take decisive actions to prevent premature births.