In 2000 the United Nations set up the Millennium Development
Goals (MDG). These are a list of global priorities set out to be achieved by
2015 and included in this eight-goal mandate was to promote maternal health.
Since then a lot of progress has been made in the reduction of maternal death. Although
the results were commendable, they were not fully achieved. For example, in
Bangladesh they had hoped to cut the maternal mortality rate by 75%, yet only a
66% reduction was achieved by 2015. In terms of figures; this equates to the
2015 MMR in Bangladesh being 181 maternal deaths per 100,000 births in comparison
to the goal laid out by the MDGs as being 143 per 100,000 births. Although still
commendable seeing as this is a 66% reduction since 1990, in the same year in
Ireland the MMR was 8 deaths per 100,000 births.
In the case of Bangladesh, the change in MMR over this period is
related to the fertility rate declining from (from 5 births per woman in
1990, to 2 in 2011) and with more skilled attendees present at the birth like
midwives (from 5% in 1991 to 32% in 2011). The emergency obstetrical care
service was also developed, in combination with a growing private sector and
the maternal health voucher scheme. http://www.who.int/pmnch/knowledge/publications/bangladesh.pdf
Although these are welcomed improvements there are a lot of
continuing challenges faced in Bangladesh to secure further development. These
challenges include; increasing the access to quality health services by
improving and further developing the workforce and their delivery of health
services. It is important to continue improving equal access of health services
to populations where large majorities may be marginalized or under-recognised.
Increase the amount of skilled birth attendees such as midwives, this will also
go hand in hand with the improvement of education facilities, equal opportunities
in education and empowerment of women. Delivery of nutritional education to the
mainstream population and understanding the importance of diet and health before,
during and after pregnancy. Improving sexual health and sexual education
amongst adolescents and a more efficient new-born health scheme.
These concepts, while they may seem obvious, are critical
factors that need to be overcome as they challenge the health of not only the mother
but her infant. When mothers are undernourished or unwell combined with receiving
poor maternity care, their new-born also faces a high risk of death and disease
(tinker, 2000). It is estimated that 30 to 40% of infant deaths could be
prevented by maternal intervention alone.
A further reduction of
maternal mortality is now part of the Agenda 2030 for sustainable
development.The target of the third Sustainable Development Goal (SDG) is
to reduce the global maternal mortality rate (MMR) to less than 70 per 100,000
live births by 2030.