Most newborn deaths in the country occur among babies born prematurely with low birthweight. Saving these premature newborns requires skilled health workers and fast quality care. Meanwhile, preventing premature births demands special attention and investment in maternal health.
These observations were made at a roundtable organised marking World Prematurity Day at the Prothom Alo office in Karwan Bazar of Dhaka yesterday, Monday.
The event was organised jointly by Prothom Alo and UNICEF Bangladesh, with support from the Directorate General of Health Services (DGHS). This year’s theme for the day is, ‘Give preterm babies a strong start for a hopeful future’.
Sheikh Sayidul Haque, additional director general of planning and development at the DGHS, said preventive measures must come first. Alongside the role of physicians, preparation by mothers planning to conceive can help reduce premature births. Healthcare centres must have quality services, and pregnant women need regular check-ups.
In addition, public awareness and campaign are crucial to prevent preterm births. Also, home deliveries have to be discouraged. However, the DGHS official noted that the government alone cannot achieve this. Coordination is required among all including the development partners and the private sector.
Syed Kamrul Islam, director of primary healthcare at the DGHS, said that partnership between the government and development partners will further improve service quality.
Professor Firoza Begum, president of the Obstetrical and Gynaecological Society of Bangladesh (OGSB), highlighted several causes of preterm birth. She said pregnancies at a very young or older age, being overweight or underweight, physical complications, and antenatal depression may all contribute to premature birth.
Every pregnant woman must visit a healthcare centre and keep track of their complete health information so early action can be taken if any complication is suspected. If necessary, the mother should be transferred elsewhere before delivery.
Dewan Md Emdadul Hoque, health manager at UNICEF Bangladesh, said primary healthcare must be strengthened to ensure maternal and neonatal wellbeing.
Services must reach all pregnant women, and they must remain under regular medical follow-up, both during pregnancy and after the birth of a premature baby. He emphasised investment in maternal health to prevent premature deliveries.
Nasir Ahmed, director of maternal and child health programme at the Directorate General of Family Planning, said not everyone can travel to district towns or major cities for treatment. For this, necessary training, supply system, and skilled staff must be ensured to improve the quality of primary healthcare services.
Speaking on the issue of private sector coming forward, Nasir Ahmed suggested that they could allocate some beds for newborn care free of charge, while the government could establish related policies.
Professor Md Abdul Mannan, chairman of the Neonatology Department at Bangladesh Medical University, said that at least 600,000 premature babies are born annually. The main causes of death among them include feeding difficulties, breathing problems, and infection. He stressed focusing on district-level healthcare to reduce these deaths.
Professor Md Mahbubul Hoque, director of Bangladesh Shishu Hospital and president of the Bangladesh Neonatal Forum (BNF), said who cares for the newborn immediately after birth is crucial. Skilled staffs are essential here, yet it is challenging in Bangladesh to find such experts. Training healthcare workers could be a solution.
Professor Faroque Ahmed, medical director of Labaid, said there is a mindset that government should handle everything. In reality, while the government can create regulations, the private sector must also take responsibility. However, the private health sector in Bangladesh has largely grown on its own and often lacks necessary training. He called for government support in developing professional caregivers in private healthcare.
The government would enact the laws, and the private sector would take the rest forward. But this has not been the case in the health sector. Here, the private sector has grown on its own and does not receive necessary training. He called for government support in developing caregiving-related professionals in the private sector.
One neonatal specialist in each district
Kohinoor Jahan Shyamaly, consultant at the 250-bed Sherpur General Hospital, described the ground reality of healthcare in district-level hospitals. She said her hospital provides neonatal care for patients coming from nine upazilas in the vicinity.
She said there was eight oxygen points at the hospital which they have now expanded to 20 due to high pressure of patients. She called for appointing at least one neonatal specialist at the district level.
At the beginning of the discussion, Nasreen Akhter, deputy director of primary healthcare support service at DGHS, presented the concept paper. She noted that the leading causes of newborn deaths in Bangladesh are premature birth and low birthweight. Nur-e-Alam Khan, upazila health officer of Pakundia, Kishoreganj, also spoke at the discussion.
The roundtable was moderated by Prothom Alo Assistant Editor Firoz Choudhury.