Bangladesh: falling maternal mortality rates

Experts are struggling to explain what has been called the “Bangladesh paradox” after the developing nation reached a milestone in the battle to reduce the number of women dying during childbirth, but failing to score well in other development indices.

It has become one of only a handful of countries to achieve one of the United Nations’ key development targets by sharply decreasing its maternal mortality ratio (MMR), the number of mothers who die per 100,000 live births.

Yet the South Asian nation of 160 million people has done so in spite of widespread poverty, regular political upheaval and weak institutions – factors some think may have even contributed to its achievement.

Doctor Zafrullah Chowdhury, the founder of one of Bangladesh’s oldest NGOs, Gonoshasta Kendra (GK), believes a transformation in attitudes towards women may explain this Bangladeshi success story.

“Culture has not changed, religion has not changed – but attitude has changed,” he said.

Bangladesh’s current MMR is about 194 maternal deaths per 100,000 live births, but between 1998-2001 this averaged 322 per year and in the intervening years, notes the Lancet, the country beat all expectations with a decline of 5.6 percent a year.

This means the MMR in Bangladesh has fallen by more than 66 percent over the last two decades – putting it ahead of its richer neighbours: Pakistan’s MMR is 260 and India’s is 230.

Bangladesh’s GDP per capita in 2011 was $752 compared with Pakistan’s $1,256, and out of all South Asia nations, it has the lowest proportions of births attended by a “skilled birth attendant” with only around 30 percent of births supervised, compared with 50 percent in India.

Pray for Bangladesh, and women who continue to face challenges. Give thanks to God for progress, and pray for continued development of care for women.

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