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Name: Syed Rahman
Professor:   Caroline Kuo
Course: THE IMPRINT OF TIME, SPACE AND PLACE IN OUR BODIES: UNDERSTANDING HEALTH DISPARITIES
Date: 20/08/2019

Title: Why Maternal and Newborn Health Disparities in Bangladesh?
Contents
Introduction    3
Health Disparities in a Demographic Context    3
Health Disparities between the Regions    3
Health Disparities between Rich and Poor    3
Health Disparities between the U
an and the Rural    3
Reasons for Health Disparities    4
Inequality of Resources and Medical Equipment    4
Lack of Checking of Medical Malpractice    5
Social Determinant of Health causing Health Disparities    6
Historical Drivers for Health Disparities    6
Milestones to Eliminate Health Disparities    7
Insured Accessibility and Health Equality among Rich and Poor, and U
an and Rural    7
Insured that, Symmetries of Medical Equipment, Doctors and Nurses among the Region    7
Insured to Practices and Law-Enforcement of Medical Malpractice among the Region    7
Conclusion    7
Works Cited    8
Introduction
The maternal and neonatal mortality rate is very high in Bangladesh. There is a high health disparity rate observed in maternal and newborn health in Bangladesh. According to the 2019 statistics, the cu
ent population of Bangladesh is 160.9 million, within which the maternal mortality rate is 176 deaths per 1000,000 live births.
The maternal death rate is 240 per 1,000 total births, stillbirth rate per 1,000 total births is 25 (UNICEF DATA, 2019). Around 8600 infant born every day, out of which 204 newborn die before reaching their first month. In Bangladesh, the leading causes of newborn mortality were identified as prematurity, birth asphyxia and trauma, sepsis, Congenital anomalies, tetanus, dia
heal disease and other (World Health Organization, 2019).
Health Disparities in a Demographic Context
Health Disparities between the Regions
The health disparity among maternal and infant population varies from region to region. For example, the region where maternal and infant health is lowest is Sylhet. The region where maternal and newborn health care is highest in Rangpur. Data suggests that Rangpur region have high care for mothers and newborn compared to Sylhet region and the ratio of caring is 4:1 respectively. (UNICEF DATA, 2019). As suggested by Anwar et al. (2015), regions, which are economically stable, have a good mother and newborn care and their maternal and newborn mortality rate is low.
On the contrary, the economically weak regions have higher newborn and maternal mortality rate. It has been observed that the states, which have good healthcare policies, healthcare facilities provided to the mother and newborn, are of high quality. This is majorly because these regions have implemented healthcare policies effectively compared to economically weak regions. As noted by Islam et al. (2015), government’s poor healthcare policies and poor implementation of existing policies are the major reasons behind high mortality rates. Further, Enayetur, Rahman Khan, and Sorowar Hossain (2019) through their cluster analysis of districts in Bangladesh suggested that Bangladesh lacks community-level interventions aimed at maternal and newborn health care requirement.
Health Disparities between Rich and Poo
    Health disparities between the rich and the poor are very high in Bangladesh. In Bangladesh, the healthcare system heavily relies on the public sectors for the financing and delivery setting. The quality of government healthcare setting is secondary. On the contrary, the private healthcare facilities are high level in Bangladesh. Thus, the private healthcare facilities are costly, which are higher than the affordable range of poor or middle-class people of the country. As mentioned by Pickett and Wilkinson (2015) there is a great health disparity between the rich and the poor. The standard of treatment provided in the public healthcare setting is poor. Enayetur, Rahman Khan, and Sorowar Hossain (2019) mentioned that socioeconomic position of mothers is at disadvantage in poor districts
On the contrary, relatively, the standard of treatment provided in the private healthcare setting is high. However, there is a lack of policies that can check the quality and standards of the care provided at the private healthcare settings. These disparities has allowed the rich to seek proper maternal and newborn care. As suggested by Truesdale and Jencks (2016), increased health disparity between the rich and the poor has resulted in high mortality rate of maternal and newborn among poor.
Health Disparities between the U
an and the Rural
    The health disparities between u
an and rural areas are evident. The quality of healthcare provided in the rural area is lower in standards in comparison to the u
an areas. The technology and machinery available in the u
an areas are not frequently available in the rural area. As mentioned by Darkwa et al. (2015), there are many reasons, which lead to the health disparities between u
an and rural areas. For example, doctors and nurses are reluctant to work in rural areas. There is a shortage of staff and low standard of treatment available in healthcare facilities. The healthcare settings in rural areas fail to provide treatment for chronic diseases and terminal diseases.
People, from rural areas, travel to u
an areas for the treatment of diseases like cancer. Apart from this, rural people are very reluctant to visit the healthcare setting to get treatment from modern medicine. There is lack of literacy among these people, which prevent them further to visit healthcare setting during pregnancy or after the delivery of the newborn. In rural areas, people are dependent on midwife for the birth, which leads to the increase of vulnerability of mother and newborn child. It has been observed that the maternal and neonatal mortality rate is very high in rural areas in comparison to the u
an areas. As suggested by Uddin et al. (2016), the vaccination coverage in rural areas is shallow.
Despite providing free vaccination to the newborns, parents fail to take the children at the hospital setting to offer mandatory vaccines to their newborn. It makes children below 5 in rural areas vulnerable towards the diseases and increases their mortality rate. On the other hand, most of the parents in u
an areas are aware of the importance of the immunization plan. Most of the children in u
an areas get vaccination on time, which prevent them from suffering from many severe diseases like mumps and cholera and...