If there is one area of healthcare where Bangladesh made commendable progress over the last three decades, it is the decrease in maternal and child mortality rates. Yet, based on data published by two recent UN reports, this success is being eclipsed by the number of stillbirths and infant mortalities still occurring in the country. According to one report, 63,000 stillbirths are recorded in the country each year, which is equal to one stillborn for every 41 births—the highest among South Asian nations. The second report shows that in 2023, over 100,000 children died in Bangladesh before reaching their fifth birthday, while approximately 75,000 did not even survive the first month after birth.

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Let's fix primary healthcare first

The impacts of these deaths, which experts say are mostly preventable, are not just about lost human lives, but also about the psychological and emotional toll on the parents and families of these children. Sometimes, families in developing countries like ours also have to bear the financial and social burden of taboos associated with stillbirths and neonatal deaths. Unsurprisingly, the inefficiency and inadequacy of our healthcare system contribute to these preventable deaths and their impact on the families. Causes of the deaths include premature birth, complications during delivery, and infections like sepsis and pneumonia, which could be managed easily if expecting mothers across the country, irrespective of their economic condition and locality, could access well-equipped and well-maintained primary healthcare units, and avail neonatal and postnatal services as well as trained midwives in time.

Instead, home deliveries are still a reality in this country, accounting for 30 percent of all births. And how can families be blamed for choosing home deliveries when upazila and union healthcare facilities fail to provide 24/7 quality healthcare services? Even the private medical centres are no better. Despite charging exorbitant fees, their service qualities remain poor. In fact, one UN report highlights how unregulated private medical centres, through their inconsistent practices, are contributing to these preventable neonatal and under-five deaths.

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Accessibility of healthcare in Bangladesh

We have repeatedly written about the need for an equitable healthcare system and the urgency of making primary healthcare affordable, accessible, and reliable in the country. While it is important to increase the number of community clinics and healthcare facilities at union and upazila levels, their accessibility should be prioritised too. Recruiting skilled manpower with good remuneration should be another priority to ensure quality primary care. This should include trained and certified midwives, birth attendants, and other community health workers. With just five years left to reach Sustainable Development Goals, we must not let the progress we have made so far go awry.