When Amina (pseudonym), a first-time mother from a village near Dhaka, gave birth at the local Upazila Health Complex, she felt anxious about caring for her newborn. Everything changed when she attended a hospital-based health education session. There, she learned the basics of newborn careâhow to breastfeed, prevent infections through handwashing, and recognize danger signs early. Armed with this knowledge, Amina gained confidence and was able to ensure her baby's healthy growth. Today, her baby is thriving, and Amina has become an advocate for maternal and newborn health in her village, sharing what she learned with other mothers. Her story shows how empowering families can lead to healthier babies.
Bangladesh has made significant progress in reducing neonatal deathsâfrom 28 per 1,000 live births in 2011 to 18 in 2023. The Sustainable Development Goal (SDG) target is to bring this number down further, to at least 12 per 1,000 by 2030. Achieving this means reducing newborn deaths by another six percent in just five years. Clearly, "business as usual" will not be enough.
The risks are highest immediately after birth. Nearly half of all newborn deaths occur on the first day of life, with an additional 25 percent happening in the first week. This underscores the urgent need for safe delivery, essential newborn care, quality antenatal care (at least four visits before delivery), and family education on newborn health.
According to the Bangladesh Demographic and Health Survey (BDHS) 2022, only 41 percent of pregnant women received at least four antenatal visits, and only 21 percent of those were considered quality care. Around 65 percent of mothers delivered at hospitals, and 70 percent of those deliveries were attended by skilled birth attendants. Yet, essential newborn practices remain worryingly low.
The BDHS 2022 assessed five key newborn care practices among 1,272 non-hospital births: clean cord cutting, proper cord care, early skin-to-skin contact, immediate breastfeeding, and delaying the baby's first bath for at least 72 hours. While the target was to raise coverage of these practices to 25 percent by 2023, the combined coverage stood at just 1.2 percent. Although clean cord cutting improved from 86 percent in 2017â18 to 97 percent in 2022, other indicators worsened: proper cord care dropped from 47 percent to 41 percent, delayed bathing from 46 percent to 27 percent, and immediate breastfeeding from 69 percent to 40 percent.
The government of Bangladesh has long recognized these challenges. Through the 2013 A Promise Renewed (APR) declaration, it committed to scaling up four key interventions: Kangaroo Mother Care, application of 1% chlorhexidine on the umbilical cord, antenatal corticosteroids, and newborn sepsis management at rural health facilities. The Bangladesh Every Newborn Action Plan (BENAP), launched in 2015, further strengthened this commitment. Yet, adoption of essential practices by families remains far from satisfactory.
Hospital-based health education programsâsuch as the Care Companion Programâalong with community-based initiatives, can play a transformative role. By equipping families with knowledge and confidence, these programs can improve newborn survival, reduce neonatal mortality, and foster healthier generations.
Empowering families is not just about improving statisticsâit means making parents informed and engaged participants in their babies' growth and development. This includes promoting antenatal care, nutrition, vaccination, and early interventions for both physical and mental development. Families who feel confident in their caregiving role are more likely to view health as a shared responsibilityâone that extends beyond individuals to the community at large.
Bangladesh has made remarkable strides, but to reach the SDG targets, more must be done. Strengthening healthcare infrastructure, standardizing essential newborn care practices, enhancing maternal education, and raising community awareness will be vital.
By empowering families, Bangladesh can ensure that every newborn not only survives but thrives.
Dr. Arefin Amal Islam is a public health professional with a medical background and over 35 years of experience in reproductive and child health in Bangladesh. Previously, he served as the Co-Country Director for Partnership and Advocacy at Noora Health, following a successful five-year term as Country Director.
He holds an MPH from NIPSOM, University of Dhaka, and has completed various specialized trainings, including a certificate course on Community-Based Rehabilitation from Queen's University, Canada, and a diploma in Leadership in Humanitarians by Relief International and FranklinCovey. He is also a graduate and trainer of Save the Children's Managing High Performance (MHP) program.
Dr. Islam is a life member of the Public Health Association of Bangladesh, a member of the Bangladesh Urban Health Network, and an alumnus of the CDC's STOP Polio Transmission Program. He has served as a national and international trainer and coach with Save the Children, START Network, and CHS Alliance.
Connect: arefin.amal@gmail.com.
