Three important survey reports that throw light on the chaotic state of the health sector are being kept under covers by the government. A week and a half after the results of a survey on maternal mortality and healthcare were published, they were removed from the official website. The report remains under review. Though the information for the Bangladesh Demographic and Health Survey was collected nine months ago, it has not been published. And survey work on Bangladesh health organisations was completed last year.
According to officials of the health directorate, the directorate of family planning and of icddr,b, the government is unwilling to publish the ugly truth about the state of the health sector before the coming election.
The National Institute of Population Research and Training (NIPORT) is basically responsible for these three surveys. Speaking to Prothom Alo on 25 November about the surveys, NIPORT director general Sushanta Kumar Saha had said, “We are trying to publish these reports as soon as possible.”
Maternal mortality has not fallen
The health ministry announced the primary results of the 2016 maternal mortality and healthcare through a grand programme held at a hotel in the capital city on 22 November. It was seen that maternal mortality had gone up. In every 100,000, a total of 196 mothers were dying. This data gives a message contrary to the development and achievements of Bangladesh. According to the 2010 survey, the maternal mortality rate stood at 194.
On the very day of that programme was held, NIPORT published the 106-page report on its website. Printed copies of the report were distributed at the programme. But within a week and a half, on 3 December the report was removed from the NIPORT website. They also stopped sending out the printed report. A report in this regard was published on 10 December in Prothom Alo. The director general of the family planning directorate, Kazi Mustafa Sarwar, told Prothom Alo, “We cannot accept the date provided in the survey report.” And the NIPORT director general at the time, Raunak Jahan, said that the health ministry has been asked to review the report.
The health ministry formed a review committee in December last year to review the report. The committee comprised representatives of the ministry, the health directorate, the family planning directorate, icddr,b, donor organisations, and professional bodies. The review committee last March handed the matter over to a technical committee.
Member secretary of the technical committee and NIPORT’s evaluation expert Mohammad Ahsanul Alam told Prothom Alo, the technical committee will send their feedback to the review committee by January 2019. The ministry then will finalise the report.
A director of the family planning directorate told Prothom Alo on condition of anonymity that the report will not be finalised or published before the national election.
A fall in maternal mortality is one of the achievements and successes of the health sector that Bangladesh highlights in the international arena. Nobel laureate Amartya Sen also has made mention of this in several of his books and the Bangladesh government often quotes from these books. But the latest results have put a damper on these achievements.
The report, based on interviews with 321,214 women, states that one in every five expectant mothers of the country do not receive healthcare. These mothers do not receive pre-natal, neonatal or post natal healthcare. Physicians were consulted to determine the cause of their deaths.
Former president of Bangladesh Medical Association and public health expert Rashid-e-Mahbub feels it has not been correct to remove the survey results from the website or delay in publishing these results. He told Prothom Alo, the survey results reveal the condition on ground and give direction to the way ahead. The data is vital for the policymakers in the health sector. Perhaps the results have not been revealed before the election as this will indicate the weaknesses in the health ministry and give rise to criticism.
Demographic and health survey spells bad news
The Bangladesh Demographic and Health Survey (BDHS) of 2017-18 indicates an increase in neo-natal infant mortality. And reproduction rates have also been at a standstill for the past eight years. That means use of birth control methods has not increased. Data on this survey was collected and completed in March this year, but has not been published.
The World Health Organisation, various UN organisations, the World Bank, donor agencies, local and foreign universities, and researchers look to BDHA as a reliable source of information. This survey is carried out every three or four days.
Data for the last survey was collected from October 2017 till March. The highlights of the survey were presented to senior officials of the health ministry on 5 September. Officials of the health ministry, health directorate and family planning directorate had two meetings on the survey results on 12 and 15 September.
At the meetings it was seen that the report indicated that neonatal infant (0-28 days) mortality rate was 30.That means, of every 1000 infants, 30 died before reaching 28 days of age. In 2014 this rate was 28.
The mortality rate of on-year-old remains the same. It was 38 in 2014 and is the same in the latest report.
DG of the family planning directorate Kazi Mustafa Sarwar told Prothom Alo, according to Bangladesh Bureau of Statistics, the situation has improved.
About the report not being published, Mohammed Ahsanul Alam told Prothom Alo, the results will be officially published as soon as the health minister gets the time. That will not happen before the elections. It will not be possible to publish the final report before August 2019.
*This report, originally published in Prothom Alo print edition, has been rewritten in English by Ayesha Kabir