Bangladesh is one of 16 countries on course to achieve their Millennium Development Goal (MDG) for reducing child mortality. Among under-fives, 54 deaths were recorded for every 1,000 live births in 2008, a significant decrease from the rate of 146 deaths in 1991. Child mortality is expected to drop further by 2015, to around 48 deaths per 1,000 live births.
But while mortality rates among young children have seen an impressive decline, maternal mortality remains an area of concern and currently Bangladesh is not expected to meet its MDG target. In 2008, nearly 350 women died for every 100,000 live births. This represented a significant improvement from 1990, when over 570 women died for every 100,000 births, but it is still some way from the target of 144 deaths by 2015. The UN sees limited access to health services for mothers as representing the main obstacle towards reducing deaths among women in the country.
However, the Guardian’s Misha Hussain this week suggests that cultural factors in Bangladesh may be as much to blame as a lack of medical facilities. Firstly, women in the region marry very early; in South Asia, nearly half of young wives (under 24) were married before they reached 18. According to the UN, this means that the average age for a Bangladeshi woman having her first child is just 16 years. Unfortunately, younger girls face a higher risk of complications during birth. The reporter also notes the general absence of fathers during the birth of their children. Since men mostly take no part in deliveries and see none of the complications which can ensue in childbirth, husbands are less likely to insist on their wives going to proper medical facilities.
In Bangladesh, over three-quarters of births still take place at home, though women are increasingly choosing to admit themselves into clinics and hospitals. The number of women giving birth in medical facilities more than doubled between 2001 and 2010. And as education levels among women improve, these numbers are likely to increase further. The Bangladeshi government is also putting efforts in training midwives. The first fully qualified midwives will start work in April and by 2015, it is hoped the country will have 3,000 in the healthcare sector. The presence of qualified female health professionals will hopefully be another factor in changing behaviour in Bangladesh, persuading more women to use healthcare facilities and increase their chances of coming through childbirth safely.