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Maternity care improves in Moulvibazar

Mahbuba Zannat
For the first time in its 25 years history, Kalapur Union Sub Centre at Moulvibazar has managed to conduct delivery in June this year.
Though most of the union sub centres provide only antenatal (check up during pregnancy) and post natal (after delivery) care, this centre has moved one step ahead with its existing logistics.
"It was made possible just because of the Maternal and Neonatal Health (MNH) initiative by the UNFPA It provided us extensive training, equipment and drugs for normal delivery. At the same time, it made some renovations in the centre which attracted people and currendy the number of service seekers has been doubled than it was four years back,” said the family welfare visitor (FWV) Kanchan Bala.
The local people now know that they would get better service from the centre and that is why they don’t go to the private clinics, she said.
The aim of the intervention is to expand capacity of the health care providers, create awareness in the community, increase institutional delivery to reduce maternal and neonatal death, said UNFPA Field District Officer Dr Golam Mohiuddin Khan adding that the programme covers 28 Family Welfare Centres out of 42 in Moulvibazar district.
It also covers five upazila health complexes, district sadar hospital, 145 community clinics and 6 tea gardens. Began in 2009, the programme gained much acceptability from the locals as they found that service has improved much in those centres.
The record shows that the institutional delivery in the district has increased from 10 percent in 2007 to 16 percent in 1010 (of total live births in the same year).
" Moulvibazar, was far behind in achieving the national health indicators
even four years back But now it is achieving the target rapidly with the joint initiative of government and UNFPA” said Deputy Director of Family Planning Abdul Hannan.
Delivery by trained personnel is 54 percent in Moulvibazar district while it is only 26 percent nationally. Though the national target of antenatal care was 52 percent, we have achieved 71 percent last year. The contraceptive acceptance rate has reached to 114 percent,” he added.
While visiting the Bhogtera Community Clinic this correspondent found that delivery arrangement has been made there whereas a significant number of community clinics in the country are yet to provide their scheduled primary health care to the people.
MNH has trained up some 435 volunteers to let the people know about the services that they would get from the clinic.
"Now we have created a community fund to assist the poorer people. We arrange courtyard meeting regularly and around 8,000 people from eight villages are seeking primary healthcare, family planning method, neonatal and post natal care from here," said Nazmul Islam, union chairman and president of community group adding that as there is no hospital in the Juri upazila, this community clinic has become the last resort to most of the people here.
"Conducting delivery at the community clinic is a great achievement especially when most of the union sub centres don't have that capacity," said the Upazila Health and Family Planning Officer Dr Sarwar Hossain adding that if the system is developed, they would be able to continue the services with the community fund even if the UNFPAstops its intervention.
Difference was found at the Barlekha upazila Health Complex also. The health complex where no caesarian section took place since 2004-09 due to lack of proper
arrangement and manpower shortage, now offers comprehensive Emergency Obstetric Care that includes safe delivery, newborn resuscitation and blood transfusion and C-Section.
“The bed occupancy rate has reached to 140 percent and we are conducting 10 to 12 caesarean section along with 60 to 70 normal deliveries per month,” said the Nursing Supervisor of the 31-bed health complex Zohra Akhter adding that it reduces patients' suffering and the risk of maternal and newborn mortality.
To facilitate the service, an information centre has also been set up in front of the complex from where the service seekers can know what type of services are available, how much those cost and where to go.
Despite tremendous manpower crisis the Moulvibazar District Sadar Hospital also offers around 50 caesarean section and around 70 normal deliveries per month.
Due to the MNH intervention and with 28 supporting staff, the operation theatre operates round the clock while the number of total delivery rose to 1372 in 2010 from 957 in2007. The maternal death also reduced to 9 from 15, said Civil Surgeon of the 100-bed District Sadar Hospital Dr. Md. Golam Razzaque Chowdhury.
Changes were seen in the tea gardens also. The workers at Marina Tea Estate of Kulaura upazila who live from hand to mouth and are indifferent to maternal and neonatal healthcare now visiting the tea garden health centre for ante natal and post natal check up.
“The delivery will soon start in the tea garden health centre as equipment, labour table and drugs have already been arranged for the centre,” said Rusia, a worker of the garden to whom the tea garden health centre is the last resort for any health complexities.
The writer is reporter with The Daily Star.