Maternal Mortality and Last Mile Challenges: Improved Perspective for Leapfrogging

Background: Reducing maternal mortality to zero is one of the 3 targeted agendas of the International Conference of Population and Development (ICPD). Though global improvements in align with SDGs commitment have witnessed comparative development but in the case of reaching zero agenda there are still much more improvements to make. Objectives: Understanding the bottom-level reality with field experiences while also paying attention to the policy voices to understand the last mile stumbling blocks. Methods: Reality check along with expert opinions working at the field level and beneficiary consultations were the primary components for this study. Three specific modalities (i) field-level consultations with the stakeholders, (ii) facility inspection and (iii) roundtable discussion were the specific tools used for this study. Results: Findings show that in Bangladesh, substantial inequities exist both in the use of facility-based maternal healthcare with scarce and the absence of competent birth attendants for home births. Moreover, socio-cultural norms and the socioeconomic status of the families contribute to maternal deaths. The poor family setting, the hospital referral system, and the familial understanding of the overall maternal healthcare are largely responsible for maternal deaths. Conclusion: All these issues related to maternal deaths need proper attention to leap forward to overcome the last mile challenges. Determined focus on defining and identifying the last mile population, breaking the pedagogical limitations and institutional barriers with an additional focus on the last mile research to reach the underserved population is imperative to reach the last mile.