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The Maternal Aid Association (MAA) has devised a primary healthcare model to revolutionise maternal healthcare in rural Bangladesh. This is known as the Hub-Spokes (HS) model. The HS model has been designed to educate a population, specialise the workforce and connect rural communities to a healthcare system. The main aims are to bring together a fragmented health system; access the remote and resource-poor populations, and add practical innovation and essential targeted resources to the field. To achieve this, MAA aims to reduce the delays pregnant women experience in a) deciding to seek care, b) reaching care and c) receiving adequate healthcare, as highlighted in the Three-delay model.

Intrauterine programming, which refers to the effects of womb conditions on a developing foetus, under such maternal conditions can lead to the retention and expression of degenerative health pre-dispositions in future generations due to increased genetic risk (Fowden, Giussani & Forhead, 2006, Kapur, 2015). If this issue is not addressed, this vicious cycle is likely to continue and hinder Bangladesh from achieving MDGs 4 (reducing child mortality) and 5 (improve maternal health) and SDG 3 (good health and well-being)(UN, 2015b, UN, 2015a).

Moreover, the newborn and foetal complications that arise from pregnant women with NCDs and related risk factors are also severe. For example, pregnant mothers who are obese have an increased risk of stillbirths and congenital malformations amongst other obstetric and neonatal complications (Akil & Ahmad, 2011, Kapur, 2015). Plus, these mothers will be more likely to develop gestational diabetes mellitus, which is a risk factor for developing type 2 diabetes in both the later life of the mother and child (Damm et al., 2016, Song et al., 2018). Additionally, being overweight or obese during pregnancy not only increases the risk of developing diabetes, hypertension and cardiovascular disease, but also increases the risk of pre-eclampsia and postpartum haemorrhage, which are two of the most common causes of maternal mortality in Bangladesh (Khatun et al., 2012, Kapur, 2015, Roy & Shengelia, 2016).

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