Call for public-pvt partnership to cut maternal mortality rate

They said the government alone cannot achieve the goal of reducing MMR to less than 75 percent by ensuring reproductive healthcare services for all by 2015.

"We need strong partnership with the government, NGOs and other agencies working in reproductive healthcare in reducing MMR," said Suneeta Mukherjee, Unfpa representative in Bangladesh, at the inaugural session of a workshop at Sheraton Hotel yesterday.

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The workshop on 'Accelerating progress towards maternal mortality reduction' was jointly organised by Unfpa and DFID.

According to an Unfpa figure, MMR in Bangladesh is still considered one of the highest in the world with 12,000 annual deaths of mothers during deliveries.

Besides, a large number of the mothers, about 45 percent, live with post-delivery complications.

One of the reasons behind the high rate of MMR is early marriage, Suneeta said, adding that on average about 57 percent adolescent girls give birth to their first child before they reach the age of 19 years and MMR is highest among the age group 15-19.

She said, "Even more shocking is the fact that about 16 percent of the adolescent girls give birth to their first child at the age of only 15."

Abortion accounts 21 percent, eclampsia 16 percent and obstructed labour eight percent for major share of the annual deaths of MMR, showed a presentation at the workshop.

The speakers pointed out that contraceptive use among the adolescent mothers is quite low with average 30 percent and most of the young mothers suffer chronic malnutrition with as high as 45 percent in Bangladesh.

Presenting her paper Stacy Saha, programme coordinator of LAMB Project in Bangladesh, said, "Only 16 percent deliveries in the rural areas take place in the hands of skilled birth attendants while the rest of the deliveries take place at home attended by mostly untrained birth attendants."

Stacy emphasised on having skilled healthcare staff at all levels and establishment of appropriate referral system with community ownership to supervise rural deliveries.

"The national maternal health strategy aims at increasing access to skilled birth attendance from existing 27 percent to 70 percent and also to raise the use of contraceptives from existing 53 percent to 65 percent," said Health Minister Dr Khandaker Mosharraf Hossain.

"Knowledge on abortions, a major cause of deaths and complication in pregnancy, is very low among the childbearing mothers. About 46 million pregnancies in Bangladesh are terminated by induced abortion and roughly 13 percent of all pregnancy-related deaths are due to complications of unsafe abortions," said Abu Jamil Faisel, country representative of Endanger Health.

He strongly suggested establishing advocacy services by all public, private, NGOs and UN agencies to inform especially adolescent girls about reproductive health.

Dr Md Mizanur Rahman, director general of health services, Dr Yasmin Ahmed, managing director of Marie Stopes Clinic Society, Dr Beena Varghese of ICDDRB, Charles Llewellyn, team leader of population and health of USAID and Dr Kayode Oyegbite, chief of health and nutrition of Unicef also presented papers at the first technical session on interventions for improving maternal health.

Dr Jenny Amery, a senior health advisor to Asian region of DFID, UK moderated the session.