Teenage pregnancy, motherhood increased in urban area: Survey

Infographic: TBS

The rate of teenage pregnancy and adolescent mothers has increased in urban areas as many girls are married off between 15 and 19 years of age.

The National Institute of Population Research and Training's (NIPORT) Urban Health Survey 2021 shows that 22.1% of women aged below 19 have already begun bearing children in slum areas.

One-fifth of the women between 15 and 19 years in non-slums and 10.9% in other urban areas also fall into the same category.

Facility delivery – one of the maternal health services supported by skilled birth attendants within the healthcare facility – was highest among those living in non-slum areas (70.3%) and lowest in slums (53.7%). 

At the same time, while early pregnancy rates have increased, breastfeeding rates have decreased. 

According to the urban health survey 2021, C-section delivery was unacceptably high among women in slum (31%), non-slum (55%) and the rest of urban areas (51%).

Nearly 77% of facility deliveries were among women in non-slums and 75% in rest urban areas compared to 58% in slums.

The contraceptive prevalence rate was highest in the urban slums (72%) and lowest in the urban areas (68%) in 2021.

Facility delivery increased between 2013 and 2021 by 17 percentage points among women living in slums and remaining urban areas, while the increase was 12 percentage points in non-slums. Although the use of family planning methods in slums surpassed that in non-slums, the use of long-acting and permanent methods is low both in slums and non-slums.

The nutritional status of under-5 malnourished children has increased significantly in all three domains compared to 2013.

Furthermore, exclusive breastfeeding among children under six months in slums and non-slums declined compared to 2013.

In the city corporations, the slum breasting rate was 54% in 2021, which was 59% in 2013.

Non-slum area breastfeeding rate was 49%, down from 58% in 2013. 

The survey also found that antibiotic treatment for under-5 children with acute respiratory infections was 10% higher in slums (62.5%) than in non-slums (52%).

90% of communities had a health facility available within two kilometres in slums, non-slums and other urban areas, said the survey.

Dr Anwar Hossain Howlader, health secretary, said urban healthcare is not good compared to upazila and district levels, which means rate of skilled birth attendance is low in the slums of the city, and the rate of normal delivery is also low.

"We are including Urban Primary Health Care in the Fifth Sectoral Plan. A separate operation is being planned. Now the problem of urban primary health care will be solved."

Health Minister Zahid Maleque said institutional delivery is still very low and it should be increased to reduce infant and maternal mortality.

"According to the World Health Organization, a C-section rate of 10-15% is normal. In our government hospitals this rate is between 20-25%. However, this rate is more than 70% higher in private hospitals. In addition to financial reasons, unnecessary cesarean rates are high in private hospitals. If more services are increased in government hospitals, people will be able to get free delivery there. The survey data shows that the rate of rural-to-urban migration is decreasing, which is a good sign," he said.

Based on the findings of the nationwide 3rd Bangladesh Urban Health Survey (BUHS) 2021, the report was launched on Tuesday at the CIRDAP, Dhaka.

The 2021 UHS is the third of its kind, followed by the 2006 UHS and the one in 2013.

The 2021 UHS is based on representative samples from three domains:  slum and non-slum populations in the 11 city corporations, the remaining urban populations of district municipalities, and large town populations over 45,000. The survey was conducted between 24 January to 10 June 2021.