Quality of maternal healthcare in Bangladesh questioned

Questions have been raised about the quality of maternal healthcare in the country. Half of the expectant mothers aren’t receiving essential prenatal care. In fact government records say that people of the poorest section are lagging behind in receiving maternal care.

Statistics says, more than 80 per cent pregnant women of the country are taking prenatal care only once. This care has reached almost universal level. However, World Health Organization (WHO) has recommended taking this care at least four times before giving birth.

A study from two years ago had found that 52 per cent of pregnant women were taking prenatal care four times. However, officials of the directorate general of family planning say that the actual rate of women taking the care is even lower.

In such a situation, World Health Day was observed Friday. This year's theme was 'Health for All'.

The message shared by World Health Organisation to mark the day stressed on universal health protection. The main idea of universal health care is that everyone will receive quality healthcare in times of their need.

Md Mahmudur Rahman, director (maternal and child healthcare), directorate general of family planning told Prothom Alo, "Our buildings were built in the 80's. Many facilities have reached a state that they cannot provide services anymore.”

“And there is a shortage of trained staff to provide healthcare. As much as 40 per cent posts are vacant on the field level,” he added.

Eight researchers from International Centre for Diarrheal Diseases Research, Bangladesh (icddr,b), Norway’s University of Bergen, Norwegian Institute of Public Health and United States’ Tacoma-Pierce County Health Department  have conducted a research on prenatal care and care during delivery in Bangladesh.

A total of 3,293 pregnant women were included in the study between October 2018 and June 2020.

It was found in the study that 98 per cent of expectant mothers were receiving prenatal care at least once. The rate of receiving the care twice is 91 per cent. It shows that as much the number of necessary care is increasing, so is decreasing the rate of mothers receiving the care.

Researchers have found that 74 per cent of mothers are receiving prenatal care three times while 52 per cent are receiving it four or more times. That means, almost half of the mothers are remaining beyond the reach of the necessary prenatal care.

Government officials however believe that the situation has worsened even further. Sources from the Directorate of Family Planning say that 83 per cent of expectant mothers are taking prenatal care once while 43 per cent are taking it four times. The situation has worsened due to the Covid pandemic.

Maternal and public health experts say prenatal care should be provided by trained health workers. And, deliveries should also be done with the help of trained health workers. In both cases the poor sections of the society are lagging behind.

Analysing data from Bangladesh Demographic and Health Survey, it was found that 35 per cent of mothers from the poorest sections of the society receive prenatal care from trained health workers. Among the wealthiest section of the society, the rate is 88 per cent.

If the delivery is done with the assistance of trained health workers, maternal and neonatal mortality risk gets reduced. Bangladesh Demographic and Health Survey data reports that only 18 per cent of pregnant women from the poorest sections of society receive the assistance of trained and skilled health workers during delivery.

As much as 82 per cent of mothers from this section do not have trained health workers by their side during delivery. Meanwhile, 73 per cent of mothers in the wealthiest class receive assistance by trained health workers during delivery.

There’s a commitment to achieve several goals by 2030 in the Sustainable development Goals. It has been said that 98 per cent of pregnant women have to be brought under prenatal care through trained staff.

By that time, there has to be trained health workers by the mother’s side in 98 per cent of the deliveries in the country. It would be impossible to reduce maternal mortality rate in the country without improving the quality of healthcare. Maternal mortality rate has to be reduced below 70 by 2030. At present, 163 mothers die against 100,000 live births.

Maternal health expert professor Rowshan Ara Begum told Prothom Alo, "Providing quality maternal care has turned into a huge challenge. Now there is no shortage of logistics supplies. The lacking is in workforce and accountability.”