In a startling revelation, a new survey shows more women in Bangladesh are dying from childbirths now than before, despite an increasing trend among women seeking maternal care at health facilities.

The preliminary results of the Bangladesh Maternal Mortality and Health Care Survey (BMMS) released on Wednesday in Dhaka showed that the maternal deaths were 196 per 100,000 live births in 2016 when the survey was carried out.

It was 194 in 2010 when Bangladesh witnessed a steady decline in maternal deaths from 322 in 2001.

But, in 2016, a total of 50 percent of births were attended by trained health professionals compared with only 27 percent in 2010.

An analysis of the survey points to the ‘low quality of care’ for this increasing rate of mortality despite women seeking medical care.

It comes as a shock to most health experts as Bangladesh was once globally acclaimed for cutting maternal deaths.

Dr Ishtiaq Mannan, Deputy Country Director, Save the Children in Bangladesh, who was one of the key analysts of the survey, called it an “alarming” trend while speaking to bdnews24.com.

“We have seen a substantial increase of some key indicators like increasing rate of facility deliveries, skill birth attendants, and healthcare utilisation rate, but the mortality rate has not dropped.”

“It means the quality of care is not good. It means women went to the hospital, but they received sub-standard treatment,” he told bdnews24.com.

Key findings

The increase in the number of medically trained providers is driven by a rapid rise in ‘facility births’. The percentage of births in health facilities increased to 47 percent in BMMS 2016 from the 23 percent in 2010.

Medically trained attendance for home deliveries has consistently been around three to four percent during 2001–2016. The private sector accounted for most of the increase in facility deliveries, the survey shows.

Between BMMS 2010 and 2016, the percentage of deliveries in private facilities jumped from 11 percent to 29 percent, while deliveries in public facilities increased from 10 percent to 14 percent.

In the public sector, 13 percent (out of 14 percent) of the births take place in Upazila and higher-level facilities. NGO facilities now account for 4 percent of births, up from 2 percent in BMMS 2010.

Delivery by C-section increased dramatically, from 12 percent in 2010 to 31 percent in 2016, an abnormal rise as WHO says 10 percent to 15 percent of the total deliveries may be C-section because of complications.

In private facilities, C-sections accounted for 83 percent of deliveries, compared with 35 percent in public facilities and 39 percent in facilities run by NGOs, according to the survey.

The percentage of women receiving the complete continuum of maternity care (antenatal care, delivery care, and postnatal care from medically trained providers) has increased significantly from five percent in 2001, to 19 percent in 2010, and to 43 percent in 2016.

Seeking facility-based care for reported maternal complications has increased from 29 percent to 46 percent between 2010 and 2016