The aim of this brief is bring out the problem of poor governance in
particular the maternal health problem, which affect the people of
Bangladesh. In addition, it analyzes the need for the Bangladesh
government to strengthen its governance in order to improve or press
forward maternal health. The diminishing health conditions are because
of poor governance. The government merely spent 7.9% of its budget on
health very small allocation compared to the country population. The
citizens are therefore, forced to pay for their medical bills. With
majority of the population been made up of the poor people maternal
death are common in this country. Most pregnant women do not have
access to medical care, and availability of skilled birth attendant is
minimal. This brief recommends that the Bangladesh government should
improve its governance on maternal health by empowering the community to
have more voice in health system governance. Moreover, the government
ought to ensure that the health workers are able to engage with the
citizen, respond to their problems, and facilitate a means through which
pregnant women can gain help.
Problem statement: Is there a need for the Bangladesh government to
strengthen good governance in order to improve maternal health?
Background of the problem: 194 out of 100,000 women in Bangladesh die
every year these deaths are caused by complications occurring during
pregnancy and while giving birth. This is mostly common in the rural
areas. The failure of the government to reduce poverty and eliminate
illiteracy has caused the reluctance of these women to seek medical help
when pregnant. The health workers too are arrogant when offering
services to this poor rural folks thus forcing them to seek assistance
from unskilled midwives (Great Britain & Great Britain, 2010).
The cost of medical services is high for the poor people in Bangladesh
Lack of enough skilled birth attendants, this is because the government
of Bangladesh has marginalized the rural dwellers.
Lacks of enough medical facilities, the governments have failed to
distribute evenly the medical facilities in rural areas. Thus, most
women in rural areas do not get the necessary assistance when giving
The government, the citizens, and the health system should be brought
together to work for the common goal of reducing these maternal deaths.
The working together of the government, the health institution, and the
community will aid in improving health by enabling the building of
consensus, collaboration, action, and negotiation. In addition, this
will provide a channel for communication between the government, the
community, and the health workers (Pathmanathan & Liljestrand, 2003).
Advantages of this policy: Application of this policy will eliminate of
barriers that prevent women from seeking medical services. The working
together of the community and the government will aid the government in
knowing the challenges facing the community and provide a solution for
Use of this policy will lead to quality improvement in terms of service
delivery, access to medical services, improvement in staff attitude and
reduction of discrimination of the marginalized communities.
Applying this policy will create mutual responsibility for all
stakeholders. Each stakeholder is assigned a specific role that will
ensure the success of this policy.
Disadvantage: This policy demands the stakeholders to be fully
committed towards the success of this policy. Thus, lack of commitment
from all the stakeholders may lead to the failure of this policy option.
Bringing together the government, the health sector and the community
may be a hard task to accomplish due unwillingness of one party.
Remember for this policy to work the three stakeholders are essential.
Community based governance, this policy will ensure that the community
is empowered and citizens are aware of their rights. Therefore, able to
evaluate reports and reviews on health service quality and can voice
their concern and hold the government accountable for failure to provide
efficient services (Organization for Economic Co-operation and
Advantage: This policy will provide a channel for the marginalized and
poor women to voice their problems and issues to the government.
This policy will ensure that the government addresses the community
grievances and takes the responsibility of ensuring that all the
pregnant women are given maximum medical attention.
Disadvantage: The health sector may make it difficult for the community
to access the reports due to the issue of confidentiality.
The government may fail to take responsibility for in adequate services.
By failing to respond to the community demands, the government will
then be refusing to take responsibility for lack of efficient services.
Most of the poor people do not feel like they are equal to other
citizens and are reluctant to take role in decision-making.
Recommendations: with the increasing maternal health problems, there is
a need for the government, the health sector, and the community to
collaborate and work together. Even though, the Bangladesh government
has made tremendous efforts in reducing maternal death, a lot more need
to done minimize this deaths to as low as possible.
I recommend the use of the first policy, which advocates the working
together of the government, the health care workers, and the community.
My reasons for recommending this policy option are the implementation of
this policy will aid in the elimination of the barriers that face women
in the marginalized areas. In addition, this policy will help in the
improvement of health care quality given to pregnant women. Lastly, the
policy will encourage the three parties involved to take responsibility
of ensuring the success of the policy implementation.
From the two-policy option, it is clear that the first policy option has
more advantages and the policy is easy to implement. Thus, the
Bangladesh government should implement it to ensure minimization of
Organization for Economic Co-operation and Development. (2010). Health
at a glance, Asia/Pacific 2010. Paris: OECD.
Great Britain., & Great Britain. (2010). DFID`s programme in Bangladesh:
Third report of session 2009-10. London: Stationery Office.
Pathmanathan, I., & Liljestrand, J. (2003). Investing in maternal
health: Learning from Malaysia and Sri Lanka. Washington, D.C: World
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