M Aminul Islam
The twin goals of safe motherhood and safe delivery have largely been achieved in the remote Panchhari sub-district under Khagrachhari in what stakeholders say as a major success over the years.
Women and neonatal deaths have dropped, thanks to special attention to mortality during the period at community clinics, union family welfare centres and upazila health complexes in the hill tract.
Plan International, Bangladesh, and Young Power in Social Action (YPSA) in partnership with donors work at government facilities like union, upazila and district health centres that limp with limited resources.
Since 2016, YPSA has been implementing the ‘Strengthening Health Outcomes for Women and Children (SHOW)’ project in five unions—Panchhari Sadar, Logang, Chengi, Latiban and Ulachhari—under Panchhari.
The Tk 7.0-crore project is being provided with technical assistance from Plan Bangladesh and financial aid from Global Affairs Canada.
The skilled health workers of the non-governmental organisation are delivering services to expectant mothers for safe motherhood, proper nutrition and hygiene during and postnatal care.
The number of immature deliveries is diminishing now. Would-be mothers’ pregnancies go to full term and give birth to babies without complicacies through skilled workers.
Before 2016, available data shows, 32 per cent safe deliveries were made at government facilities like hospital and union health centre at Panchhari, which is almost 70 per cent now.
Again, before the baseline year in question, home deliveries were 68 per cent in the upazila. But the trend is downward with only 30 per cent now.
SHOW project sensitises women to the importance of spacing out their pregnancies, the nutritional values of food they eat, the intake of adequate calories and bad habits like maternal smoking during pregnancy.
YPSA Panchhari office delivers dos and don’ts for most marginalised and vulnerable mothers and pregnant women, adolescent girls, newborns and children under five.
The SHOW project’s community health workers always stand ready to help service-seekers, especially expectant mothers for full developmental growth of babies in their tummies.
They disseminate necessary information about safe motherhood, reproductive health, maternal, neonatal and infant mortality, peer education and male engagement in household activities, among others.
Another component of the scheme is village savings group (VSG) that helps the beneficiaries set aside some money, not only for health care, but also for major expenses like education and business.
While visiting Logang union health and family welfare centre at Panchhari, upazila family planning officer Shohag Moy Chakma said core service is being dispensed by existing government set-up.
The centre gives round-the-clock delivery service. Its outdoor work goes on from 9 to 5. Plan is implementing mobile referral system there, he disclosed this one fine afternoon in early November.
Plan helps deliver the job faster as it renovates infrastructure and installs solar panels at the centres that provide emergency services for pregnant women, Mr Chakma said.
Each centre has three staff members to serve delivery patients—a family welfare visitor (FWV) of its own and two community skilled birth attendants (CSBAs) of Plan.
Biplob Barua, Khagrachhari district family planning deputy director, said union family welfare centres used to give family planning service, but some model centres now give delivery and adolescent welfare services.
“Twenty-two out of 38 unions under nine upazilas here have a single union welfare centre. Sadar unions don’t have UFWCs as there are health complexes at each upazila,” he cited.
Mr Barua said a union welfare centre needs five staffers, including a visitor, a pharmacist and an ayah, for smooth delivery of primary services.
Ana Islam, SHOW project manager of Plan International Bangladesh, said the project reflects the national perspective given the yet higher maternal mortality and neonatal mortality ratios.
Mothers are happy to ponder that they are going to give birth to full-blown babies, but many mothers still die of post-partum hemorrhage in Bangladesh.
“Plan Bangladesh has identified skilled manpower shortages and weak management, and it is working with the government authorities to address the problems to achieve sustainable development goals by 2030.”
According to sources, new posts should be created and vacant posts be filled without delay for the greater good of the service-seekers.
They said non-governmental organisations play an important role in helping government-run health centres to boost institutional capacity.
Heath care beneficiaries also shared their experiences and views, and also expressed their satisfaction with the services they are getting from the centres.
The 44-month SHOW project at Panchhari is scheduled to conclude in March 2020.