Bangladesh – Reducing child mortality rates
Bangladesh population consists of 150 million people, out of which 49% live below the poverty line. The poor migrate to cities, in search of economic opportunities than of social services. According to the Multiple Indicator Cluster Survey, 2009, the social indicator of urban slums is worse than those of rural areas. In addition, there is a low social status of women in the Bangladeshi society.
However, Bangladesh, a low-income country has successfully managed to lower their under-five mortality rates by more than two-thirds between 1990 and 2011. Among under-fives, 54 deaths were recorded for every 1,000 live births in 2008, a significant decrease from the rate of 146 deaths in 1991. The Millennium Development Goal for Bangladesh is to reduce the under-five child mortality to around 48 deaths per 1,000 live births by 2015.
Bangladesh has made significant progress in reducing the child mortality rate although it is far below the related Millennium Development Goal target. The United Nation said that Bangladesh has made “remarkable progress” in reducing the under-five mortality rate over the last two decades still a “significant number” of children are still severely malnourished.
A recent survey done by Bangladesh Maternal Mortality Survey, 2010, shows a rate of 194 deaths per 100,000 live births representing 40 percent reduction over the last decade. According to the United Nations Millennium Declaration, 2005, the reason behind the rapid decline in infant mortality in Bangladesh is successful family planning program. In addition, over the past two decades, the country has progressed in expanding child immunization coverage.
Bangladesh experience shows that it is possible to bring about fertility and mortality decline in poor countries even in the absence of strong economic growth and improved socio-economic conditions.
Child malnutrition is another important factor to infant and child mortality. In Bangladesh, child malnutrition rates are very high. According to the Household Income and Expenditure Survey, 2005, 40% of the population does not obtain the minimum level of dietary energy. In 1990, 63% children were underdeveloped and 62% children were underweight. At present, 43% of children are underdeveloped (low height for age) and 41% are underweight (Bangladesh Demographic and Health Survey, 2007).
Over the last 15 years, the rate of breastfeeding has remained stagnant at 43% (Bangladesh Demographic and Health Survey, 2007). Reasons: inadequate feeding and caring practices and food insecurity. According to the Institute of Public Health Nutrition, World Food Programme and UNICEF-Household Food Security and Nutrition Assessment, 2009, children aged 6-23 months have higher rates of malnutrition problems than children ages 25-59 months, indicating poor feeding practices.
In 2003, only 40% mothers received antenatal care. At present, half of mothers (53%) receive antenatal care from skilled providers. Health care links with household wealth and educational background. Access of health care is lower in poor urban and rural areas. The major health systems problems are lack of access to health facilities, staff shortages, insufficient supplies, and inadequate supervision and monitoring. Due to insufficient funds and lack of knowledge amongst the poor, the demand for and use of health services is less.
However, Bangladesh has made impressive progress in reducing child underweight rates during the last 15 years. The Government has had several nutritional intervention programmes going back to the 1970s. These include Food for Work (FFW), Test Relief (TR), Food for Education (FFE), Gratuitous relief (GR) and Vulnerable Group Feeding (VGD).
Yet, Bangladesh is far from achieving the child mortality-related Millennium Development Goal. They will have to strive very hard to achieve that goal. However, with the right type of contribution for achieving strong economic growth, expansion of female schooling, family planning programs that motivate women to delay child-bearing, expanded child immunization coverage and prevention of child malnutrition, the child mortality related Millennium Development Goal could be achieved easily.