Professor Tahera Ahmed
Faculty of Reproductive Health and Maternal & Child Health, North South University
Former Acting Chief, Sexual and Reproductive Health and Rights (SRHR) at UNFPA
Photograph by Ashraf Uddin Apu
-By Natasha Rahman
Our achievements in the sector of Maternal and Child Health (MCH) in Millennium Development Goal (MDG) are remarkable. Now that MDG is over and Sustainable Development Goal (SDG)s are in, what are we looking forward to in that sector?
The third goal in the SDGs covers maternal health fully and is well-targeted. Twenty years ago, maternal mortality rate was very high. I remember in 2001, the maternal mortality survey results showed that 13,500 women were dying due to complications in pregnancy. Now the rate has come down to 5000. From there we have come a long way though a lot is yet to be achieved.
A number of activities have been established at the upazila health complex and district levels. One of them is Emergency Obstetrics Care (EOC). EOC consists of medical doctors and anaesthetists ready to facilitate women during pregnancy, delivery and post-delivery period.
As of now, there are three delays-in decision making, transportation and receiving quality care which needs to be fixed. There are incidents when a woman, who is in an obstructed labour for more than 8 hours, ends up losing a lot of blood due to poor decision making. The hassle to look for transportation comes next. Lastly, you have to wait at the hospital for the doctor to attend your needs. So if we address these issues more, the maternal mortality will drop down even more. Although the maternal mortality rate has come down to 5000, I feel that not a single woman should die from giving birth. There are still gaps here and there so SDGs are looking into the quality of care as of now.
Early marriage of girls is a hindrance for ensuring maternal health. The debate over age limit is still going on. What’s your take on that?
The minimum age should be 18 and no less than that though we still have cultural norms which agree on marrying off girls in their teens. In addition, families are worried about their daughters’ security and welfare. In extreme poverty, managing a home is tough. However, knowledge about family planning and physical changes a woman experience in different stages of her life is essential. My personal opinion is a girl should be at least 21 at the age of her marriage. This is the age when she is emotionally and mentally calmer and responsible.
Being a veteran in the field of MCH care, what roles do you think the policy makers, the civil society and the youth play?
Policy makers have a big role to play. We have various conferences on policies, but we have to focus on implementing them as well. It’s essential to focus on the field level because policies will come from top down but should be generated from bottom up since that’s where the action really is. It’s important to acknowledge that policies can’t be perfect and should be adapted to the culture and the country itself. Based on that, action plans should be formulated.
The civil society changes the mindset of the people. Lobbying, advocating and getting the message across and working closely with people are important. Keeping our cultural norms in mind, the civil society will know what works in a different country may not work here and keeping that in mind, adjustments have to be made.
Bangladesh was one of the first countries to develop adolescent reproductive health strategy under my guidance. Later Nepal followed our footsteps. Ministries for education, youth and women and children welfare were involved in the process with a focus to harness the power of the youth. We must conduct awareness programs about certain misconceptions. The sex of a child depends on the man and not the woman but more often we see women getting blamed for giving birth to a daughter. Proper education and information among the youth can dispel the darkness of such ignorance.