BRAC, a non-governmental organization in Bangladesh has responded to the agenda of the Beijing Platform for Action on women’s access to gender sensitive health care. This paper presents how the gender sensitivity of a maternity care was assessed at the BRAC Health Center (BHC), what lessons were learned from the study and what suggestions were made.
Even with the high maternal mortality and morbidity in Bangladesh, use of hospital facilities is very low, particularly in rural areas. A qualitative approach was used to assess rural women’s low utilization of the BHC maternity care. Women’s understandings of childbirth, the quality of care and power relations within home and at the BHC were addressed to comprehend the issues of gender sensitivity in maternity care. The rural women experiencing BHC and home birthing, traditional birth attendants (TBAs) and health providers of the BHCs were interviewed and observed. The rural women understood childbirth as natural and normal event, and preferred TBAs, but they sought care from the BHC when faced complications. The concept of
gender sensitivity became more concrete following the study. The TBAs seemed marginalized, even though the community preferred them.
The strength of the research lies in the use of qualitative approach to assess the issues of gender sensitivity in maternity care. The following issues need to be addressed to make the BHC gender sensitive: use of comprehensive obstetric care; skills of the health providers; use of aseptic procedures; access to information; issues of privacy, dignity, caring attitudes and emotional supports; preference for women health providers; use of indigenous birthing positions; decision making power of women; costs; and transports. Substantial efforts need to be made to enhance rural women’s use of BHC maternity care, which will subsequently contribute to reductions of maternal deaths.