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Rezaul Haque

Rezaul Haque. Achieving Millenium Development Goals on Maternal health. General information of Bangladesh.

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Rezaul Haque

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  1. Rezaul Haque Achieving Millenium Development Goals on Maternal health

  2. General information of Bangladesh Peoples republic of Bangladesh is bordered by India on three sides except for a small border with Myanmar (Burma) to the far southeast and by the Bay of Bengal to the south. The capital is Dhaka Total area of Bangladesh is 1,47,570 square kilometer. Total population is 15,25,18,015 out of that male is 7,63,50,518 (50.06%) and female is 7,61,67,497 (49.94%). Population Growth rate is 1.34%.

  3. Contraceptive prevalance rate is 61%. Life expentency for male and female are 65.7 and 68.3 years respectively. The population density is 1034 per square kilometer. MMR 194/100000 live birth. Malnutrition among women of reproductiveage group is 45%. Mean age at marriage (Female) 18.5 years.

  4. Gonoshasthaya Kendra (GK)(People’s Health Center) GK started the journey during the liberation war in 1971 as Bangladesh Field Hospital. In 1972 it is registered as a public Charitable Trust with the vision that the fate of the country depends upon the fate of the poor and the development of the country depends upon the development of rural community particularly women, with basic health services including reproductive and child health care services through a cadre of village-based health workers, known as paramedics, mostly female to over one million population in 647 villages in 50 unions in 17 locations of Bangladesh till 2012. To access in the health care services GK introduced a social based heath insurance scheme for the benefit of the poorer section of the community in 1973.

  5. Objectives of GK Develop people oriented health management programs and make people aware of health issues. Train paramedics, doctors and impart skills to women and men to make them self-reliant, thereby making GK a self-reliant organization. Enable women to improve their self-image and encourage them to assert themselves. Organize poor women, train them and provide them opportunities for income generation. Provide basic education, particularly to children and women of poor families. Play an advocacy role for the well being of poor people in national and international levels. Undertake relief and rehabilitation programs for natural disaster mitigation and also conduct preparedness programs. Promote the Bengali language and instill pride in the mother tongue. Create social awareness against fundamentalist, protect the interest of minorities and fight communal violence

  6. Reproductive Health Care Services of GK To provide comprehensive primary health care GK adopted the holistic approach where women are brought in the center of planning and development. After the formal training the health workers are posted at GK‘s Union level Health centres they work together with the Traditional Birth Attendants under the supervision of a senior health worker worker to provide services to the families in village 15 to 18 days in a month and carry simple medicines with them. GK provides a wide range of reproductive and child health and family planning services in its programme villages.

  7. Services of reproductive health care (i) In ANC services i) checking of oedema ii) checking blood pressure, jaundice and anaemia iii) Testing of urine for sugar and albumin iv) Examining eyes, ears and teeth v) Examining abdomen for fundal height, foetal movement and foetal heart sound vi) Cutting nail vii) Doing blood grouping and random blood sugar viii) Distribution of iron and calcium tablets amongst pregnant women ix) Immunisation of pregnant women against tetanus x) Identification and regular follow-up of high risk mothers and ensure their timely treatment including referral Health awareness massages to pregnant women and their families for additional 2 hours rest in noon and additional food even before the male members. Promotion and delivery of family planning services

  8. (i) In PNC servicesi) Follow-up of the mothers and the newborns ii) Immunisation of children under age one against eight deadly diseases: Diphtheria, Whooping Cough, Tetanus, Polio, Tuberculosis, Measles, hemofailas influenza and hepatitis-B iii) Promotion of additional nutrients and a balanaced diet for lactating mothers and newborns with family members iv) Promotion and delivery of family planning services

  9. Gender equality and equity for women In the training curriculum for the paramedics gender issues are incorporated. A crèche at GK is enabling women to work and study despite the demands of motherhood GK women are entitled to six months maternity leave, four months with full pay They are paid through a bank rather than in cash. It helps them to have some degree of autonomy within their families.

  10. Maternal mortality ratio (MMR) in GK program area 2000-2012 Figure 1 show a considerable reduction in Maternal mortality ratio (MMR) by 39.14%, from 178.76 per 100,000 live births during 2000-2004 to 108.79 per 100,000 live births during 2009-12 GK programme area.

  11. MMR, National and GK programme areafrom 1990-2011 MMR in GK area during 1992-93 is 36.54% lower than the national level (570) during 1990. MMR in GK area during 2001 – 2002 is 46.96% lower than that of the national level (320) in 2001. MMR in GK area during 2010-2011 GK achieved the Millennium Development Goal on MMR of 143 in 2015 and 36.34%lower than that of the national level MMR 194.

  12. MMR in GK programme area from April 2002 – April 2012 The figure shows the trend of Maternal Mortality Ratio in GK programmes area. GK achieved the Millennium Development Goal on MMR in April 2008 to April 2009 (1415 Bangla year).

  13. Place of maternal death in GK programme area from April 2002- April 2012 Figure shows that most of the maternal death occurs in the hospital (108/238) 45.38% and (88/238) 36.97% in home and (42/238) 17.65% on the way to hospital

  14. Distribution of birth, reproductive age and maternal deaths from April 2002-April 2012 The table presents all female, 15-49 years female age group death rate and maternal mortality ratio in the GK area during April 2002 - April 2012.

  15. MMR by Life Span (duration) of GK Program Area from April, 2011- April, 2012 The table shows that MMR is 62.07% and 52.74% lower than that villages of GK is working 10 years in comparing of that village 0-4 years and 5-9 years

  16. Factors behind the succes Identification and Follow-up of ‘High Risk Mothers’ Social accountability Skilled/Trained Traditional Birth Attendants (TTBAs) Backup Hospital with motivated and committed staffs 1. Higher ANC Visit and Services

  17. Maternal Mortality by direct Causes of Death from April 2002 - April 2012

  18. Indirect Causes of Maternal Death from April 2002 - April 2012

  19. Conclusion Achieving MDGs in MMR is possible in rural areas Trained and committed workers, who are related to ANC and PNC services A backup hospital to support the referral cases

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