Birth rate static, child mortality rate declines
The country's birth rate remains static at 2.3 since 2011, the year when the rate of 2 was set to be achieved by 2016.
A very insignificant advancement in contraceptive use is the reason for this stationary birth rate.
The use of contraceptive among the married women [aged 15-49 years], between 2011 and 2014, rose by a meagre one percent to stand at 62, still trailing by 10 percent from 2016's target of 72.
However, not everything is bleak in the preliminary findings of the Bangladesh Demographic and Health Survey (BDHS), 2014, which was presented at the Radisson Blu Hotel in Dhaka yesterday.
Success came in the forms of under-five child mortality rate and stunting [height for age] reduction as Bangladesh could achieve targets in both these areas two years ahead of 2016.
A target was set to reduce under-five child mortality to 48 deaths per 1,000 live births by 2016 from 53 in 2011. Bangladesh has already lowered the rate below 46.
Similarly, the rate of stunted children has reduced to 36 in 2014 from 41 in 2011 against a set target of 38 by 2016.
The experts attributed the no-change in birth rate since 2011 in an over-populated country of nearly 160 millions to the almost static contraceptive usage.
They also pointed out very high birth rates in Chittagong and Sylhet divisions.
While the total fertility rates in Khulna, Rajshahi and Rangpur divisions range between 1.9 and 2.1, it is 2.5 to 3.1 in Chittagong and Sylhet. In Dhaka and Barisal the range is 2.2 to 2.3.
The National Institute of Population Research and Training (NIPORT) conducted the seventh BDHS between June and November last year with support from the USAID Bangladesh.
The survey was based on data collected from about 17,000 married women aged between 15 and 49 from across the country.
“The birth rate remains static simply because contraceptive use has not really increased much,” said Peter Kim Streatfield, scientist at the ICDDR, B.
Of all forms of contraceptive methods, the use of pills stands highest at 27 percent, while long-term and permanent birth control method is only 8 percent.
“Pills are not a very effective method in the families where husbands work in the cities or abroad and wives stay at villages,” said Streatfield, explaining that a wife may forget to take pills when her husband comes home, leading to unexpected pregnancy.
Long-term and permanent methods, which are not very available, need to be promoted, he suggests.
Chittagong, Sylhet and Dhaka divisions need to be given special emphasis in terms of making contraceptives and other health services available, the population expert observed.
The BDHS said underweight (weight for age) came down to 33 percent from 36 in 2011 and infant mortality dropped to 38 from 43.
At least 37 percent of the babies were delivered at health facilities in 2014, which was only 17 percent in 2007 and 29 percent in 2011.
However, 22 percent of the deliveries were made at private facilities and 13 percent at public facilities, said researcher Kanta Jamil, presenting a part of the survey.
“In 2014, 23 percent of the babies were delivered by C-section. Urban women are twice more likely than rural women to have C-sections,” she added.
However, vitamin-A supplementation last year was only 62 percent, witnessing a 2 percent rise from 2011, whereas the target is 90 percent by 2016.
Measles vaccine for children under 12 months stands at 80 percent, witnessing a 4 percent decline from 2011. Besides, acute respiratory infection treatment during this time declined from 71 percent to 34 percent in 2014, according to the survey.
Moreover, exclusive breastfeeding for six months, which is termed crucial for child nutrition, has declined from 64 percent in 2011 to 55 percent last year.
Ishtiaq Mannan, chief of a section of Mamoni Health Systems Strengthening Project, said many of the health indicators in the low quintile of the population and Sylhet and Chittagong regions were not really good.
He suggested that the health facilities for the grassroots be strengthened.
Health Minister Mohammed Nasim said while Bangladesh progressed in many aspects of health, there were a number of shortcomings as well. He called upon all medical personnel to work sincerely to improve the situation.
State Minister for Health Zahid Maleque, US Ambassador Marcia Stephens Bloom Bernicat, USAID Bangladesh Mission Director Janina Jaruzelski and NIPORT Director General Wahid Hossain also spoke at the programme chaired by Health Secretary Syed Monjurl Islam.
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