Abstract

PIP: Maternal and child health (MCH) services in Bangladesh reach about 42 million people who can theoretically receive health and nutrition education through the nationwide network of health care facilities which would prevent most health problems of women during pregnancy and childbirth. Yet most women do not use the services. Sociocultural barriers prevent them from doing so. Maternal mortality averages around 6/1000 live births. The leading cause of maternal death was eclampsia, but now is septic abortion. Only 3% of women want their next child to be a girl. The growth spurt of girls and age at 1st menstruation occur late. Maternal health in the 3rd trimester of pregnancy deteriorates. The nutritional status of pregnant women declines regardless of which trimester they are in during the food scarcity period (mid-September to mid-November). Illiteracy, high fertility, and low socioeconomic status also contribute to maternal death. The major causes of neonatal mortality are low birth weight, tetanus, respiratory infection, malnutrition, and diarrhea. In 1985, a Task Force on Mch designated family planning (FP), safe delivery, oral rehydration therapy (ORT), and expanded program on immunization (EPI) as priority areas. The Directorate of Health Services operates EPI and ORT while the Directorate of FP (DFP) operates safe delivery and FP. Each Upazila Health Complex (UHC) has an MCH unit, but out of 349 UHCs the DFP operates only 152. 1250 of 4350 unions do not have a family welfare center. Due to difficult terrain and an underdeveloped communication system, 9-17% of the population do not receive health services when ill. They tend to be people who live 2 miles from a government health facility. The government has set 3 goals of reducing MCH mortality during 1990-95. It has also identified ways to do so including increasing coverage of pregnant women from 10% to 60% and ensuring that safe delivery practices occur during at least 40% of deliveries.