Maternal and Child Health and Nutrition

Key Facts Bangladesh appears to be on track to achieving MDG 5

Maternal mortality declins in Bangladesh by 40% in the last 9 years to 194 per 100,000 live births

The main reasons for this decline in maternal mortality are Fertility reduction The use of fecilities for maternal complication increased from 16% to 28%

Bangladesh has achieved remarkable progress in population and health over the past 30 years and is one of six countries that are on track to achieve the MDG for reducing child mortality. In the last 15 years, under 5 mortality rate has declined from 133 deaths per 1000 live births to 65. This decline is mostly due to reduction in the child mortality rate from 50 to 14 and the post-neonatal mortality rate from 35 to 15. The neonatal mortality rate, however, remains high at 37 accounting for 57 percent of all under-5 deaths. Although maternal deaths continue to decline steadily, the metarnal mortality rate is still high about 340 per 100,000 live births. Since, the early 1970s, the Total Fertility Rate (TFR) has declined from 6.3 children per women to 2.6 in 2011, and the contraceptive prevalence rate has increased from 8 percent to 56 percent. However, unplanned pregnancies still account for 30 percent of all births. Improvements in the use of family planning and maternal and child health services are particularly slow in some geographic areas of the country.

'It is not so easy task to perform child delivery. I have to take risk of two lives at a time, the mother and the baby', says Aklima Begum, a renowned and admirable traditional birth attendant in her locality Boddipur colony, Satkhira. At a time she is a housewife, a mother of two daughters, a midwife and also a small trader. She runs a tea-shop of her own.

Aklima attended two trainings on Traditional Birth Attendant (TBA), provided by Health and Economic Development Project under Satkhira ADP. She reflected her changes onto the community mother and family too. Earlier whereas family members insisted the mother to give birth in dirty place on old jute bag, they have become careful about the hygiene now. Before, people prevented newborn from drinking mother's milk particularly colostrum, but now they spontaneously ensure breast milk to newborn within one hour of birth, a necessary measure for saving lives of thousands of children in the country. Aklima feels proud of herself as well as happy as a successful midwife as she has got the opportunity to serve her community because people can bear the expense in comparison to spending at hospitals. Sometimes she also provides voluntary service to the poor. It has also addressed the need of having a local and sustainable solution to safe delivery.

Aklima thinks her profession is a noble one because she can serve the community as well as her family. She thinks someday somehow her effort will help her dream to come true of seeing her daughter as a good nurse in future.

MOTH

ER &

CHILD HEALTH

Goal: To improve the health and nutrition status of children and mothers and in doing so lower mortality rates

OutcomesWVB has been implementing health and nutrition interventions through ADPs over the past three decades, addressing the following key strategic objectives:

Key Results1. A total of 5,07,439 (100%) community people including adolescents boys & girls, mothers, community volunteers &

TBA/SBA have been trained in different health education interventions like immunization, safe motherhood, diarrhea management, nutrition and WATSAN in 55 ADPs under six WVB Divisions

2. About 52107 (132% of plan) children of age 12-23 months have been fully immunized (direct & supportive service) through all WV ADPs

3. A total of 20474(104%) non-pregnant women (15-49 years) received TT 5 vaccine 4. 9131(108%) pregnant mothers (15-49 years) have been immunized with TT 2 vaccine to save the newborn baby &

mothers from tetanus diseases5. ADPs immunized 2,7271(99%) community people with ‘Hepatitis B’ vaccine6. 16,963(90%) pregnant women completed Ante Natal Care (ANC) 7. 8,257(94%) lactating mothers received Post Natal Care (PNC)8. 251,746 (103% ) children received Polio Drops9. 246 (11%) malnourished children rehabilitated10. 3,481(122%) pregnant women targeted under feeding program

References:1. Bangladesh Demographic profile 20112. Bangladesh Maternal Mortality & Health Care Survey 20103. Human Development Index 2011, UNDP4. Ministry of Health and Family Welfare, Bangladesh 5. World Health Statistics 20116. Banglapedia, National Encyclopedia of Bangladesh7. The State of the World Children 2011/UNICEF8. Bangladesh Maternal Mortality and Health Care Survey 2010

World Vision BangladeshAwal Center (4th floor)34, Kamal Ataturk AvenueBanani, Dhaka-1213Web: www.wvasiapacific.org/bangladesh

40 Years of Service to the Children of Bangladesh

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World Vision Bangladesh’s ResponseWorld Vision Bangladesh’s ResponseWorld Vision Bangladesh’s Response

1. Improve child nutrition and health care and prevent sickness through Supplement feeding and breastfeeding programs and education

Awareness building on child health issues and on conditions under which medical assistance is necessary

Community mobilization and awareness on immunization

Curative care facilitation for children including cost reimbursement for health consultations and prescription medication

Education for mothers and other care givers on how to provide proper home care during sickness

Enhancement of local doctors’ referral knowledge and capacity to deliver basic care

Establishment of a referral system linking patients through satellite clinics to quality Upazilla Health Complex care

Facilitate PD hearth sessions with parents that cover a household level nutrition security and WASH to reduce water borne diseases and found that a total of 15, 245

under 3 years children gained body weight of more than 400 grams in the first month of joining the program.

Education and awareness on oral rehydration therapy Assistance in sanitary latrine and safe drinking water source installation

2. Ensure healthy pregnancy and delivery through Awareness building and education in adolescent reproductive health Capacity building for birth attendants Facilitation of antenatal and postnatal care by medically-trained providers

3. Promote the well being of disabled children and reduce preventable childhood disability through Education on disability prevention Provision of assistive devices and physiotherapy to meet the special needs of disabled children

4. Enhance mother and child health care during emergencies and disasters through Facilitation of medical consultancy, support and medication delivery in affected areas