Newsletter, MIS-Health, DGHS, Dhaka, Bangladesh Emergency Obstetric Care (EmOC) Performance Report January-June 2011 Issue 10 October 2011 Contents Introduction-1 Information covered in the newsletter-1 Messages-2 Method-3 Results-3 Performance-measuring indicators-5 Division-wise status of EmOC services-5 Comparison of EmOC service status between year 2009 to 2011-6 Key findings-7 Limitation about the data source-7 Recommendation-7 Conclusion-7 Annexure-8 Voice of MIS-Health Introduction Maternal Mortality Ratio (MMR) and Infant Mortality Rate (IMR) have decreased significantly over the past years. Bangladesh could reduce its MMR by 66% from 1990 to 2010 (in 20 years). In 1990, MMR in Bangladesh was 574 per 100,000 livebirths. According to Bangladesh Maternal Mortality Survey 2010 (BMMS 2010), it was to be 194 per 100,000 livebirths in 2010. The Millennium Development Goal 5 has set target for reduction of MMR by three-fourths between 1990 and 2015 (25 years), which means a 75% reduction. This reduction in MMR in the country is attributable to the Government's strong commitment through national policies and programs. The Government is committed to improving the health services of the common people, particularly of the mothers and children. Various programs have been undertaken on Reproductive Health, which include strengthening of Comprehensive Emergency Obstetric Care (EmOC) services, amongst others, at various medical college hospitals, district hospitals, upazila health complexes, and at community levels. This newsletter provides information on the status of EmOC facilities in Bangladesh from January to June 2011 and compares with the status in 2009 to 2011. Information covered in the newsletter • Status of EmOC services provided from January to June 2011 in public, private and NGO facilities with division-wise and health facility-wise distribution • Comparison of EmOC service status between year 2009 and 2011
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Newsletter, MIS-Health, DGHS, Dhaka, Bangladesh
Emergency Obstetric Care (EmOC) Performance Report January-June 2011
Issue 10 October 2011
Contents
Introduction-1
Information covered in the newsletter-1
Messages-2
Method-3
Results-3
Performance-measuring indicators-5
Division-wise status of EmOC services-5
Comparison of EmOC service status between year 2009 to 2011-6
Key findings-7
Limitation about the data source-7
Recommendation-7
Conclusion-7
Annexure-8
Voice of MIS-Health
Introduction Maternal Mortality Ratio (MMR) and Infant Mortality Rate
(IMR) have decreased significantly over the past years.
Bangladesh could reduce its MMR by 66% from 1990 to
2010 (in 20 years). In 1990, MMR in Bangladesh was 574
per 100,000 livebirths. According to Bangladesh Maternal
Mortality Survey 2010 (BMMS 2010), it was to be 194 per
100,000 livebirths in 2010. The Millennium Development
Goal 5 has set target for reduction of MMR by three-fourths
between 1990 and 2015 (25 years), which means a 75%
reduction. This reduction in MMR in the country is
attributable to the Government's strong commitment
through national policies and programs. The Government is
committed to improving the health services of the common
people, particularly of the mothers and children. Various
programs have been undertaken on Reproductive Health,
which include strengthening of Comprehensive Emergency
Obstetric Care (EmOC) services, amongst others, at
various medical college hospitals, district hospitals, upazila
health complexes, and at community levels. This newsletter
provides information on the status of EmOC facilities in
Bangladesh from January to June 2011 and compares with
the status in 2009 to 2011.
Information covered in the newsletter
• Status of EmOC services provided from
January to June 2011 in public, private and
NGO facilities with division-wise and health
facility-wise distribution
• Comparison of EmOC service status
between year 2009 and 2011
Director, Primary Health Care (Additional Charge)
and Line-Director, ESD
Directorate General of Health Services Mohakhali, Dhaka
I am happy to know that MIS-Health of DGHS is publishing the 10th issue of "Voice of MIS-Health" with support from UNICEF Bangladesh
focusing on the EmOC performances. We may have a good level of satisfaction that we could make a remarkable success in reducing maternal
mortality rate. It is now 194 per 100,000 livebirths, i.e. 40% reduction from 2001 figure and 66% reduction from 1990 figure. In the next sector
program, we are providing much more emphasis to enhance the maternal health program. Therefore, we may believe that we would be able to
achieve the targets of MDG 5 by 2015.
This newsletter will definitely help us understand different parameters of EmOC performances. If we learn from the lessons, we would be
benefited towards achieving our goal.
I thank the MIS-Health, DGHS, for their valuable efforts. I would like to thank everyone who worked hard to publish this newsletter.
(Dr. Md. Shamsul Haque)
Message
Message
Additional Director General (Planning & Development)
and Line-Director, Management Information System
Directorate General of Health Services
Mohakhali, Dhaka
Bangladesh has made a remarkable progress in maternal and child healthcare services in the recent time. Bangladesh Maternal and Child Mortality Survey
2010 (BMMS 2010) shows 194 maternal deaths per 100,000 livebirths. Maternal Mortality Ratio (MMR) is now used as a global indicator of overall health status
of women in any given country, where Bangladesh certainly has shown success. Emergency Obstetric Care (EmOC) has been recognized as an accepted
intervention for reducing the maternal mortality. When we have greater confidence about achievement of MDG 5, we should have greater effort to enhance the
intervention too for Emergency Obstetric Care (EmOC).
It is my great pleasure that the 10th issue of the newsletter "Voice of MIS-Health" is going to be published. The newsletter reports the EmOC performances and
their analysis based on the UN process indicators, which would enable comparison of data with other countries. However, the data presented here were not
collected in a research setting; rather were extracted from the facility registers and records filled in by staff nurses. We reported selected process indicators as
relevant to our context.
The UNICEF (Bangladesh) deserves special thanks for funding EmOC programs as well as for providing technical assistance and funding support for printing
this newsletter. I gratefully acknowledge the efforts made by members of the Editorial Board, who provided their time to review inputs of this newsletter.
(Professor Dr. Abul Kalam Azad)
Message
Director General
Directorate General of Health Services
Mohakhali, Dhaka
Our country made a significant progress in achieving MDG 5. This progress has been made in the past decade. Maternal mortality rate in
Bangladesh was 574 per 100,000 livebirths in 1990. It was 322 per 100,000 livebirths in 2001. The current rate is 194 per 100,000 livebirths.
This trend indicates that we will achieve our target of 143.5 per 100,000 livebirths by 2015. However, there is no room for complacence. As the
target is nearing, difficulty may also be much more to achieve more progress. Therefore, we would need to strengthen our efforts so that we can
reach the MDG 5 target by 2015.
It is, indeed, a great pleasure for me to know that the 10th Issue of "Voice of MIS-Health" on EmOC performances is going to be published by
MIS-Health. I am pleased to see that UNICEF is continuing its support to publish the newsletter. I thank UNICEF for this assistance.
I hope that the persons concerned with EmOC interventions, the planners and the managers of different levels will find this report useful in
improving the existing EmOC program. Finally, I would like to thank everyone who worked hard directly and behind the screen for publishing
this newsletter successfully.
(Professor Dr. Khondhaker Md. Shefyetullah)
MethodData from 649 health facilities, consisting of 14 medical
college hospitals, 62 district and general hospitals, 417
upazila health complexes, 57 maternal and child welfare
centers (MCWCs), 35 NGOs and 62 private hospitals in 62
districts, and 2 other types of hospitals, have been used for
analysis. Census 2011 data covering the current
population, expected births, and expected complications of
pregnancies have been used. Crude birth rate (CBR) was
calculated as constant of 19.4 births per thousand
populations (SVRS 2009, Bangladesh Bureau of
Statistics). Finally, the CBR and the census population of
year 2011 by division and district were used in generating
the expected number of births in each area. These
numbers of births were used in calculating the process
indicators.
ResultsTable 2 shows the division-wise distribution of admitted
patients, total deliveries, caesarean sections, livebirths,
stillbirths, maternal deaths and neonatal deaths. Data
show that there were 278,312 reported deliveries at EmOC
facilities in the country during January to June 2011 and,
out of them, 272,981 yielded livebirths and 8,344 resulted
in stillbirths. Among the total deliveries, caesarean sections
were 117,198. There were 668 maternal deaths and 1,335
neonatal deaths.
Table 3. Number of populations, expected births, and obstetric complications estimated for January to June
2011 by division
Category Barisal Chittagong Dhaka Khulna Rajshahi Rangpur Sylhet Total
To,DirectorManagement Information System (MIS)Directorate General of Health Services (DGHS) Mohakhali, Dhaka -1212, BangladeshPhone:88-02-8816459; Fax: 88-02-8813875 E-mail: [email protected]