Causes of Maternal Mortality Decline in Matlab, Bangladesh

摘要: Bangladesh is distinct among developing countries in achieving a low maternal mortality ratio (MMR) of 322 per 100,000 livebirths despite the very use skilled care at delivery (13% nationally). This variation has also been observed Matlab, rural area Bangladesh, where longitudinal data on are available since mid-1970s. The current study investigated possible causes decline Matlab. analyzed 769 deaths and 215,779 pregnancy records from Health Demographic Surveillance System (HDSS) other sources safe motherhood ICDDR,B government service areas Matlab during 1976-2005. major interventions that took place both early 1980s were family-planning programme plus menstrual regulation services (midwives for normal late equal access to comprehensive emergency obstetric [EmOC] public facilities women areas). National programmes social development empowerment through education microcredit implemented areas. quantitative findings supplemented by qualitative interviewing local community providers their change practices healthcare over time. After introduction programme, reduction was higher (68.6%) than (50.4%) 1986-1989 2001-2005. Reduction number due fertility (30%) (23%) 1979-2005. In each area, there substantial abortion-related mortality—86.7% 78.3%—in respectively. Education strong predictor Possible explanations are: better EmOC services, total rate, improved women. To achieve Millenium Development Goal 5 targets, policies bring further EmOC, strengthened expanded females essential.