The global and local context of maternal and neonatal health

Pregnancy and childbirth are major threats to women’s health in many parts of the world, while a significant proportion of deaths of children under 5 years of age occur in the neonatal period.

Since 1990, there has been a dramatic decline in maternal and child deaths due to preventable causes, both of which have fallen by about 50% globally.  Even so, every two minutes a woman somewhere in the world dies from a pregnancy-related complication. Some 70% of these deaths are caused by five preventable conditions: 

  • post-partum haemorrhage
  • eclampsia or pre-eclampsia
  • puerperal sepsis
  • complications from unsafe abortion
  • obstructed labour. 

Each year, 2.8 million neonates die globally, mostly from preterm birth, birth asphyxia or severe infections. In addition, 2.6 million babies are stillborn. The vast majority of neonatal deaths occur in low- and middle-income countries.

Neonatal health and maternal health are inextricably linked. Improving women’s health and the quality of care during and immediately after birth could substantially lower maternal and neonatal mortality, including stillbirth.

The situation in Bangladesh

Bangladesh has achieved remarkable progress towards Millennium Development Goals. Even so, mortality rates among mothers and children remain high. A dramatic decline in deaths among children under 5 years of age mostly reflects reduced post-neonatal mortality. Mortality among newborns has not declined as rapidly, and accounts for almost 60% of all deaths under 5 years of age. The main causes of neonatal deaths are severe infection, birth asphyxia, prematurity/low birth weight and acute respiratory infection.

About 70% of women in Bangladesh still deliver at home without a skilled birth attendant. Effective interventions during pregnancy and birth are often absent, and the quality of available services is generally poor. Overall the health system remains weak, lacking skilled birth attendants, resources and appropriate policy support.