We live in a world where every day 830 women die while giving birth to her child from causes that are easily preventable. But it can also be scary when a mother doesn’t know what to expect if she experiences severe complications during childbirth.
Maternal mortality is one of the highest in Bangladesh which often fades the country’s robust success in many sectors. According to SDG target, by 2030 maternal mortality rate must be reduced to 70 or below per 1 lakh live birth.
In order to improve maternal health, the government is implementing several innovative programs but more need to be done. For example, the second most important reason for maternal mortality is hypertension-related complications known as preeclampsia and eclampsia can be reduced significantly by introducing MgSO4 at the community level.
Population Council has recently conducted a USAID funded project titled ‘Ending Eclampsia’ in 12 selected upazilas of Tangail, Comilla, Rangpur and Bhola district of Bangladesh in order to increase use of MgSO4 to catalyze the coverage of detection, prevention and treatment of pre-eclampsia and eclampsia (PE/E).
A dissemination seminar was arranged today, 27 June in Four Points by Sheraton, Dhaka to share the findings of this project. The program was chaired by Dr. Mohammed Sharif, Director (MCH-Services) & Line Director (MCRAH), DGFP. Representatives from different governmen departments, development partners, international and national agencies also attended the program. Findings from other countries suggest that treatment of preeclampsia/eclampsia (PE/E) with MgS04 has significantly lowered the risk of maternal morbidities and mortality. Despite its proven effectiveness, this inexpensive drug is not widely used in Bangladesh. Population Council has assisted MoHFW to expand the use of MgS04 in 116 primary healthcare facilities and trained 399 primary healthcare providers for the management of PE/E. The study used pre-post cross-sectional design and both quantitative and qualitative data was collected.
Study findings show that knowledge of primary healthcare (PHC) providers regarding loading dose of MgS04 has increased significantly. While blood pressure was measured for every patient, urine testing for albumin was not universal. This study also found that the referral mechanism was effective and 94% providers collected feedback or maintained contact with the pregnant mothers after they were referred.
In addition, the antihypertensive study found that practice outcomes such as taking a history of hypertension, measuring blood pressure, detecting hypertensive pregnant women increased over time. Simultaneously, a post-partum follow-up study found that among the follow-up patients, 18% had persistent proteinuria and 36% reported high serum cholesterol during the last follow-up. Chairperson, Dr. Mohammed Sharif, Director (MC), DGFP commented that ‘It is encouraging that primary healthcare providers knowledge of identifying the hypertensive disorder in pregnancy, especially PE/E has been increased’. He added that ‘I believe that ending eclampsia findings will be helpful for policy action and management of PE/E’.
In the discussion few concerns were identified related to the quality of care such as counseling about danger signs of pregnancy, using appropriate family planning methods after delivery, and risk of occurrence of PE/E at post-partum period, shortage of drugs and not packed according to need etc.