Maternal Mortality Ratio (MMR) in Bangladesh is still quite high; thus, a priority health and development issue. This study aims to describe maternal healthcare situation in Bangladesh to identify influences behind key causes, especially postpartum hemorrhage, of maternal morbidity and mortality. A literature review was conducted. Direct and indirect causes of MMR are 63.5% and 35.5%, respectively. Among direct causes only obstetric hemorrhage occupies 31% of all maternal deaths. Nearly two thirds of total maternal deaths occur during postpartum period. To reduce maternal deaths, government-initiated community-based skilled birth attendant programme outcome is insignificant. Nearly three-fourths of all deliveries are conducted by traditional birth attendants at home; thus, maternal deaths from primary PPH barriers to MMR reduction. Unskilled deliveries are directly related to low education and rural dwelling. Overall, use of oral misoprostol for active management of third stage of labour has been found effective. Demand side financing programme has improved skilled deliveries. To reduce MMR, evidence-based skilled management of labor along with good referral system is a high priority. However, incentives for service providers and improvement of mass- population awareness are substantially important to reduce unskilled home deliveries for improving maternal health and wellbeing in Bangladesh.
Ashim Roy, Lela Shengelia