Background: Bangladesh has about 5.7 million people living in urban slums that are characterized by adverse\r\nliving conditions, poor access to healthcare services and health outcomes. In an attempt to ensure safe maternal,\r\nneonatal and child health services in the slums BRAC started a programme, MANOSHI, in 2007. This paper reports\r\nthe causes of maternal and neonatal deaths in slums and discusses the implications of those deaths for Maternal\r\nNeonatal and Child Health service delivery.\r\nMethods: Slums in three areas of Dhaka city were selected purposively. Data on causes of deaths were collected\r\nduring 2008-2009 using verbal autopsy form. Two trained physicians independently assigned the cause of deaths.\r\nResults: A total of 260 newborn and 38 maternal deaths were identified between 2008 and 2009. The majority\r\n(75%) of neonatal deaths occurred during 0-7 days. The main causes of deaths were birth asphyxia (42%), sepsis\r\n(20%) and birth trauma (7%). Post partum hemorrhage (37%) and eclampsia (16%) were the major direct causes\r\nand hepatic failure due to viral hepatitis was the most prevalent indirect cause (11%) of maternal deaths.\r\nConclusion: Delivery at a health facility with child assessment within a day of delivery and appropriate treatment\r\ncould reduce neonatal deaths. Maternal mortality is unlikely to reduce without delivering at facilities with basic\r\nEmergency Obstetric Care (EOC) and arrangements for timely referral to EOC. There is a need for a comprehensive\r\npackage of services that includes control of infectious diseases during pregnancy, EOC and adequate after delivery\r\ncare.
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