Need for skilled workforce to ensure maternal and neonatal health services to avert maternal and neonatal death: Evidence from Demographic and Health Survey in Bangladesh

Background and objective: In Bangladesh 82% deliveries occurred at home. Of them 80% assisted by friends, relatives, neighbors which is one major reason of maternal and neonatal mortality and also indicates lack of skilled health workforce including nurse/midwives at community level to conduct safe delivery at home more in rural areas.

Methodology: Data of births of last 5 years preceding the Demographic and Health Survey 2007 used for study.

Results: Only 3.4% births attended by nurse/midwife at home. Among births attended by nurse/midwife at home neonatal death rate is 2.9% while it is 3.7% among births not attended by nurse/midwife. Findings from bivariate and Cox’s regression analysis revealed following potential factors to reduce neonatal death among birth occurred at home: received ANC, birth attended by nurse/midwife, higher age of mother at birth, urban residence, wealth index, educated mothers and fathers, watch television, give colostrum immediately after birth.

Conclusions: Evidence from study indicate urgent necessity of required skilled workforce at community level to conduct safe delivery at home and counsel and motivate mothers and family members to play role for reducing maternal and neonatal mortality. Hence JPGSPH, BRACU has taken initiatives to develop community based midwives.