Published: Sunday, September 22, 2013
Report shows Bangladesh’s outstanding success over 22 years
Children don’t die in big numbers in Bangladesh now as they did 22 years ago.
The country is preventing over 1,100 child deaths a day, thanks to a successful reduction in child mortality by 72 percent in last two decades.
Back in 1990, as many as 1,454 children used to die a day even before they could reach their fifth birthday. Now that number has come down to 347.
According to a report jointly released by the United Nations Children’s Fund (Unicef), the World Health Organization (WHO), the World Bank and the United Nations Population Division last week, Bangladesh has outshone all its South Asian neighbours save the small island nation the Maldives in terms of reduction in child mortality.
By slashing 89 percent between 1990 and 2012, the Maldives topped child mortality reduction chart in South Asia followed by Bangladesh (72 percent) while India and Pakistan remain among the biggest contributors to global child mortality, said the report titled “Levels & Trends in Child Mortality”.
The report, published as part of the UN Inter-agency Group for Child Mortality Estimation’s (UN IGME) annual data release on child mortality, identified India, Pakistan, Nigeria, Congo and China as the five countries where half of over 6.5 million global yearly child deaths occur.
India has the highest number of under-five deaths in the world, with 1.4 million under-five deaths in 2012.
The Unicef, WHO, the WB and UN Population Division are the four partners in the UN IGME, founded in 2004.
In the last 22 years (1990-2012), global rate of under-five mortality came down from 90 to 48 (per 1,000 live births).
By reducing its own under-five mortality rate from an astounding 144 to 41 during the same period, Bangladesh has made significant strides in minimising the preventable child deaths.
Bangladesh’s child deaths dropped from over 0.5 million a year (1990) to 0.12 million in 2012.
Cutting the world child mortality rate by one-third (from the 1990 bench year) is a key millennium development goal (MDG-4) that Bangladesh had already attained four years ahead of target year 2015.
However, Unicef in its child survival progress report 2013 warned that at global level the MDG-4 goal would not be reached until 2028 if the current trends continue.
“The cost of inaction is alarmingly high — as many as 35 million more children could die mostly from preventable causes between 2015 and 2028, if the global community does not take immediate action to accelerate progress,” reads the Unicef report, also published earlier this month.
Projecting Bangladesh as a country-level progress example, Unicef said, “In Bangladesh, under-five mortality rate decreased by 72 percent from 1990 to 2012, mainly thanks to expanding immunisation for children, delivering oral rehydration therapy to treat diarrhoea, and providing Vitamin A supplementation.
“Expanding a network of community health workers also improved the quality of healthcare and led to an increased use of health facilities. Women’s empowerment, education for mothers, improving mothers’ health, and implementing strategies to reduce poverty also contributed to reducing child deaths.”
Talking to The Daily Star yesterday, Director of the Centre for Medical Education Prof Dr Fatima Parveen Chowdhury attributed the success to building public awareness, extensive coverage of vaccination and vitamin A supplementation, high-level political commitments as well as active participation of non-government development organisations in various child survival interventions.
Fatima, also a former director of the Institute of Public Health Nutrition (IPHN), said increased habit of exclusive breastfeeding by lactating mothers had a pivotal role in dropping down the under-five deaths. Since 2007, the percentage of exclusive breastfeeding among children under six months in the country has risen from 43 percent to 64 percent, she noted.
As per the UN IGME report, Bangladesh also succeeded in reducing the infant deaths from 365 (in 1,000 live births) in 1990 to 102 in 2012. But the rate of neonatal deaths (76 in every 1,000 live births) remains high. Infant mortality is rated on probability of dying between birth and one-year age while neonatal deaths are rated on probability of dying in the first month of life.
“Absence of skilled (child) delivery persons and lack of sufficient antenatal and postnatal care cause such high number of neonatal deaths,” explained Dr Fatima, also secretary of Bangladesh National Nutrition Council.