Prof. Asad Islam, Monash University, Australia
Firoz Ahmed, Associate Professor, Khulna University, Bangladesh
Tabassum Rahman, School of Public Health, University of Newcastle
Partners: Laerdal Foundation
Timeline: January 2022 to December 2023
Overview of the study:
Despite remarkable improvement in maternal and child health over the last three decades, maternal mortality rate in Bangladesh stands at an alarming 176 per 100 thousand live births (UNICEF 2021). Neonatal deaths (30/1000 live birth) account for 67% of all under-5 deaths in Bangladesh (BDHS, 2020). During infancy, the risk of dying in the first month of life (30 deaths per 1,000 live births) is nearly four times greater than the rate of dying in the subsequent 11 months of their first year of life, meaning providing improved care early on could prevent loss of lives and help achieve sustainable development goals around maternal and child health. Clinical significance of preliminary studies: Lack of availability of quality maternal health care, combined with low level of health literacy, traditional gender norms, fear of stigma, and cultural beliefs about pregnancy are some of the challenges to ensuring quality maternal healthcare services and thus, safe motherhood in rural areas (Oyeyemi and Wynn, 2015; Mwilike et al., 2018; Wulandari & Laksono, 2020). Moreover, there are disparities between rural and urban areas in terms of access to reliable and evidence-based information, with rural areas having lower access to important health information. Overall, mortality is high among children in the lowest wealth quintile than among children in the highest wealth quintile, indicating a clear disparity in child health in relation to socioeconomic standing and geographical location (BDHS 2020). One of the major challenges for developing countries like Bangladesh is to reach out to remote rural areas with validated information. Moreover, COVID-19 has disrupted maternal and child healthcare services and exacerbated the inequality in access to meager health care services. The disruption in healthcare services, including immunization, caused by COVID-19 may have led to an estimated 228,000 additional maternal and child deaths in South Asia (source: https://www.bbc.com/news/world-asia-56425115). Measures for social distancing and infection control during the pandemic have altered how health care has been provided to women during pregnancy, delivery, and postpartum period. The lack of access to radio and television, and poor internet connectivity are major challenges in disseminating health information to women living in the rural parts of Bangladesh (BDHS 2020, LIRNE Asia 2018). Information through the internet, online video clips, or social media could not reach the majority of targeted women. In contrast, mobile phones are widely used in Bangladesh, where 94% of rural households own at least a basic cellular phone (BDHS 2020). In this context, a mobile phone-based innovative approach could lead to better access to this information and improve the quality of maternal health care services.