A new study presented at a national dissemination seminar has raised serious concern over persistently high rates of child marriage, adolescent pregnancy, and home deliveries in Rangpur’s hard-to-reach communities—levels that remain significantly above national averages despite years of policy attention.
The seminar, titled “Maternal and Newborn Health: Integrating Evidence into Practice and Policy,” was jointly organized by Save the Children in Bangladesh, icddr,b, RDRS Bangladesh, and KOICA under the Jononi Project, and held at Hotel Amari in Dhaka.
Senior government officials, development partners, health experts, and practitioners reviewed new evidence and discussed strategies to strengthen maternal and newborn health (MNH) services in underserved regions.
The Jononi study revealed that child marriage in Rangpur’s disadvantaged and hard-to-reach areas has risen to 58.9%, compared to the national average of 50.1%.
Even more alarming, adolescent pregnancy has surged to 17.3%, nearly three times the national rate of 5.9%. Six in ten girls are already married, and most have experienced or are currently experiencing pregnancy.
Severe service gaps compound these risks. One in five pregnant women lack access to diagnostic services, 70% face shortages of essential MNH commodities, and non-institutional births remain strikingly high. According to the report, 50.3% of deliveries still take place at home, well above the national figure of 34.9%.
Experts attributed these disparities to entrenched social norms, economic precarity, limited education, and the chronic absence of skilled maternal health services in remote areas.
Despite the challenges, the Jononi initiative has piloted a midwife-focused mentorship approach in Rangpur and Lalmonirhat that has led to a 50% improvement in Knowledge, Attitude, Practice and Skills (KAPS) among midwives and Family Welfare Visitors.
Technical experts from Jononi and the Obstetrical and Gynecological Society of Bangladesh described the model as both scalable and sustainable for reducing preventable maternal and newborn deaths.
Dr Abu Hena Mohammad Raihanuzzaman Sarkar, deputy director (PHC) at the Directorate General of Health Services (DGHS), said that while institutional deliveries have increased nationally, “adolescent pregnancy in Rangpur remains a major concern,” stressing the need for stronger facilities and supply-chain readiness.
DGHS Director-General (Planning and Development) Dr Sheikh Sayidul Haque said primary healthcare must become more integrated and evidence-driven to transform outcomes at scale.
Jononi Project Director Dr Uzzal Kumar Roy told Dhaka Tribune that deep-rooted cultural practices continue to drive home births and unreported complications.
Through partnerships with government bodies, local authorities, and cultural groups, the project is using household visits, courtyard sessions, and traditional performances—including jari gaan, pala gaan, and street theatre—to discourage child marriage and promote safe delivery.
Strengthening 40 union-level health facilities has already boosted institutional delivery numbers, with about 11,000 births recorded between 2023 and July 2025.
