Maternal, newborn and child health (MNCH) encompasses the sector of public health, policy making and intervention programmes designed to improve survival and nutrition for mothers, infants and children under 5. The approach emphasizes the importance of improving survival and nutrition for mothers and children.
Bangladesh has made significant strides in the health of women and children and has achieved its Millennium Development Goal (MDG) 4 (to reduce child mortality) and is on track to MDG 5a (to reduce maternal mortality). Bangladesh was recognized by the United Nations in 2010 for its exceptional progress towards MDG 4 and 5a to reduce child and maternal mortality in the face of many socioeconomic challenges.
Indeed, we have achieved remarkable progress in the sector in the last three decades. However, our maternal mortality rate is still quite high and in order to achieve the Sustainable Development Goals (SDGs) we have to focus our resources and attention to this sector.
SDG 2 and 3 directly identify the MNCH goals we have to achieve by the year 2030. SDG 2 addresses the need to “end hunger, achieve food security and improved nutrition and promote sustainable agriculture.” Under this, NPI (national priority indicator) 3 is to reduce the prevalence of stunting among children under 5 years of age to 12% (SDG Indicator 2.2.1).
SDG3 addresses the need to “ensure healthy lives and promote well-being for all at all ages.” Under this, NPI 5 is to reduce neonatal mortality rate to 12 per 1,000 live births (SDG Indicator 3.2.2). NPI 6 is to reduce under-5 mortality rate to 25 per 1,000 live births (SDG Indicator 3.2.1). NPI 7 is to reduce the maternal mortality ratio to 70 per 100,000 live births (SDG Indicator 3.1.1).
Currently, the neonatal mortality rate stands at 17.1 per 1,000 live births, which is lower than the global average. Under-five mortality rate in Bangladesh is 32 per 1,000 live births. Both these figures show vast improvement in the last decade. For both these figures, the SDG milestones are significantly closer compared to the maternal mortality rate.
Maternal mortality rate in the country stands at 173 deaths per 100,000 live births. While we have achieved tremendous progress in this field as well, but we have a long way to go before we can reach the SDG milestone. Between 1990 and 2010, maternal mortality in Bangladesh decreased from 574 per 100,000 live births to 194 per 100,000 live births.
The success has been possible in part due to the initiatives to reduce the total fertility rate, as well as increased skilled delivery attendance. Several development programmes carried out by the government, in association with NGOs can be credited to bringing down the number drastically. Moreover, rapid development of the private sector has also contributed to reducing the maternal mortality rate.
The importance of reducing the rate of maternal mortality cannot be stressed enough. Mothers are responsible for the next generation. Ensuring the wellbeing of mothers is akin to securing the future of the entire nation. We must raise awareness on the importance of maternal health during and after pregnancy by ensuring access to healthcare and assistance.
In order to achieve our targets in the field of MNCH, there is a need to increase knowledge on maternal, neonatal and child health. We have to work to ensure that quality maternal, neonatal and child health services are readily available to everyone, particularly at community levels.
Resources for and services of antenatal care, delivery care, postnatal care, newborn care and management of birth asphyxia, diarrhoea, ARI and some common ailments must be available to everyone regardless of their financial ability or geographical location. Emergency services must be set up for expectant mothers as well as newborns and young children, particularly in remote areas.
There is also a great need for human resources in the field of MNCH and that vast gap between service providers and recipients has only widened due to the outbreak of the coronavirus. Many are being denied treatment due to lack of healthcare workers and an increased pressure on medical facilities.
Moreover, many people have lost their source of income and are unable to afford food and basic healthcare. As a result, expectant mothers, newborns and children under-5 are facing malnutrition and other health problems. They are also more prone to the disease due to having weaker immunity systems.
Therefore, it is crucial that the field of MNCH receives urgent funding during these trying times. The government agencies associated with this field, including the Directorate General of Family Planning must be provided with the further provisions to deal with the crisis while working to achieve the SDG targets that the government has set its eyes on.
With increased support from the government, as well as from the private sector, we will surely be able to overcome this crisis. We must continue to dedicate our time and resources to this important field in order to achieve the SDG targets which are key milestones on the road to development.
Synthia Kainath Nur is working with Bangladesh Post