BANGKOK, Thailand (WOMENSENEWS)–Tamana Khatun is not a doctor. Nor is she a community leader in her remote and un-electrified Chanka village in Satkhira district of Bangladesh.
But when a woman in the village went into labor in the middle of the night the panicked family turned to 14-year-old Khatun, a grade 10 student who lived nearby and was able to arrange for the community’s skilled birth attendant to come in time, saving the lives of the mother and newborn.
Khatun’s ability as a trained health volunteer helped out in many ways. The family did not have the birth attendant’s number and the woman probably would have delivered without any assistance at home, like an estimated 73 percent of births in Bangladesh. But because Khatun shares a good rapport with the birth attendant that she was able to call her in the night. And because she works in tandem with the attendant, she could help ensure that the attendant administered tablets to prevent postpartum hemorrhage, a major killer that stalks childbirth.
In nearby Sushilgati village, 17-year-old Irani Akhtar, a college student, is also making the difference between life and death. Akhtar, whose elder sister died young during childbirth, makes homes visits to discuss maternal health when she’s not in school.
"It was lack of awareness about pregnancy-related dangers that led to death of my sister," said Akhtar in an interview on the sidelines of a recent U.N.‘s international Asia Pacific conference held here focused on gender equality and women’s empowerment. "I want to ensure no other family faces the same tragedy."
The UNAIDS office in Bangladesh invited Akhtar and Khatun to the conference to share their experiences as participants in an initiative of the Community Health Foundation, a nonprofit based in Dhaka, to educate girls in grades 9 to 12 about pregnancy and childbirth and then link them to pregnant women in their community through government female health workers.
Known as the Golden Girl Project, its 275 volunteers help increase awareness among pregnant women and facilitate access to skilled birth attendants, bringing down maternal mortality risks.
Their efforts are proving critical in a country where 7,000 women die of pregnancy-related causes every year.
The country’s maternal mortality has declined from 322 for 100,000 live births in 2001 to 194 for 100,000 live births in 2010. Bangladesh is one of the countries on track to meet the UN’s Millennium Development Goal on reducing maternal mortality. But it still has a long way to go to ensure universal skilled birth attendants at deliveries, and that antenatal, post-partum and emergency obstetric care are readily available.
Obstetric complications during childbirth continue to be deadly, claiming nearly two-thirds of all maternal deaths. Only 27 percent pregnant women in the country are able to access to skilled birth attendant.
As community members, the golden girls are often able to reach out to new couples before the local family planning field worker. They are thus able to share sexual and reproductive health information and help the couple plan their families. The project, which runs in Satkhira district at present, is likely to be introduced to other districts soon.
Avoiding Early Marriage
In addition to safe motherhood Khatun and Akhtar also campaign vociferously to end early marriage.
The training helped Khatun persuade the parents of a senior schoolmate to resume her education after she had dropped out for marriage. "I understood the links between early marriage, motherhood and maternal mortality. When I explained this to her parents, they agreed to let their daughter return to school provided the educational expenses were taken care of. The local council authorities I approached in this matter are helping her and she is back in school," said Khatun.
Approximately 66 percent of women in Bangladesh were married before the age of 18 according to UNFPA, making it the country with the highest percentage of child marriages in the Asia Pacific region. Girls are often forced to leave school early for marriage and motherhood. About 33 percent of girls begin childbearing before the age of 20.
In addition to their training in reproductive and sexual health, the golden girls themselves also commit to completing high school and delaying motherhood for as long as possible.
Adolescent fertility in Bangladesh is one of the highest in the world, with 126 births per 1,000 women between the ages of 15-19. The global average is approximately 50 births per 1,000 women for the same age group.
Volunteers’ parents consent to the training and affirm their daughters will not be married before graduation. This contributes to reducing dropouts as well as early marriage.
Although progress in girls’ formal schooling in secondary level has been made with approximately 51 percent female enrollment ratio in secondary schools during 2008-2012 according to UNICEF, Bangladesh has the highest rate of marriage involving girls under age 15.
"The point of choosing female students for this project is because Bangladesh has done well in female education," said Labin Rehman, the Dhaka-based consultant to the project, who officially accompanied the girls to the Bangkok conference. "So, it makes sense to equip them with information on reproductive and sexual health because when we teach one, they are able to teach many more."
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