Social Networks Are Needed to Support Women Through Pregnancy in Bangladesh

Few pregnant women in low- and middle-income countries receive the minimum number of antenatal (ANC) and postnatal (PNC) appointments recommended by the World Health Organization, and millions of births still take place annually without a skilled birth attendant. In Bangladesh, the Shustha Ma, Shustha Poribar — Healthy Women, Healthy Families — Project focuses on the under-served population of first-time parents in urban slums of Tongi who often have specific needs for information and social support that are not met through available health services.

To address these challenges, MSH — in collaboration with Scope, BRAC, and The Population Council — is developing a person-centered, tailored group ANC-PNC program. Human-centered design is being used to help understand this population’s unique needs and perspectives. An initial component of this process included holding in-depth discussions with multiple stakeholders including pregnant women, fathers, and mothers-in-law, as well as health providers and community health workers.

These conversations provided context and insights into the needs, barriers, and concerns of first-time parents, first-time pregnant women, and the people making up their social support networks. A first-time pregnant woman shared in one of these focus group discussions, “Only my husband and I live here and there is no other help that we have.” Many women living in the urban slums of Tongi do not have family support due to the transient population and informal settlements established for working in the nearby factories.

When sharing their views on their role during pregnancy, men felt parenthood should be a joint venture and wanted to be more involved with sharing equal preparation and parenting responsibilities. A first-time father shared, “If I could have been more involved during the care my wife received during her pregnancy, it would have been better as I could have reminded her of a few things as remembering everything is often not possible. While discussing it I could have asked or added a few things.”

The data from these focus groups, numerous interviews and observations were then used to develop initial ideas for the service model. These ideas were then tested with women, men, midwives and family members to observe what worked well and what did not and to listen to ideas about what they wanted for the model. The next step is to test the model in BRAC maternities in Tongi and periodically make adaptations and adjustments as needed when it encounters real world implementation. The program will strengthen extrafamilial social support networks by enabling first-time pregnant women, recent mothers, and recent fathers to share experiences and create bonds amongst each other and with facility and community health providers.

As the project continues to test, finalize, and collect results, updates will be shared on the project’s webpage: Healthy Women, Healthy Families, “Shustha Ma, Shustha Poribar” and shared over social media.

“The Shustha Ma, Shustha Poribar — Healthy Women, Healthy Families — is a three year project led by Management Sciences for Health with implementing partners BRAC, Scope, and The Population Council. It seeks to improve the quality and use of maternal, newborn, and child health and family planning services and information among young women and their partners in the urban municipality of Tongi in Gazipur district, Bangladesh. This photo essay was developed in collaboration with Scope and BRAC is based on the Healthy Women, Healthy Families: Insights and Opportunities Report, follow this link to find out more.”