WOMEN FREINDLY HOSPITAL INITIATIVE

Updated: February' 2013

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Background:

The total number of female population in Bangladesh is 60.4 million (BBS-2001), which is about 50% of the total population. The status of a woman is always judged by some basic facts like maternal mortality ratio, accessibility to health care, antenatal, post natal care including measures against violence of the women etc. Some basic facts which is prevailing in Bangladesh are enumerated below. Globally Maternal Mortality Rate is an indicator of the overall status of women of a country.The current estimated maternal mortality ratio (MMR) of 3 maternal deaths per 1,000 live births) in Bangladesh is among the highest in the world, unacceptably high in comparison to countries such as Srilanka (0.8 per 1,000 live births) In Bangladesh, MMR represents the end point in a lifetime experience of gender discrimination, neglect and deprivation. Among the 4,000,000 women becoming pregnant every year, an estimated 600,000 develop complications.14% of deaths of women during pregnancy and puerperium are related to violence and injury. The proportion of deaths due to violence is even greater than those related to pregnancy.

Every hour three Bangladeshi women die of complications related to pregnancy and childbirth. These women succumb, their lives ending in pools of blood, in the throes of convulsions or even in the agony of their bodies being torn apart. Every hour three Bangladeshi women die of complications related to pregnancy and childbirth. These women succumb, their lives ending in pools of blood, in the throes of convulsions or even in the agony of their bodies being torn apart.

Every hour three Bangladeshi women die of complications related to pregnancy and childbirth. These women succumb, their lives ending in pools of blood, in the throes of convulsions or even in the agony of their bodies being torn apart. Every hour three Bangladeshi women die of complications related to pregnancy and childbirth. These women succumb, their lives ending in pools of blood, in the throes of convulsions or even in the agony of their bodies being torn apart.

Those who survive with complications that ranges from discomfort to situations of indignity. At the extreme is the woman who drips urine constantly

Those who survive with complications that ranges from discomfort to situations of indignity. At the extreme is the woman who drips urine constantly

an abnormal passage is created by the head of the baby pressing down too hard for too long to be released through a path that is not wide enough. She is associated with a smell that makes her company undesirable leading to her being abandoned by husband and outcast by society.

Bangladesh government has made a commitment to improve the Quality of Care at all level of health facilities. Elements of Quality Care encompass:

1.         Promotion and protection of health

2.         Accessibility and availability of services

3.         Acceptability of services

4.         Technical competence of the health care providers

5.         Essential supplies and equipment

6.         Quality of client interaction

7.         Information and counseling of the client

8.         Involvement of clients in decision

9.         Comprehensiveness of care and linkages to other services

10.       Continuity of care and follow

11.       Support to health care providers

Why the concept of women friendly hospital arose?

The mother and the baby during the intra-natal life as well as after birth should be considered as one entity. That is why the Mother_Baby approach is an important part of a "Women Friendly Hospital".

In Bangladesh Neonatal Mortality Rate is still high in comparison to developed countries.  Each baby is unique and as such cannot be adequately replaced. Each baby who dies from a preventable or treatable complication of pregnancy is a personal tragedy for the parents and a loss to the society. The common response to a prenatal death is for the mother to get pregnant soon after. The short birth interval increases the risks of nutritional anemia as well as other complications and so threatens the life of the mother and the next baby.

The Challenge

In the last decade of the twentieth century maternal mortality is not a mystery. While we cannot predict most complications of pregnancy, we have the technology to save women from dying of these complications. No new discoveries are needed to save the lives of most women from death due to pregnancy related causes but effective strategies for intervention are needed. Hence, the high rate of Maternal Mortality continues to be a challenge for Bangladesh.

In summary, the situation is-

·      every year 26,400 women die of pregnancy related causes

·      violence against women is associated with 13.8% of maternal deaths

·      violence is increasing

·      Neonatal deaths are 60% of the infant mortality rate.

To encourage women and their families to seek care, the hospitals must provide quality care, not only for obstetric patients but for all women's health problems. The hospitals must be known to be women friendly.

Women Friendly Hospital

Definition

A woman friendly hospital is one in which -

1.      Women are treated with respect, dignity and equity.

2.      Women receive adequate and appropriate care that is timely and affordable.

3.      A woman is respected as the person to receive the necessary information

And

·     Can voice her opinion and be heard.

"Women" in the Women Friendly Hospital Initiative includes all female persons regardless of age and hence these include Young girls, adolescents, women of reproductive age, elderly women

Women who are caregivers to their own family members

As hospital staff.

Goals

·        To create in hospitals the conditions necessary for women

·        To be treated in a way that respects human dignity and women's needs while challenging oppressive cultural practices

·        To be able to make use of the services provided

·        To be able to voice opinion and demand services

·        To reduce the maternal mortality by providing Essential Obstetric Services

·        To provide appropriate measures for women affected by violence

·        To use hospitals as an opportunity for empowering women.

·        To eliminate from hospitals discrimination against women

·        To facilitate equity for women in and through health facilities.

·        To maintain linkages with other programme elements for women.

Objectives of Women Friendly Hospital

The objective of a Women Friendly Hospital is summarized as:

A. To ensure availability of services to women

B. To create a suitable environment for women

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WOMEN FREINDLY HOSPITAL INITIATIVE

ACTION PLAN

Updated: November, 2012

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WOMEN FREINDLY HOSPITAL INITIATIVE

PRESENT STATUS

Updated: September 2011

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Present Status of women friendly hospitals:

10 (Ten) district hospitals have been accredited as Women Friendly Hospitals for 2011:

·      Manikganj District Hospital

·      Rajbari District Hospital

·      Narail District Hospital

·      Jamalpur District Hospital

·      Cox's Bazar District Hospital

·      Moulovibazar District Hospital

·      Joypurhat District Hospital

·      Gaibandha District Hospital

·      Nilfamari District Hospital

·      Thakurgaon District Hospital

Six (06) more District hospitals and 04(four) UHC are on the process of WFH, these are:

·      Madaripur DH

·      Kishoregonj DH

·      Kurigram DH

·      Gopalgonj DH

·      Magura DH

·      Lalmonirhat DH

·      Borolekha Upazilla health complex, Moulovibazar

·      Fatikchori UHC, Chittagonj,

·      Chowgacha UHC, Jessore

·      Bhoirab UHC, Kishoregonj

Comments:

The process of transformation of public hospitals into WFH is lengthy and complicated. There are several steps to follow like, baseline assessment, orientation of service providers, development of LLP, implementation of LLP, providing extra support, intense monitoring and assessment by the National Accreditation Body for WFH. At first in 2010,  4-DH & 3 UHC accredited by NAB as WFH and in 2011, 10-DH already accredited by NAB as WFH. 21 DH already targeted to transform into WFH by 2015 and the rest of the hospitals will be under WFH phase wise.

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