Bangladesh
Bangladesh has made significant progress in reducing newborn death rates with a decline from 63 deaths per 1000 live births in 1985-1989 to 34 in 2002 to 2006. Progress in reducing maternal mortality has been less impressive with 570 women per 100,000 live births still dying in 2005. Around eighty five per cent of births in Bangladesh occur at home and only around 18 per cent of women giving birth do so with a skilled attendant.
Women and Children First currently works in three districts in Bangladesh: Bogra, Faridpur and Moulavibazar.
Perinatal Care Programme (PCP): 2002-2008
With funding from the Big Lottery Fund, Women and Children First has been working in Bangladesh since 2002 in partnership with the Diabetic Association of Bangladesh (BADAS) and the University College London Centre for International Health and Development (CIHD). The project, which came to a close in mid-2008, established 162 women’s groups in three Districts (Bogra, Faridpur and Moulavibazar). With support from their communities the women’s groups implemented locally appropriate strategies to address their most important maternal health problems. Solutions include community awareness activities, increasing communication with healthcare staff and developing emergency funds to pay for healthcare or transport to a hospital. Healthcare staff received training in maternal and newborn healthcare skills, so when women do access health facilities they are treated with respect and receive high quality care.
With the support of CIHD the impact of the project activities on maternal and newborn health was evaluated, demonstrating a 12 percent decrease in newborn deaths and no maternal deaths among women’s group members since 2006. There have also been improvements in the uptake of antenatal care, exclusive breastfeeding for six weeks after birth and immediate care of the new born baby.
Case Study
Rahatun was pregnant and so Shanti and Shajeda, two members of a women’s group, advised her to go to Nandigram hospital for an antenatal check up, which she duly did. Rahatun moved to her parent’s house in preparation for her delivery. When her contractions started she did not tell anyone. On the second day she called Shanti, who advised her husband to take her to Bogra Mohammad Ali hospital because she had been experiencing contractions for over 12 hours. However, Rahatun’s father did not have enough money to pay for her treatment and so Shanti arranged for him to borrow 500 Taka (£4) from the women’s group emergency fund. Rahatun was admitted to hospital and had a caesarean section. Both mother and baby are now in good health.
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