Maternal and Child Survival in Haor Region in Bangladesh. An Analysis of Fathers’ Capabilities to Save the Future

Abstract

Maternal and child survival is a major public health problem in haor areas in Bangladesh. Fathers feel responsible as expressed by their capability “to save the future”. Using the Capability Framework for Child Growth, we aimed to identify what contextual factors underlie a father’s real opportunities to secure a safe delivery, including social norms and beliefs. Parents from households having children less than two years old were asked to participate in two rounds of qualitative research. In total, 25 focus group discussions and eight in-depth interviews were conducted. Late admission to health facilities emerged as the overarching disabling factor for fathers’ capability to save the lives of mothers and children. Poor communication about the mother’s health condition between spouses and fear for caesarean birth were underlying this late admission. In addition, inadequate advice by local doctors, underdeveloped infrastructure, and seasonal extremities contributed to late admission to health care facilities. The participants indicated that mother’s autonomy in haor to seek health care is a constraint. This capability analysis points towards relevant interventions. In addition to the need for an improved health infrastructure, programs to improve maternal and child survival in haor could focus on the gendered household responsibilities and poor communication between spouses.

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“…When women give birth to a baby and there are complications, it is difficult to get to a hospital in time. Because of the patriarchal culture in Bangladesh, women themselves have little say in the process surrounding childbirth (Chakraborty, Darak et al 2020). While fathers have a strong sense of responsibility for the survival of the mother and the baby, they can often do very little to help, either because they have too little income, or because there is simply no way to transport the woman to a clinic under these harsh conditions.…”