title: Maternal complications in a geographically challenging and hard to reach district of Bangladesh: a qualitative study.
abstract: Background:Maternal complications contribute to maternal deaths in developing countries. Bangladesh still has a high prevalence of maternal mortality, which is often preventable. There are some geographically challenging and hard to reach rural districts in Bangladesh and it is difficult to get information about maternal complications in these areas. In this study, we examined the community lay knowledge of possible pregnancy complications. We also examined the common practices associated with complications and we discuss the challenges for the community.Methods:The study was conducted in Moulvibazar of north east Bangladesh, a geographically challenged, difficult to reach district. Qualitative methods were used to collect the information. Pregnant women, mothers who had recently delivered, their guardians and traditional birth attendants participated in focus group discussions. Additionally, in-depth interviews were conducted with the family members. Thematic analyses were performed.Results:The study revealed that there is a lack of knowledge of maternal complications. In the majority of cases, the mothers did not receive proper treatment for maternal complications.   There are significant challenges that these rural societies need to address: problems of ignorance, traditional myths and family restrictions on seeking better treatment. Moreover, traditional birth attendants and village doctors also have an important role in assuring appropriate, effective and timely treatment.Conclusions:The rural community lacks adequate knowledge on maternal complications.  Reduction of the societal barriers including barriers within the family can improve overall practices. Moreover, dissemination of adequate information to the traditional birth attendant and village doctors may improve the overall situation, which would eventually help to reduce maternal deaths.
authors.affiliation: School of Health Sciences, Örebro University, Örebro, Sweden; Centre for Injury Prevention and Research (CIPRB), Dhaka, Bangladesh.
authors.forename: Animesh
authors.initials: A
authors.lastname: Biswas
authors.affiliation: School of Health Sciences, Örebro University, Örebro, Sweden.
authors.forename: Koustuv
authors.initials: K
authors.lastname: Dalal
authors.affiliation: Centre for Injury Prevention and Research (CIPRB), Dhaka, Bangladesh.
authors.forename: Abu Sayeed Md
authors.initials: AS
authors.lastname: Abdullah
authors.affiliation: School of Health Sciences, Örebro University, Örebro, Sweden.
authors.forename: Mervyn
authors.initials: M
authors.lastname: Gifford
authors.affiliation: Centre for Injury Prevention and Research (CIPRB), Dhaka, Bangladesh.
authors.forename: M A
authors.initials: MA
authors.lastname: Halim
keywords: Bangladesh; Maternal complications; deaths; rural community