Pregnant women in urban slums need health facilities to reduce child mortality

A 2021 Bangladesh Urban Health Survey (BUHS), conducted by the National Institute of Population Research and Training, shows that only 40 per cent of pregnant women in slums received over four antenatal care checkups. WHO guideline recommends a minimum of eight visits to reduce prenatal mortality — the number of stillbirths and deaths in the first week of life — and improve expectant mothers’ care, majority of the slum women hardly visit physicians, resulting in complexities, stunt, and underweight and malnourished childbirth.
Compared to mothers in non-slum areas, those in slums don’t receive the required antenatal or postpartum healthcare, nor have access to essential prenatal micronutrients or a trained birth attendant. Inadequate visits to the maternal clinics can cause major complications, nutrition imbalance, and delivery or family planning difficulties. Missing vaccines can lead to other health issues. Pregnant mothers are also recommended to take iron and folic acid, calcium carbonate, and vitamin B supplements with a diet rich in nutrition-dense foods.
An overwhelming majority of the expectant mothers in slums showed a preference for home births unless they experienced earlier pregnancy complications or suffered from any life-threatening conditions. Almost half of all slum mothers prefer to deliver at home, even though facility deliveries have increased by 17 per cent in 2021 from 2013. Health and nutrition experts say slum mothers must get priority in the government’s nutrition programmes, especially after the pandemic largely affected their dietary patterns. In children of urban slums, the rates of under-5 stunting are 34 per cent, wasting is 16 per cent and being underweight is 28 per cent. All three rates are the highest compared to other urban areas.
In the 2022-23 fiscal, 7,740 poor expecting and lactating mothers of Dhaka South and North are supposed to receive Tk 800 per month under social safety net support. But this number represents only 0.62 per cent of the mothers in the capital’s urban areas compared to the total targeted beneficiaries. For comparatively strong community networks, NGO activities, and union parishad-centric social service delivery, rural women are now more aware of the government’s social safety net facilities. The government and development partners should focus on urban poverty and bring the urban poor under the social safety net.