Bangladesh's progress on curbing maternal deaths slowing down, experts warn
Rising fertility, home births and limited access to antenatal care are major factors behind the slowdown
Highlights:
- Only 41% of pregnant women receive at least four check-ups from trained providers; progress in reducing maternal deaths has slowed.
- 54% of maternal deaths happen at home, and 55% occur within the first 24 hours after childbirth.
- Maternal mortality ratio fell from 574 (1986–1990) to 136 (2023), but the pace of decline has slowed.
- Bangladesh may miss the UN target of reducing maternal deaths to 70 per 100,000 live births by 2030.
Bangladesh has reduced maternal deaths significantly over the past three decades, but the pace of improvement has slowed in recent years, public health experts warned yesterday, citing official data.
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Long-term data show a sharp fall in the maternal mortality ratio from the late 1980s to 2010, followed by only a modest decline since then. Experts said the slower decline is linked to rising fertility, the continued preference for home births, and low use of antenatal care. Only 41% of pregnant women receive at least four check-ups from trained providers, well below the level needed for a safe pregnancy and delivery.
At an event held at the Bangladesh Medical Association (BMA) Bhaban in the capital yesterday, Professor Farhana Dewan, immediate past president of the Obstetrical and Gynaecological Society of Bangladesh (OGSB), said, "We see that 54% of maternal deaths happen at home, and the numbers are higher in rural areas than in cities."
The event, titled "Maternal and Newborn Health Situation in Bangladesh and Postpartum Haemorrhage, Pre-eclampsia and Leadership Development Initiative," was jointly organised by OGSB and the Bangladesh Health Reporters Forum.
Experts at the event presented long-term data showing how Bangladesh's progress in reducing maternal deaths has slowed over the years. According to the data, the maternal mortality ratio fell from 574 deaths per 100,000 live births in 1986–1990 to 322 in 1998–2000. It continued to decline to 194 in 2010, and by 2023, the figure had dropped to 136.
Although this marks a major improvement since the 1990s, the pace has slowed over time. In the 1990s, maternal deaths fell by 252 per 100,000 births. The decline dropped to 128 in the following decade, and between 2010 and 2023, it narrowed further to 58.
This slowdown puts Bangladesh at risk of missing the UN target of reducing maternal deaths to 70 per 100,000 live births by 2030. Experts said stronger and more consistent measures are needed for the country to reach the goal.
During her presentation, Professor Farhana Dewan said fertility rates have increased, and stronger family planning efforts are needed. "We need to encourage couples to choose permanent family planning methods and prevent teenage childbirth," she said. She added that about 11% of couples who want family planning services still do not receive them.
She said the hours immediately after childbirth remain the riskiest for mothers. "Fifty-five per cent of maternal deaths occur within the first 24 hours, yet many mothers leave the hospital even before eight hours have passed," she said, adding that stronger antenatal and postnatal care is essential to prevent such deaths.
Targeted interventions to reduce maternal deaths
To reduce maternal deaths, the Directorate General of Health Services, the Directorate General of Family Planning, the International Federation of Gynaecology and Obstetrics (FIGO) and OGSB are running a joint project in four district hospitals in Faridpur and two non-profit hospitals in Dhaka.
The project focuses on treating postpartum haemorrhage, hypertensive disorders of pregnancy, preterm births and maternal anaemia. As part of the initiative, 200 PPH and eclampsia kits have been supplied to upazila health complexes, while 400 refrigerators have been distributed to district and upazila facilities for essential maternal health supplies. A non-pneumatic anti-shock garment (NASG) programme is also underway in Moulvibazar to prevent deaths from postpartum haemorrhage.
Professor Dr Ferdousi Begum, past president of OGSB, said postpartum haemorrhage remains the leading cause of maternal deaths. She called for following WHO's updated guidance, including eight antenatal visits, treating anaemia, using early warning charts, and measuring blood loss with calibrated drapes.
She also highlighted a low-cost local innovation – a Tk5 calibrated drape made from transparent polythene bags – that helps measure blood loss after childbirth and allows faster treatment.
Experts added that faster progress will require stronger leadership, better teamwork, improved emergency care, proper training and equipment, and closer monitoring across facilities.
