About 50 percent of conceptions in Bangladesh are unplanned and almost 25 percent of pregnancies are unwanted.
Nearly three quarters of mothers receive no antenatal care during pregnancy and perinatal mortality is high among Bangladeshi women.
A study has found high rates of caesarean sections, pre-eclampsia, fetal distress and obstructed labour in mothers diagnosed with gestational diabetes (GDM).
The reasons are plenty: Low socio-economic status, social discrimination, social and religious barriers, lack of adequate nutritional knowledge, myths and misinformation related to diabetes in pregnancy and lack of knowledge related to proper pregnancy planning and care.
The goal of the project is to improve community awareness of preconception care and prevention of non-communicable diseases, particularly gestational diabetes (GDM), among newly married couples in Bangladesh through religious leaders.
Three groups are targeted by this project: Newly married couples, religious leaders (Kazis)
and health service providers (physicians, nurses and educators).
In the preparatory phase, a 6-member expert advisory committee will be established. It will include specialists within diabetes, gynaecology, nutrition, a member of the association of Kazis and representation from relevant ministries.
In this phase project implementation, planning and recruitment of personnel will begin, as well as the development of culturally and religiously appropriate material concerning health before pregnancy.
In the training component, a curriculum will be developed by the Diabetic association of Bangladesh (BADAS) for the training of religious leaders. It will include information on pre-conception and family planning, diabetes incl. risk factors, screening, GDM and other NCDs, lifestyle counselling and immunisation.
The curriculum for health care personnel includes; pre-conception counselling and family planning, DM/GDM management, risk factors, screening, lifestyle measures, immunisation and anthropometric measurements and referral.
To ensure service delivery, pre-conception services and counselling at hospitals and clinics will be established. Screening, care and referral by trained health care personnel will also be organised, and the trained religious leaders will organise pre-conception counselling.
Awareness activities include: community awareness regarding pre-conception counselling and prevention of NCDs including diabetes, the development of a website for preconception care and prevention of NCDs, and a mobile help line that also includes antenatal care.
- Expected results
- 400 religious leaders and 300 health service providers trained in pre-conception care and counselling incl. diabetes/GDM and NCDs
- 50 pre-conception care services established at clinics and hospitals
- 30,000 newly married couples received pre-conception counselling by religious leaders
- 30,000 women received pre-conception/ante-natal care from established pre-conception services
- 4 tv and radio broadcasts with religious leaders reaching 3 million people
- Referral system between religious leaders and BADAS diabetes clinics established
- Pre-conception care strengthened and integrated with maternal and neonatal health at community level
- A mobile hotline for counselling and pre-conception care established
- Electronic database developed for monitoring
- National consensus guidelines and materials to improve maternal and neonatal health, NCDs and GDM developed