The state of maternal and child healthcare in the Rangpur Division is worse than the national average. Many mothers in the char areas of Rangpur are themselves adolescents, making the situation particularly distressing. Certain remote areas remain extremely difficult to access for healthcare delivery. Without addressing Rangpur, achieving national progress will remain unattainable. Furthermore, healthcare is not solely the responsibility of the Ministry of Health; coordinated action from multiple ministries is essential. Collective efforts, along with skilled personnel, infrastructure and dedicated budgetary allocation, must give special consideration to Rangpur.
These observations were made yesterday, Wednesday, at a roundtable discussion on ‘Maternal and Newborn health services in Rangpur: Current Status, challenges and things to be done’ held at the Directorate General of Health Services in Mohakhali, Dhaka. The discussion was organised under the ‘Jononi Project’ by ‘Save the Children Bangladesh’, with support from the Korea International Cooperation Agency (KOICA) and in partnership with Prothom Alo as media collaborator.
At the outset, Ujjal Kumar Roy, Project Director of Jononi, presented a concept paper. He reported that the neonatal mortality rate in Rangpur stands at 30 per 1,000 live births, compared to the national figure of 20. The child mortality rate is 33 in Rangpur, while nationally it is 25. The maternal mortality rate nationally is 196 per 100,000 live births, whereas in Rangpur it is 223.
Child marriage rates are also significantly higher. Nationally, 27 per cent of girls marry below the age of 18, but in Rangpur this rises to 63 per cent. Similarly, 63 per cent of women conceive before the age of 19 in Rangpur, compared with 24 per cent nationally. Births attended by midwife for 70 per cent nationally, while in Rangpur the figure is only 49 per cent.
During the discussion, speakers expressed their views on these findings. S M Abdullah Al Murad, Line Director for Maternal, Neo-natal and Child Health at the Directorate General of Health Services, highlighted various government initiatives. He stressed that antenatal care is indispensable for ensuring the health of mothers and newborns. Pointing out the urgent need for action in Rangpur, he emphasised public awareness campaigns, particularly within schools, to address the prevalence of child marriage.
Dewan Morshed Kamal, Divisional Director of Family Planning in Rangpur, shared his personal experiences from visiting char areas. He noted that the conditions of many young mothers were harrowing, a 15-year-old carrying a child, with one in her arms and another unborn. Despite attempts at raising awareness, he acknowledged that socio-economic pressures, administrative shortcomings and other barriers hinder prevention efforts.
He further observed that there is a lack of connection between Union Health and Family Welfare Centres and Community Clinics, stressing the need for greater coordination.
Sohel Habib, Line Director (NCRH) of the Directorate General of Family Planning, identified child marriage as one of the most significant obstacles to improving maternal and neonatal healthcare in Rangpur. He underlined that awareness campaigns must be conducted with administrative support, alongside strong inter-ministerial coordination.
Dr Gausul Azim Chowdhury, Divisional Director of Health Services in Rangpur, stated that efforts are being made to increase institutional deliveries and improve antenatal services. He emphasised the need to ensure transport facilities, including ambulances for mothers and to build confidence among adolescents in order to prevent child marriage.
Zainal Abedin, Line Director for Hospital Service Management at the Directorate General of Health Services, observed that despite numerous government programmes, questions remain regarding the availability of quality services. Large numbers of people seek care in government hospitals and health centres, necessitating adequate infrastructure and skilled manpower. He suggested the establishment of healthcare centres through public–private partnerships, where the government would provide human resource support and the private sector would contribute infrastructural investment.
Saiful Islam Majumder, Senior Assistant Secretary of the Health Services Division under the Ministry of Health and Family Welfare, drew on his field experience, stressing the need for integrated action at district and Upazila levels by all relevant ministries.
Dr Shams El Arifeen, Emeritus Scientist at icddr,b, highlighted the significant disparity between rich and poor care, describing systemic barriers as a key factor. He added that although many argue healthcare delivery is difficult in remote regions, the very recognition of this difficulty indicates the path to a solution, requiring collaboration with the relevant ministries and organisations.
Public health specialist Ikhtiar Uddin Khondaker emphasised the need to increase skilled human resources at the grassroots level and to strengthen inter-ministerial coordination. He noted that healthcare is not the sole responsibility of the Ministry of Health alone; multiple government agencies play vital roles in establishing an effective healthcare framework. He further stressed that it is essential to assess the specific challenges in Rangpur, determine whether government programmes are functioning effectively and ensure that committees are active. Without addressing Rangpur, national-level success will not be achieved. He called for separate consideration of budget allocation and manpower for Rangpur.
The roundtable discussion, moderated by Firoz Choudhury, Associate Editor of Prothom Alo, also featured contributions from, Dr Golam Modabbir, Director of Health and Nutrition, Save the Children in Bangladesh, Mojibul Haque Monir, Head of Social Development, RDRS Bangladesh, Animesh Biswas, Maternal Health Programme Specialist, UNFPA Bangladesh, Md Wazed Ali, Deputy Director (Rangpur), Directorate General of Health Services, Md Nasir Ahmed, Programme Manager (Newborn and Child Health) and Assistant Director (Services), Moazzem Sarkar, Programme Manager (Maternal Health), Directorate General of Health Services, A N M Mostafa Kamal Majumder, Deputy Director (Services) and Programme Manager (Maternal Health), Shahin Sultana, Civil Surgeon of Rangpur, Abdul Hakim, Civil Surgeon of Lalmonirhat, Selina Akter, Deputy Programme Manager (Monitoring) of Maternal Health services, Nasima Khatun, Programme Officer, Mother and Child Support Programme, Md Shah Jalal, Deputy Director (Family Planning) of Lalmonirhat, Md Saiful Islam, Deputy Director (Family Planning), of Rangpur.