Gender and Power Analysis for Strengthening the Maternal and Neonatal Health System in Rangpur, Bangladesh (Jononi) Project

The “Strengthening the Maternal and Neonatal Health System in Rangpur, Bangladesh (Jononi) Project,” a five-year initiative (March 2023 – December 2027) led by Save the Children and funded by KOICA, aims to improve maternal and neonatal health (MNH) outcomes across 13 upazilas of Rangpur and Lalmonirhat districts. Through a comprehensive gender equality and power analysis, the study identifies critical barriers and enabling factors that impact women’s and girls’ access to MNH and sexual and reproductive health rights (SRHR) services.

Employing a mixed-method approach, the study engaged 600 survey respondents and 268 participants in FGDs, IDIs, and KIIs. Findings reveal that deep-rooted gender norms, child marriage, lack of autonomy, social taboos around menstruation and contraception, and the unequal distribution of household responsibilities severely limit women’s access to institutional healthcare. Power dynamics at the household and community level show that men and in-laws dominate healthcare decision-making, and traditional beliefs often override medical guidance. Moreover, adolescent girls and marginalized groups face multiple layers of exclusion, including mobility constraints, poor health literacy, and fear of violence.

Despite challenges, positive shifts were observed, such as increased dialogue on contraception and prioritization of pregnant women’s healthcare in some families. Community committees like CMPCs and NNPCs have potential to enhance accountability but require capacity-building and stronger linkages with local governance structures.

Key recommendations include revising the project’s Theory of Change, promoting counter-narratives to harmful cultural practices, training stakeholders on gender and power dynamics, enhancing data systems, and improving service accountability through community engagement and advocacy. Addressing social norms, enabling legal frameworks, and fostering women’s agency are essential to achieve the project’s long-term goal of reducing maternal and neonatal mortality in northern Bangladesh.