Each year as yet, umpteen women and newborns around the world -- Bangladesh is no exception -- have to embrace preventable deaths owing to complications related to pregnancy and childbirth. Behind each loss lies a tragic story of lives cut short and families left to endure deep grief, shock, and a wide range of emotional trauma.
As the world observes the World Health Day today (Monday), under the theme 'Healthy Beginnings, Hopeful Futures', the urgency of addressing maternal and newborn health has become even more critical -- particularly for low-income countries like Bangladesh.
This year's observance happens to come at a time when Bangladesh's interim government led by Nobel-laureate economist Professor Dr Muhammad Yunus has embarked on sweeping reforms in key areas of governance. Among these is health-sector overhaul. A reform commission led by Professor Dr AK Azad Khan is tasked with making healthcare more people-centric, accessible, and universal.
The commission is expected to submit its recommendations by April 30, and maternal and newborn health is likely to feature prominently in its proposals. Typically they are believed to be backbone of a healthy nation.
As we reflect on the World Health Day, it is crucial that maternal and newborn health is not overlooked in the reform agenda. Healthy beginnings are not just a theme -- they are the foundation of a hopeful and thriving future for Bangladesh
On March 20, the Bangladesh Bureau of Statistics (BBS) released a public-opinion survey titled Health Sector Reform 2025, based on responses from 8,256 households across the country. The findings revealed that 92.6 per cent of respondents supported the introduction of health cards for patients-an initiative aimed at improving accessibility and accountability. The BBS survey further shows that 91.3 per cent of respondents wanted primary healthcare to be recognised as a constitutional right -- a call that underscores the public's growing demand for inclusive and equitable healthcare.
Whether in rich or poor households, in urban or rural areas, babies in Bangladesh continue to die each day before reaching their first month of life. Stillbirths occur daily, with many going unreported or unnoticed in the national conversation.
The UNICEF data from 2015 show that approximately 3.1 million babies were born in Bangladesh that year -- an average of 8,600 births every day. Alarmingly, around 204 babies die each day, while 218 are stillborn. Neonatal mortality -- defined as the death of a baby within the first 28 days of life -- stands at 23 per 1,000 live births.
The disparities become even more pronounced when broken down demographically. In rural areas, neonatal mortality is as high as 33 per 1,000 live births, compared to 29 in urban areas. Among the poorest households, the figure rises sharply to 42, while among the wealthiest it drops to 20.
The UNICEF report identified key causes of neonatal deaths in Bangladesh: prematurity accounts for 29.7 per cent, birth asphyxia and trauma 22.9 per cent, and sepsis nearly 20 per cent. These are all largely preventable with timely and quality healthcare.
In rural regions, only 18 per cent of women receive the recommended four or more antenatal-care visits, compared to 43 per cent in urban settings. When it comes to skilled attendance at birth, the disparity is equally troubling -- 36 per cent in rural areas versus 62 per cent in urban ones.
Postnatal care within the critical first two days of a baby born -- which is essential for both mother and baby -- is received by just 47 per cent of newborns in rural areas, compared to 69 per cent in urban centres, according to the UN agency findings.
Although this data is from at least a decade back, the overall state of the health sector has changed little since because of chronic underinvestment in the health sector. In the 2024-25 fiscal year, Bangladesh allocated only 5.2 per cent of its national budget to health -- equivalent to just 0.74 per cent of GDP -- placing the country among the lowest health spenders globally.
In 2021, only Djibouti, Benin, and The Gambia spent less on health as a share of GDP among the world's 45 least-developed countries (LDCs).
Beyond budget numbers, pregnant women in Bangladesh face a host of systemic and cultural barriers.
Access to quality prenatal and postnatal care is limited, especially in remote and underserved areas.
There is a critical shortage of skilled birth attendants, with many rural women still delivering at home without professional help.
Weak referral systems further delay access to emergency care at better-equipped facilities during childbirth complications.
The current health-sector reform commission is expected to recommend ways of strengthening the referral system -- linking primary care to specialised facilities more effectively.
Mental-health support is also lacking. Conditions like perinatal depression and anxiety are often overlooked or untreated, leaving new mothers to suffer in silence.
Hospital infrastructure remains inadequate, with poor sanitation, limited emergency obstetric services, and a shortage of neonatal intensive care units (NICUs).
Legal and social protections are also weak. Although the government mandates six months of maternity leave, this is seldom enforced in the private sector-especially in the garment industry, which employs a large number of women. While some well-structured private companies comply, most do not, leaving pregnant women vulnerable to job loss, discrimination, or unsafe working conditions.
A central focus of the World Health Organisation (WHO) campaign is the need to listen to women and support families. Too often, women's voices are reportedly absent from health-policy decisions. Health systems are designed through top-down approaches, failing to reflect the lived experiences of women and resulting in poor service delivery.
In government medical colleges and hospitals across the country, women frequently report disrespectful or even abusive treatment during childbirth, long wait, a lack of privacy, and a general fear of neglect in under-resourced facilities.
Often, patients' families feel compelled to spend extra money on medicine and tips for lower-tier hospital staff in hopes of receiving better care.
Tackling the maternal and newborn health crisis does not always require high-tech solutions. Many low-cost, high-impact interventions have already proven effective:
l Ensuring regular antenatal checkups and skilled birth attendance.
l Providing access to essential medicines, such as magnesium sulfate for pre-eclampsia and antibiotics to prevent or treat sepsis.
l Expanding access to family planning to avoid unplanned pregnancies and promote safe spacing between births.
l Strengthening community health-worker programmes, particularly in remote and underserved regions where skilled doctors do not prefer to stay.
But these interventions can only succeed if governments treat maternal and newborn health as a national priority rather than an item on a policy checklist.
Hope on the horizon: Despite the grim statistics and neglected ones, there are reasons for cautious optimism under the present interim government.
Countries like Nepal, Rwanda, and Sri Lanka have shown that political will, strategic and planned investment, and community-based healthcare models can significantly reduce maternal and neonatal deaths.
In Bangladesh, the success of immunisation programmes, community clinics, and reductions in under-five mortality proves that large-scale health interventions can work here. These models now need to be adopted and scaled up to specifically target maternal and newborn health.
Under the present regime, this is a defining moment -- through bold reform recommendations reprioritize health allocation and spending, and building compassionate systems that honour, respect, and protect the dignity of every mother and child, regardless of their wealth or status. Only then we can truly deliver healthy beginnings and hopeful futures for all-no mother left unheard, no newborn left behind.
jasimharoon@yahoo.com
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