A number of initiatives by the government and non-government bodies have helped increase awareness level of adolescent girls about reproductive health that expected to make an impact in the country’s mother mortality rate in coming days as per public health experts.
Country like Bangladesh, regardless of socio-economic status or educational background, open discussion about Sexual and Reproductive Health (SRH) remains a cultural taboo, particularly for adolescents, comprise more than one-fifth (14.4 million girls and 15.1 million boys) of the total population.
As most parents express discomfort and school teachers are also reluctant to discuss SRH with their adolescent, they have very limited or no access to SRH-related information and services, and face serious barriers to getting information and guidance regarding the issues.
“After our campaign, we have observed that now adolescent girls even at the rural areas are coming out from their hundred years long taboos and discussed their physical changes with adults,” said Shahin Ahmed who worked in the field of Sexual and Reproductive Health Rights (SRHR) in BRAC.
Ahmed said it is important for every teenager to have a clear idea about their physical and mental changes of adolescence, because they do feel sudden changes in their bodies.
She said girls across the country now-a-days are much more aware about their reproductive changes and even they are buying sanitary napkins by their own.
“Yes, I am a girl, and I know I have to go through the menstruation as I am growing up. I need sanitary napkins for my good health. Nothing shy about it. I used to go to pharmacy and buy my own stuff that I need for my betterment,” said a 15-year 10-grader adolescence girl living in Dhanmondi.
Health experts said the government has taken various initiative in ensuring primary health care facilities at the doorsteps of common people that increase the awareness level among the women and adolescent girls as well.
“The healthcare awareness level has helped in reducing the mother mortality rate in Bangladesh,” said Ahmed.
Global evidence indicates that integrating adolescent friendly services into existing health delivery systems is more effective than establishing separate or stand-alone youth and/or adolescent centers or clinics.
In line with that the Bangladesh government has set up Adolescent Friendly Health Corners (AFHCs) at public health facilities in early 2015 through the with the financial support of several development partners including USAID.
These awareness-raising efforts provide a unique opportunity to ‘rebrand’ how adolescent friendly centers are viewed as sources of prevention and counseling services, and not just as treatment centers, USAID’s public health expert Dr. Samina Chowdhury said.
These centers have the potential to be seen and serve as important ‘information hubs’ to serve a broad range of adolescent health and counseling needs, she added.
Besides, health workers of various NGOs are taking initiative to provide information, counseling and workshops through health programs in different schools of the country.
Noting that there is a need for greater awareness about reproductive health, she said, if a child does not get proper nutrition, then his reproductive organs will not grow properly.
Selina Amin, head of Midwifery Education of BRAC university’s James P. Grant School of Public Health, said, it is possible to reduce maternal mortality at a significant rate by emphasizing midwife services.
Skilled midwives can assist the mothers for normal delivery as well as make referral arrangements in case of complications, she said.
Since independence, Bangladesh has made a remarkable progress in many health indicators while the latest Bangladesh Bureau of Statistics data released in 2018 said the maternal mortality rate has come down per 100,000 live births come down from 478 in 1991 to 169 in 2018.
Thirteen percent of the deaths of females aged between 15 and 49 occur due to maternal causes, including haemorrhage and abortion-related complications, says another government survey released recently.
The study styled “Bangladesh Maternal Mortality and Health Care Survey 2016” was conducted by the National Institute of Population Research and Training (Niport) while icddr,b provided technical assistance.
It said the rate of female deaths due to maternal causes was 20.2 percent in 2001 while It dropped to 14.1 in 2010 and 13.1 in 2016.
According to the survey report, haemorrhage was the most common cause of maternal deaths, followed by eclampsia, a condition in which one or more convulsions occur in a pregnant woman suffering from high blood pressure, and abortion-related complications.
