Improving maternal and newborn health: the case of rural Bangladesh
Women and Children First recently concluded a 2½ year project in Bangladesh, where over 10,000 women and girls joined their community women’s groups.
Since the start of the project, significant advances in maternal health were reported: mortality rates decreased and group members readily adopted safer maternal health practices.
When we first began this project in the Bogra district of northern Bangladesh, very few women were actively seeking antenatal care and delivering with the assistance of a healthcare professional. In the communities where we worked, the percentage of women attending four antenatal-care sessions was barely 10%, but increased to almost 75% after the women’s groups were established and women learnt how vital antenatal-care was for their health and that of their baby. The women deciding to give birth at health facilities also increased by 12%, to more than 50% of women.
The change in pregnant women’s practices was likewise perceived by those working at a facility in Bhatgram Union. As one health professional expressed, “I have worked here for 5 years. I had hardly seen pregnant women, even those living close to the community clinic, coming to get ANC. But, in the last year they have started coming every month for check ups, to take tablets and capsules. The number of pregnant women coming was around five or six per month, but now it has increased to 18 – 22 per day.”
More sanitary practices were also adopted by the women who decided to deliver at home, ensuring that even if these newborns were not delivered at a facility, they still represented safer births. These improvements ranged from the attendant washing their hands with soap prior to delivery, which increased by 18% to 97%, to the thread used to tie the umbilical cord being boiled prior to use, which increased by 40% to almost 100% of all home births.
Throughout the two-year project, there was also a surge in the use of safety delivery kits, which can contain a bar of soap, a clear plastic sheet, an umbilical cord tie, a blanket and latex gloves. Indeed, the percentage of newborns born at home where the attendant used a safe delivery kit increased from 37% to almost three quarters of all births, improving hygiene in home births and reducing the likelihood of the mother suffering an infection. A Bhatram Union health worker likewise expressed that “sales [of safe delivery kits] have increased. These days we are struggling to meet demand, whereas in the past we could not sell even ten kits.”.
The project ran from July 2014 until December 2016 and 196 women’s groups where established throughout three Unions in Sonatola and Nandigram Upazilas, in the Bogra District in northern Bangladesh. The project was funded by UK AID, and implemented with our local partner, the Diabetic Association of Bangladesh – Perinatal Care Project (BADAS-PCP), who we’ve worked with since 2002.