According to the United Nations, more than 5,500 women die in pregnancy and childbirth each year in Bangladesh. That’s 8 percent of total deaths among women of childbearing age, and many of these deaths are preventable with the right interventions.
Women and children in southwest Bangladesh face many risks that increase their vulnerability, including unsafe water, sanitation, and hygiene conditions, and reduced access to proper healthcare facilities and information. Furthermore, early marriage is prevalent here: In 2017, Bangladesh ranked fourth on the list of countries with the highest rates of the practice. And early marriage is closely associated with early first pregnancy and closely spaced subsequent pregnancies and births, which are among the most frequent causes of infant and maternal mortality in developing countries.
Better health from a better clinic
But Nobo Jatra — a five-year program funded by USAID and implemented by World Vision and Winrock International in partnership with the World Food Program and the government of Bangladesh — is working to change all that in southwest Bangladesh. Overall, Nobo Jatra seeks to improve food security and nutrition in this part of Bangladesh, and a big part of that is making sure moms and babies stay healthy and nourished.
Through the program, citizens in Bangladesh’s Chunkuri village advocated to their government for improvements to their local community clinic. Now, Chunkuri mothers can receive pre- and postnatal care in a clean, up-to-date government facility, rather than having to pay more and travel farther to a private clinic.
They can also meet with Jotika Roy, the clinic’s Family Welfare Assistant. Among other services, Jotika counsels families about their options regarding the healthy timing and spacing of pregnancies (HTSP).
“I love to talk with couples,” says Jotika. “I love to advise people. I like to see the healthy children with the couples.”
Culturally appropriate family planning
When Jotika provides counseling to couples on healthy timing and spacing of pregnancies, she also gives them information to help them voluntarily choose an appropriate contraceptive method based on the size of their family and the date of the most recent pregnancy. The counseling Jotika provides includes how to use methods safely and effectively.
It’s been demonstrated that culturally appropriate programs promoting HTSP save millions of infant, child, and maternal lives and help prevent abortion. HTSP could prevent as many as one-third of maternal deaths by enabling women to delay their first pregnancy to at least age 18, space pregnancies by two to five years, protect women from unplanned pregnancy, and limit childbearing to a mother’s healthiest years.
“In our area, almost 80 percent of people are using these planning methods,” says Jotika.
Community clinic helps families make a plan
20-year-old Momtaz Begum and her 1-year-old son Junayed are among the Chunkuri citizens who received valuable advice from Jotika that helped Momtaz decide to wait and make sure she was old enough to have a healthy pregnancy.
“I got married three years ago, and Jotika advised me to take the pill and wait a few years to have my first child,” says Momtaz. Now she plans to wait a few more years to have a second child so she can care for Junayed in his infancy: Otherwise, “I might not get enough time to take care of this baby.”
Jotika has been working at the Chunkuri clinic for nearly eight years — before the Nobo Jatra program began — and helped the people in Chunkuri advocate to the government for a better facility and services.
“Before, if a mother wanted to go for a health visit, they went to private doctors,” says Jotika. “Now people will come to the community clinic.”
Thanks to Nobo Jatra and the engaged Chunkuri citizens, the clinic has more and better services to offer to local mothers and children, creating positive impacts for years to come.
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Top photo: Local mothers visit the Chunkuri Community Clinic to access regular growth monitoring for their newborn babies. Aparna Mondal, a Community Nutrition Facilitator and a new mother herself, has been working at the clinic for three years and has seen big changes in the area since Nobo Jatra began. (©2019 World Vision/photo by Jon Warren)
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