Causes of neonatal and maternal deaths in Dhaka slums: Implications for service delivery

BMC Public Health

Research Article

Munira Sultana¹  Allisyn C Moran²  Mohammad Sohel Shomik²  Sabrina Rasheed²  Ashraful M Alam²  Abbas Bhuiya²  Fatema Khatun²  Mohammad Iqbal²  Nuzhat Choudhury³ 

[1] BRAC, BRAC Centre, 75 Mohakhali, 1212, Dhaka, Bangladesh;ICDDR,B, 68 Shaheed Tajuddin Ahmed Sarani, 1212, Mohakhali, Dhaka, Bangladesh;ICDDR,B, 68 Shaheed Tajuddin Ahmed Sarani, 1212, Mohakhali, Dhaka, Bangladesh;BRAC, BRAC Centre, 75 Mohakhali, 1212, Dhaka, Bangladesh;

关键词: Maternal Death;    Neonatal Death;    Neonatal Sepsis;    Verbal Autopsy;    Urban Slum;   

DOI  :  10.1186/1471-2458-12-84

 received in 2011-08-07, accepted in 2012-01-26,  发布年份 2012

来源: Springer

【 摘 要 】

BackgroundBangladesh has about 5.7 million people living in urban slums that are characterized by adverse living conditions, poor access to healthcare services and health outcomes. In an attempt to ensure safe maternal, neonatal and child health services in the slums BRAC started a programme, MANOSHI, in 2007. This paper reports the causes of maternal and neonatal deaths in slums and discusses the implications of those deaths for Maternal Neonatal and Child Health service delivery.MethodsSlums in three areas of Dhaka city were selected purposively. Data on causes of deaths were collected during 2008-2009 using verbal autopsy form. Two trained physicians independently assigned the cause of deaths.ResultsA total of 260 newborn and 38 maternal deaths were identified between 2008 and 2009. The majority (75%) of neonatal deaths occurred during 0-7 days. The main causes of deaths were birth asphyxia (42%), sepsis (20%) and birth trauma (7%). Post partum hemorrhage (37%) and eclampsia (16%) were the major direct causes and hepatic failure due to viral hepatitis was the most prevalent indirect cause (11%) of maternal deaths.ConclusionDelivery at a health facility with child assessment within a day of delivery and appropriate treatment could reduce neonatal deaths. Maternal mortality is unlikely to reduce without delivering at facilities with basic Emergency Obstetric Care (EOC) and arrangements for timely referral to EOC. There is a need for a comprehensive package of services that includes control of infectious diseases during pregnancy, EOC and adequate after delivery care.

【 授权许可】

CC BY   
© Khatun et al; licensee BioMed Central Ltd. 2011