Child and Maternal Mortality
in Islamic Countries
59
The most recent 2016 Bangladesh Maternal Mortality
and Morbidity Survey (BMMS) data estimated MMR of
195 deaths per 100,000 livebirths, which suggests that
maternal mortality decline has stagnated in the country.
Increasing delivery with skilled birth attendant is a key
strategy for safe motherhood initiative. Although the
country has doubled the skilled attendance at birth from
21% in 2007 to 42% 2014, the MMR has not reduced
during this period in the country. The sociopolitical
situation in Bangladesh is stable in recent period and in
the absence of any external shocks, this data suggests
that increasing skilled attendance at birth and the
facility-based delivery alone is not sufficient to reduce
maternal mortality. There is a consensus that improving quality of care is critical for reducing
maternal mortality.
The availability of data from three rounds of the Bangladesh Maternal Mortality and Morbidity
Surveys (BMMS in 2000-2001, 2010, and 2016), seven rounds of the Demographic and Health
Surveys (BDHS) data, and four rounds of the UNICEF’s Multiple Indicator Cluster Surveys (MICS)
provides unique opportunities to examine the differentials in maternal and child mortality by
socioeconomic and demographic variables. BMMS data also provide opportunity to examine the
causes of maternal mortality by women’s sociodemographic variables. The 2014 Bangladesh
DHS survey also conducted a Service Provision Assessment (SPA) survey at health facilities,
which provides an opportunity to examine the association of service availability in the area on
health care utilization. Bangladesh is one of the very few low- and middle-income countries,
besides Indonesia and Ghana, that has conducted national level mortality surveys based onmore
on more than 100,000 households for directly measuring maternal mortality.
3.1.1. Maternal and child mortality in Bangladesh
Trends of maternal mortality in Bangladesh
The maternal mortality estimates in Bangladesh at a national level are available from three
sources: Bangladesh Maternal Mortality and Morbidity Surveys (BMMS), which were conducted
in 2001, 2010 and 2016; the MMEIG/UN/WHO estimates and the IHME/GBD estimates. The
results are shown in Figure 3.1 and 3.2.
The BMMS estimates are based on direct household method.48 The 2001 and 2010 BMMS
estimates suggest that MMR has reduced almost 40% from 322 (95% CI: 253-391) deaths per
100,000 live births to 194 (95% CI:149-238) during the period. The follow-up BMMS survey in
2015 estimated an MMR of 196 (95% CI: 159-234), suggesting that maternal deaths stagnated
in Bangladesh.
The UN/WHO/MMEIG estimated MMR for Bangladesh in 2015 was 176 (80% credible interval:
125-280) deaths per 100,000 live births (the newly published WHO report [September 19,
2019] estimated Bangladesh MMR of 173 in 2017; data not shown).