During the 15-year era of the Millennium Development Goals (MDGs) (2000-2015) maternal mortality was halved and the number of couples, mostly women, accessing contraception increased to 62 percent. Is Bangladesh thus winning in the pursuit for universal sexual and reproductive health care services for all of its citizens? Unfortunately, it is not quite as straightforward; the many achievements already made are still outweighed by some significant challenges the country faces – especially girls and women.
Each year, 5,200 women die due to pregnancy and childbirth related complications in Bangladesh. This amounts to nearly 15 women losing their lives every day.
Life-saving emergency obstetric and newborn care is often not available or is of poor quality. 62 percent of women still give birth at home and 58 percent, without skilled birth attendance. This doesn't come as a surprise when taking into account that the health portfolio receives only 4.1 percent of the government budget, opening up opportunities for private facilities, which in turn can lead to high out-of-pocket expenditures for patients. Limited infrastructure and a fear of high costs and poor quality, paired with harmful social norms which limit girls' and women's decision-making power, leave Bangladesh in a situation where adolescents, young mothers and couples can't access the care they need. Women with no education and living in the poorest households are far less likely to be assisted by a skilled attendant during delivery.
Bangladesh is lagging behind other South Asian countries particularly in terms of the ratio of midwives and nurses to population. Depending on the year of measurement, India and Sri Lanka have between five and six times as many midwives and nurses as Bangladesh, and Pakistan has almost twice as many. Bangladesh has only 2.2 nurse-midwives per 10,000, who do not meet a global standard of midwifery, and which is less than half the global average for low-income countries. Overall, workforce density is well below the internationally recommended figure of 22.8 per 10,000 required to achieve relatively high coverage for essential health interventions in countries most in need.
Midwives who are educated and regulated to international standards can provide 87 percent of the essential care needed for women and their newborns; investing in midwifery education and deployment to community-based services can potentially yield a 16-fold return in terms of lives saved and costs of caesarean sections averted.
In 2012, only 1 percent of Bangladesh's population was covered by some form of health insurance.
The World Socialist Party (India): 257 Baghajatin ‘E’ Block (East), Kolkata – 700086,
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