Abstract: Averting the devastating majority of maternal mortality, BRAC initiated an intervention

named Manoshi in 2007; maternal, neonatal and child health programme for the urban poor of Dhaka city.

It established delivery centres (DC) to provide clean and safe delivery services by community health

workers (CHW) as well as referring maternal and neonatal complications to equipped hospital.

Methods: The study aimed to measure the performance of DCs and explore the factors related to

its performance. Data were collected using qualitative methods during December 2009 – January 2010 from

six DCs in the slums of Dhaka city. Findings: Findings revealed that the DCs at Magbazar and

Kamrangir Char performed ‘well’ due to availability of CHWs, their emotional support and caring attitude,

regular antenatal care (ANC) visits, convenient location, cleanliness and free services of the DCs.

The DCs at Madertek and Shyampur performed ‘average’ and Ramna and Kotwali DCs performed

poor. Poor performance was largely due to lack of CHWs, less motivation, frequent dropout due to low

remuneration, and recurrent slum demolition. The reasons for women not attending DCs were fear of

being referred to the hospital which might compel them to have a caesarean delivery, lack of

comprehensive services at DCs including doctorassisted normal deliveries, medicines, and emergency

case management. Neonatal mortality rate in poor performed DCs found to be high. The respondents

recommended that instead of referring women for minor complications, DCs should be competent of

providing supervised skilled service package with basic treatment during childbirth, tetanus toxoid

during ANC and child immunizations during postnatal care. Conclusions: Given the existing

scenario, the programme needs to pay attention to the ‘poor’ performed DCs with developing alternative

strategies to enhance collaboration with existing health facilities and emphasizing community

mobilization on ANC, safe delivery and strengthen appropriate referral for obstetric and neonatal

complications. Keywords: Childbirth; delivery centre; factors; performance