Maternal health care: Increase allocation, take up sustainable programmes
According to the United Nations Population Fund (UNFPA), Bangladesh has seen a decline in maternal mortality rate, which is positive news. However, the country still has a long way to go in achieving the target set by the Sustainable Development Goals (SDGs) of reducing the rate to 70 or below by 2030.
During a recent seminar at Bangabandhu Sheikh Mujib Medical University (BSMMU), experts emphasised the need for safe and dignified maternal healthcare. Unfortunately, Bangladesh lacks the necessary infrastructure and workforce to ensure such care. Many mothers still rely on untrained midwives, posing risks to both themselves and their newborns.
Moreover, district hospitals, upazila health complexes, and community clinics often lack trained midwives, and even larger hospitals face shortages. Additionally, inadequate privacy measures during childbirth are prevalent in both public and private hospitals, hindering safe and dignified delivery.
Another matter of concern highlighted by the experts is the prevalence of unnecessary surgeries in private hospitals, driven by profit. The Vice Chancellor of BSMMU, Sharfuddin Ahmed, emphasised the importance of following established medical protocols and identifying the need for surgery based on clear indications. Promoting normal delivery or other medical issues through social media advertisements was deemed inappropriate by the physicians.
During the seminar, it was revealed that there has been a decline in the rate of prenatal care among pregnant women in Bangladesh. In 2017-18, 46 per cent of pregnant women received this service, compared to 41 per cent in 2022. As reported by Prothom Alo, half of the pregnant women are deprived of prenatal care.
The reasons behind this is lack of communication and poverty. These mothers are not only suffering from lack of care during pregnancy, but also being deprived of nutritious food. It increases the risks for both the mother and the child, especially when complications arise. It is concerning that 51 per cent of women in Bangladesh still get married before the age of 18, further exacerbating these risks.
In a recent round table meeting organised by Prothom Alo, several recommendations were made to address these issues. These include increasing the government budget for maternal health services, improving the quality of maternal health services across all levels, strengthening the supervision of private institutions, training midwives, implementing registration systems for expectant mothers, providing pregnancy services and allowances, among others. However, there are doubts about the extent to which the government takes these recommendations and suggestions into account.
Bangladesh celebrates Safe Motherhood Day since 1997. It constitutes that the government is aware of the issue and the concerned government agencies carried out different programmes on this day.
But is that sufficient to ensure safe motherhood? Like many other developing and less developed countries, women from poor families are deprived of maternal care. It is essential to implement separate programmes aimed at helping these vulnerable groups. Even if the SDG targets are achieved or approached, there is no alternative to increased allocation of resources and sustainable programs for maternal health services.