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,
Tel:
2425-0208,
E-mail: wspindia@hotmail.com
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