The Women's Health Project consists of three sub-projects: Strengthening Emergency Obstetric Care (EmOC); Women Friendly Hospital Initiative; and Social Mobilization and Communication.
The health of women is a crucial factor in the health of children, but gender discrimination leaves women particularly vulnerable to disease and death.
The Maternal Mortality Rate (MMR) declined from 440 per 100,000 childbirths in 1997 to 320 per 100,000 childbirths in 2001. Translated into real numbers, this means that of 2.5 million women who become pregnant each year, an estimated 370,000 develop fetal complications, which the health facilities in the country are neither equipped nor able to handle. Increasing access to emergency obstetric care (EmOC) is a key element in reducing maternal mortality.
Only 8.6 per cent of births take place in hospitals or local health centres and only 11.8 per cent of deliveries were assisted in 2001 by doctors, midwives, nurses or family welfare visitors. The remaining 88.2 per cent were attended by relatives or other people, of whom only 11.9 per cent by trained traditional birth attendants (TBAs).
The health seeking behaviour of women during pregnancy and childbirth is low: only 48 per cent utilize antenatal care and 16 per cent postnatal care. There is also evidence of a disparity in health seeking behaviour according to educational and economic status. Poorer, less educated women are less likely to seek qualified routine or emergency obstetric care. Only 40 per cent of women who perceived that they had life threatening complications during their pregnancy sought immediate care – 70 per cent of women in the highest wealthy fifth of the population and 50 per cent of those in the lowest fifth.
Maternal malnutrition, infections during pregnancy, anaemia and repeated pregnancies contribute to low birth weight babies and a high rate of maternal mortality. The maternal mortality rate is among the highest outside sub-Saharan Africa, and the vast majority of infants are born at home. The nutritional status of women in Bangladesh is also alarming. The body mass index (BMI) of 52 per cent of women of reproductive age is less than 18.5; this means they are very underweight. They are also very stunted. This has been compounded by a high prevalence of iron deficiency anaemia (more than 50 per cent) and Vitamin A deficiency (more than 2.8 per cent suffer from night blindness).
The poor nutritional status of female children at birth is compounded by a lack of access to various services, resources and opportunities associated with high workloads and lack of rest. All this results in poor health, and low birth weight of babies, who tend to go on to be more malnourished in childhood and beyond. This vicious cycle has been repeated for centuries.
Reducing the rate of maternal deaths is not possible solely through health and nutrition initiatives. Maternal mortality is an indicator of the overall situation of women in a society, so a more comprehensive social development approach is needed. This means nurturing a socio-cultural movement that addresses the reduction of maternal mortality as a woman's right and also enhances women's self esteem and status.