The dangerous trend of cesarean section (C-section) operations in Bangladesh continues to go up despite the government recruiting and deploying more physicians and midwives at the healthcare facilities.
Findings of the Bangladesh Demographic and Health Survey (2022), conducted by National Institute of Population Research and Training (NIPORT) in the June-December period last year, show that 45 per cent of the babies in Bangladesh are now born through C-section.
This is an alarming increase from 34 per cent recorded in 2017. NIPORT, supported by icddr,b and USAID Bangladesh, made the disclosures at a data dissemination programme of the preliminary report.
This is the ninth iteration of the survey, and the previous one came out in 2017.
The study mentions that though the Bangladesh government received praise for achieving millennium development goals, the latest survey sheds light on some matters of concern. Wasting among children has increased, while breastfeeding declined.
This survey further indicates that the intake of diet food among children has declined. Adverse incidents such as child marriages has decreased over time, but still half of the women are getting married before they are legally eligible, and one in four teenagers is childbearing.
The study was conducted on over 30,000 households. A five member team from the three institutions presented the report in the programme.
Discussing maternal and newborn care, Associate Scientist (Maternal and Child Health Division) at icddr,b Dr Ahmed Ehsanur Rahman said, “The increase in private facility births is two times the rate of increase in public facility births in Bangladesh.
“The ratio of poor and rich in terms of going to the medical facilities has decreased and the wealth inequality gap steadily is declining as well. The equity gap was 1:6 in 2011 and only 1:2 in 2022.”
More expectant mothers are now rushing to healthcare facilities to give birth, but the number of C-sections is increasing alarmingly too, Ehsan added, saying that 45 per cent of births are now conducted through C-sections.
He further said, “C-sections occupy 69 per cent of all facility births. This rate rose by 27 percentage points in the past one decade. The most alarming matter is that 84% of all C-Sections happen in private facilities.
“This means four out of five women going to the private hospitals for deliveries are having C-sections.”
According to the researcher, 70 per cent of births are attended by medically trained healthcare providers, mostly (57%) by qualified doctors. But surprisingly, the involvement of midwives is poor at only 14 per cent, virtually unchanged compared to the previous study.
While talking about the causes of under-5 deaths he said that Pneumonia, Prematurity and LBW and Birth Asphyxia are causing 62 per cent of the total deaths in 2022. So, if they can be given higher priority the deaths could be deducted significantly, he advised.
During a presentation on Child Nutrition and Feeding, Knowledge Management and Communications Specialist at the University of North Carolina BD Chapter Shusmita Khan said, “Stunting continues to drop, while underweight remain in a stagnation for the last five years.
“But the worst part is wasting, which has increased from 8 per cent to 11 per cent. The percentage of children under 6 months exclusively breastfed has decreased from 65 per cent to 55 per cent. We need to find out the reason behind it.”
The diet food intake has also been decreased among the children. Shusmita claimed that taking fast food at a very early age is causing the children to have an irregular food habit.
Speaking about child marriage, she said the percentage of women aged 20-24 years married before age 16 has come down to 27 per cent, which was 43 per cent in 2011 and 35 per cent in 2017.
According to survey data, around 50 per cent of these women got married before they were 18.
“Good news is that early marriage is declining, but the truth is that 50 per cent of the women who are getting married are under 18 years – which is the legal age of marriage for women in Bangladesh,” Shusmita points out.
Another matter of concern is that the total fertility rate has stood at 2.3 for the last 11 years. It needed to be changed.
During the previous survey, Sylhet had the highest fertility rate at 2.6, which now stands at 2.3. Mymensingh is now at the top with a fertility rate of 2.7, an increase from 2.5. Chattogram and Rangpur must be kept under observation in this regard, she added.
At the programme, NIPORT Director (Research), Ahsanul Alam said, “Bangladesh has achieved several goals and targets of the SDGs, but several other issues such as child mortality, is still on track to be improved. The total fertility rate in Bangladesh needs immediate attention.”
Director of the Office of Population, Health, and Nutrition of USAID/Bangladesh Carrie Rasmussen thanked the Bangladesh government for fully funding the data collection of the research, and said it will inspire the researchers more.
Health ministry’s Medical Education and Family Welfare Division Secretary Azizur Rahman said the survey data showcased the country’s current condition, and it will help the government to formulate the next sectoral plan.
NIPORT Director General Shafiqul Islam, Family Health team lead of USAID, Bangladesh Dr Umme Salma Jahan Meena also addressed the event, along with icddr,b Assistant Scientist Mohiuddin Haider.
