Understanding the Trends of Maternal and Neonatal Mortality in Bangladesh in the Context of South Asia

Introduction: This article is presenting the overall situation of maternal and neonatal health in Bangladesh in comparison to other South Asian countries. Bringing down the maternal mortality ratio from 569 to 143 was the target for Bangladesh which was achieved up to 176 per 100,000 live births by 2015 but the target as per the Millennium Development Goal 5 was not fulfilled yet and remained as a challenge. Besides, the improvement in reducing the neonatal mortality rate during 1993-2014 shows a national level decline from 52 to 28 per 1000 live births, which is almost half during this period with a percentage change of about 46% and so more care is needed here also. Objectives and Methods: The manuscript has three objectives: to present the trends of maternal and neonatal mortality, to explain the maternal and neonatal mortality rate by background characteristics and the causes of maternal and neonatal deaths in Bangladesh on the basis of South Asian perspective. The main source of data collection and analysis was the secondary sources, from different journals and project reports published between the years 2001 to May 2018. Main Text: In Bangladesh, 35% maternal deaths occurred as indirect causes and 9% causes of deaths are still remaining unidentified. In addition, hemorrhage (31%) and pre-eclampsia-eclampsia (20%) are found two vital causes of maternal deaths with two more causes which are due to obstructed labor (7%), and termination of pregnancy (1%). It is found that Bangladesh has shown a great improvement in maternal mortality ratio by reducing maternal mortality to 176 in 2015 from 569 deaths per 100,000 live births in 1990, with an increase of 69% as progress. On the other hand, it is found that 43% of neonatal deaths in Bangladesh occurred due to birth asphyxia, 24% due to neonatal pneumonia, 22% due to prematurity, 5% due to sepsis, 0.2% due to meningitis and encephalitis, 0.1% due to congenital malformation and 5% causes are still remain undetermined. While comparing the situation to other South Asian countries, it is seen that the causes of neonatal deaths by prematurity are in the highest position that causes 29.7%, 43.8%, 30.8% and 39.3% deaths and birth asphyxia is in the second highest position that causes 22.9%, 18.9%, 23.4% and 20.9% deaths in Bangladesh, India, Nepal and Pakistan respectively. Conclusion: This paper will support health researchers and medical anthropologist for further studies and specifically for the health-policy makers and corresponding authorities to take necessary actions for overcoming the obstacles of improving maternal and neonatal health situation in Bangladesh.