Abstract
BackgroundIn Bangladesh, the targets on reduction of maternal mortality and utilization of related obstetric services provided by skilled health personnel in Millennium Development Goals 5 remains unmet, and the progress in reduction of neonatal mortality lag behind that in the reduction of infant and under-five mortalities, remaining as an essential issue towards the achievement of maternal and neonatal health targets in health related Sustainable Development Goals (SDGs). As access to appropriate perinatal care is crucial to reduce maternal and neonatal deaths, recently several mobile platform-based health programs sponsored by donor countries and Non-Governmental Organizations have targeted to reduce maternal and child mortality. On the other hand, good health-care is necessary for the development. Thus, we designed this implementation research to improve maternal and child health care for targeting SDGs.Methods/designThis cluster randomized trial will be conducted in Lohagora of Narail District and Dhamrai of Dhaka District. Participants are pregnant women in the respective areas. The total sample size is 3000 where 500 pregnant women will get Mother and Child Handbook (MCH) and messages using mobile phone on health care during pregnancy and antenatal care about one year in each area. The other 500 in each area will get health education using only MCH book. The rest 1000 participants will be controlled; it means 500 in each area. We randomly assigned the intervention and controlled area based on smallest administrative area (Unions) in Bangladesh. The data collection and health education will be provided through trained research officers starting from February 2017 to August 2018. Each health education session is conducting in their house. The study proposal was reviewed and approved by NCCD, Japan and Bangladesh Medical Research Council (BMRC), Bangladesh. The data will be analyzed using STATA and SPSS software.DiscussionFor the improvement of maternal and neonatal care, this community-based intervention using mobile phone and handbook will do great contribution. Thus, a developing country where resources are limited received the highest benefit. Such intervention will guide to design for prevention of other diseases too.Trial registrationUMIN000025628 Registered June 13, 2016.
Highlights
In Bangladesh, the targets on reduction of maternal mortality and utilization of related obstetric services provided by skilled health personnel in Millennium Development Goals 5 remains unmet, and the progress in reduction of neonatal mortality lag behind that in the reduction of infant and under-five mortalities, remaining as an essential issue towards the achievement of maternal and neonatal health targets in health related Sustainable Development Goals (SDGs)
Every year, approximately 290,000 women die due to pregnancy and childbirth, and 99% of maternal mortality occurring in the developing world
Bangladesh is one of those developing countries with high maternal mortality ratio (MMR), standing at 170 per 100,000 live births [1]. It has become a lower-middle income country with economic growth and achieved various targets of the Millennium Development Goals (MDGs), the target on reduction of maternal mortality and utilization of related obstetric and reproductive services provided by skilled health personnel remains unmet, and the progress in reduction of neonatal mortality ratio (NMR) lag behind that in the reduction of infant and under-five mortalities, with the proportion of neonatal mortality accounting for 39% of under-five mortality in 1991 increasing up to 60% in 2012 [2]
Summary
In Bangladesh, the targets on reduction of maternal mortality and utilization of related obstetric services provided by skilled health personnel in Millennium Development Goals 5 remains unmet, and the progress in reduction of neonatal mortality lag behind that in the reduction of infant and under-five mortalities, remaining as an essential issue towards the achievement of maternal and neonatal health targets in health related Sustainable Development Goals (SDGs). Bangladesh is one of those developing countries with high maternal mortality ratio (MMR), standing at 170 per 100,000 live births [1] It has become a lower-middle income country with economic growth and achieved various targets of the Millennium Development Goals (MDGs), the target on reduction of maternal mortality and utilization of related obstetric and reproductive services provided by skilled health personnel remains unmet, and the progress in reduction of neonatal mortality ratio (NMR) lag behind that in the reduction of infant and under-five mortalities, with the proportion of neonatal mortality accounting for 39% of under-five mortality in 1991 increasing up to 60% in 2012 [2]. As proved in previous studies, a participatory community-based intervention is effective to improve birth outcomes with low-cost, and realistic to achieve the progress for the rural area [5, 6]
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