Antenatal Attention And Postnatal Care

Antenatal Attention And Postnatal Care

Maternal mortality is defined as loss of life of women from motherhood- related problems occurring throughout pregnancy, labor, childbirth and in the postpartum period (up to the 42nd days after delivery (WHR, 2005). Maternal mortality is one of the major open public health concerns on the globe. Fatality during postnatal period is participating in an important role in increasing maternal mortality and morbidity ratio (BMMMR, 2010).Antenatal Attention And Postnatal Care

Postnatal period (or called postpartum) is identified by the WHO as the time beginning one hour after the delivery of the placenta and carrying on until six weeks (42 days) following the birth of an infant. The first hours, days and nights and weeks after childbirth are a dangerous time for both mother and newborn baby. In this era, the physical study of the mom and proper counselling by skilled health service agency is very essential to prevent the health issues. The That has advised postnatal visit for at least three times. The first visit within 24 hours, second visit within 2-3 times and the fourth visit in the seventh day is the standard schedule for postnatal visit. These visits help to discover medical problems with time.

Antenatal good care (ANC) and postnatal attention (PNC) are the key indicators to gauge the maternal health, especially safe motherhood. Antenatal care is a very good predictor of safe delivery and provides health information and services that can improve the health of women and babies (Bloom, Lippeveld & Wypij, 1999; WHO & UNICEF, 2003). The primary goal of antenatal good care is to achieve, by the end of pregnancy, a wholesome mother and a healthy baby. In addition, antenatal attention has a positive impact on the use of postnatal healthcare service (Chakraborty, Islam, Chowdhury & Bari, 2002). Postnatal care and attention and intra-partum attention significantly reduces maternal mortality and morbidity because most maternal deaths happen in the first week after delivery (Campbell & Graham, 2006; Hurt et all, 2008).Antenatal Attention And Postnatal Care

Despite improvements, motherhood – related complications remains the key cause of loss of life and impairment among women and of child bearing years disproportionately among different rural-urban dwellers, poor-rich communities, cultural communities and indigenous non indigenous teams (Gill & Ahmed, 2004; BDHS, 2007).

The present situation shows a noticable difference in the global maternal fatalities percentage (Hawkins, 2005). Globally 47 % maternal fatalities decline this year 2010 from 1990 (WHO, UNICEF, UNFPA & The World Bank estimations, 2010). However, improvement towards the Millennium Development Goals (MDG) has been very slow-moving in many countries (Bhutta, 2010).


Bangladesh has strengthened its emergency obstetric care and attention (EmOC) under the Directorate Standard of Health services through countrywide and international collaborations (Islam, Haque, Waxman, & Bhuiyan, 2006). The US Population Fund (UNFPA) commenced support of federal improvement of 64 maternal and child welfare centres for EmOC in 1993 (Gill & Ahmed, 2004). Furthermore, the Obstetrical and Gynaecological World of Bangladesh with the support of UNICEF improved EmOC in 11 district hospitals on a pilot basis in the period 1994-1998, with following development to other districts (Chakraborty, et. al, 2002). As a result ANC and PNC appointments increased substantially in Bangladesh from 1999-2000 to 2007. However, being pregnant related complications remains the best cause of loss of life and impairment among women.Antenatal Attention And Postnatal Care

Global urbanization has become a vital issue lately. The urban inhabitants is expected to increase by 84%, from 3. 4 billion in ’09 2009 to 6. 3 billion in 2050 (United Land, 2010). Bangladesh along with other Asian countries, has experienced fast urban expansion in the recent ages (NIPORT, 2008 & Uzma et all, 2004) This speedy urbanization in Bangladesh, increased with the progress of metropolitan slums, is likely to have profound implications on its health profile, especially on maternal and child health (NIPORT, 2008). Maternal and child health is strongly related with values and tactics around being pregnant and childbirth which has implications for the health of the kid and mother following the labor and birth (Choudhury et, all, 2012).

The maternal mortality percentage (MMR) in Bangladesh was 320 per 100, 000 live births in 2001 which reduced to 194 per 100, 000 live births this year 2010 (BMMMS, 2010). Bangladesh is currently on track to attain the primary concentrate on of Millennium Development Goal (MDG) -5 with a goal to reduce the maternal mortality. Not surprisingly achievement the condition in metropolitan slums is worse compared to metropolitan non slum areas regarding antenatal care and attention by medically trained service provider (62% vs. 85%), delivery at a health facility ( 12% vs. 46%) and skilled assistance at delivery (18% vs. 56% ) respectively (NIPORT, 2008). This makes urban medical issues, especially of the slum dwellers a high priority. It is therefore crucial to talk about maternal health of the metropolitan slum dwellers in Bangladesh. Usually in metropolitan slums, the maternal health services are offered at home or in static service delivery sites handled by nongovernmental organization (NGO) field employees. In some illustration, services can be found at treatment centers or dispensaries managed by NGOs, the federal government or the private areas (NIPPORT, 2008).Antenatal Attention And Postnatal Care

Pregnancy and childbirth are the important event of life. However, the women are more susceptible to difficulties and the fatalities in this period. Therefore, the correct treatment and support is necessary from the motherhood to postnatal period. Just as the world, there are a wide variety of communities and religious groups, the way of treatment and support differs in being pregnant, childbirth and postnatal period. Some of the community applies their cultural methods during childbirth and postnatal health care. The study implies that have confidence in the supernatural things such as evil eye and spirits are still rooted in a few communities. In spite of religion, class, urban and rural roots, nearly all Bangladeshi people believe in the existences of any supernatural world (Afsana & Rasid, 2000). Medical care seeking behavior during being pregnant and child delivery are linked to women’s cultural and ethnical interpretation of disease and well-being and any difficulties in birth tend to be related to supernatural triggers (Afsana & Rasid, 2000).

Food taboo is also the strong in the folks especially during motherhood and postnatal period. It depends after the people’s beliefs. A study done by (Choudhury, et. al, 2012) shows that the moms are permitted to take only dried out food that was cooked without drinking water, and rice with mashed potato and dark-colored cumin seed because these food types are believed to keep stomach of the women cool and initiate the creation of breast milk. Another review also implies that there have been various dietary constraints enforced on the mothers which deprived them of proper nourishment consumption. Commonly, the moms were not permitted to have food during the first day after delivery to allow restoration of the delivery passage (Choudhury & Ahmed, 2011).

In some civilizations, the mom should stay static in isolation for few days after delivery. During that period mothers stay in a separate room. Matching to a report, the mom should stay in internal kimma (a private room) for 7-9 times. During this time, women sit down by the hearth, drink hot water, eat burning sodium with grain and place searing materials on their back (Islam, 2011). Another analysis also proved that the ladies have to stay in isolation for the first 5-9 days and nights after delivery because women are believed to be impure during this time period. They are not allowed to touch any food for organizing meals (Choudhury & Ahmed, 2011).Antenatal Attention And Postnatal Care

To enhance the maternal and child health of slum dwellers, many INGOs and NGOs will work in this field. BRAC is also employing the project called “MANOSHI” with the same target in every slums of Dhaka city. As the effect, the maternal and child health is increasing gradually.

1. 2 Rationale / Justification

Maternal mortality is the major health problem in producing countries like Bangladesh. Alongside the improvement in knowledge and recognition degree of community and the many intervention put in place by government, the maternal healthcare service usage is increasing. However, the scope of service utilization is still low particularly natal and postnatal attention services. More than 29 out of 100 deliveries take place at home and only 27% seek postnatal treatment from health service provider (BDHS, 2011). Postnatal care and attention continues to be a neglected concern since it is not as emphasized as antenatal health care.


The maternal mortality and morbidity study shows that majority of deaths occurred anticipated to postnatal difficulties. Around 31% of total maternal fatalities occurred credited to haemorrhage. As a result, postpartum deaths now comprise a higher proportion of maternal deaths (73%) up from 67% in 2001(BMMMS, 2010). It indicates that postnatal good care interventions should get more priority. The federal government and other stakeholders should take consideration of PNC when employing the maternal health programs.Antenatal Attention And Postnatal Care

Millennium development goal (MDG 5) is attainable in Bangladesh because of treatment by the federal government. However, people surviving in the rural and urban slums are not utilizing the maternal health services effectively. Socio social factors are the main factor that can play important role in changing the health seeking behavior. The behaviour can’t be changed unless knowing the socio-cultural norms in the contemporary society.

This study aimed to explore the potential factors that can affect utilization of postnatal care and attention services. Findings from this study will give a reflection of maternal health status as well as amount of post natal attention service utilization which can be used to increase the utilization of post natal treatment in metropolitan slums.Antenatal Attention And Postnatal Care