Infant mortality rate in the country is not decreasing. For every 1000 births, 30 infants die before reaching 28 days of age. Five years ago this rate was 28. The condition of one-year-old or five-year-old children is not good either.
These figures appeared in the Bangladesh Demographic and Health Survey (BDHS) 2017-18 report. The report said that in the past the mortality rate of one-year-old children had steadily decreased, but has come to a standstill over the last five years. In 2014 the mortality rate of one-year-olds had been 38 and it remains the same. The report was made public on Saturday.
The health directorate and family planning directorate deal with child health development. Line director of the health directorate’s Mother Neonatal Care and Adolescent Health (MNC&AH) programme Shamsul Huq told Prothom Alo that he was unaware of the contents of the report. He was unwilling to comment on why the mortality rate of newborns or one-year-olds was not decreasing.
Meanwhile, line director of the Maternal and Child Health Services of the family planning directorate, Mohammad Sharif, said that a comprehensive neonatal emergency service programme had been put in place and the situation had begun to improve.
Experts have said that the expanded immunisation programme, the diarrhoeal disease control programme and the nutrition programme played a role in improving child health. The deworming and Vitamin A programme also had improved children’s health. Infant mortality rate was further lessened by obstetric programmes for safe delivery.
At one time the donor community and NGOs had extensive programmes for child health development, but these are steadily shrinking. Many hospitals and clinics do not provide the necessary emergency services. There is also a lacking in quality service.
The BDHS report (2017-18) was prepared by the National Institute of Population Survey and Training (NIPORT). As always, the survey was funded by USAID, with technical support from ICF, also of the US.
The survey covered 20,250 thanas of 679 sample areas in 64 districts. Also, 20,100 women of the 15 to 49 age bracket were interviewed. The private organisation Mitra and Associates collected the data between October 2017 and March 2018. The last survey was done in 2014.
There have been eight surveys since 1993. These reports are considered to provide the most reliable data concerning Bangladesh’s child health, nutrition, population and such topics.Infant mortality trends
The report said that the infant mortality rate works as an indicator of a country’s socioeconomic condition and quality of life. An important objective of the BDHS 2017-18 survey was to measure the rate and trends of of infant mortality.
An infant is considered newborn up till 28 days. In 2007 the neonatal mortality rate was 37. The rate began to fall in the reports after that. In 2014 this was 28. This is now 30. The mortality rate of one-year-olds had decreased in the past too.
Chairman of the neonatal department at Bangabandhu Sheikh Mujib Medical University and chairman of Bangladesh Medical and Dental Council Mohammad Shahidullah told Prothom Alo the situation cannot change with the existing services. The services must be expanded and the quality of services must be improved. Neonatal deaths would decrease with an increase in pre-delivery care and institutional delivery for the mothers.Family planning in bad shape
Bangladesh has achieved success in the population sector by reducing the total fertility rate or TFR. TFR means the number of children given birth by a reproductively capable woman of 15 to 49 years of age. In 1971 a woman would give birth to over 6 children on average and the TFR then was 6.3. The condition hasn’t been decreasing since 2011.
The new survey stated that the rate of contraceptive use had come to a standstill. In 1975, a total of 8 per cent of the fertile couples used one contraceptive method or the other. The rate of contraceptive use increased every year from then. In 2011 it has reached 61 per cent. In 2014 it saw a slight increase to 62 per cent. Presently it remains at 62 per cent.
Experts said that the house-to-house visits by family planning workers and media publicity had taken the birth control programme ahead. Presently there are many vacant posts in birth control services at the field level. Many of the field workers have aged and no longer go from house to house. Publicity is on the wane too.
Chairman of Dhaka University’s population sciences department Mainul Islam, speaking to Prothom Alo, said TFR was higher in very young mothers. Unless child marriage could be prevented, TFR would not go down. The programmes would also have to be strengthened in Sylhet, Mymensingh and Chattogram.Improvement in child nutrition
The BDHS 2017-18 report indicates an improvement in child nutrition. The number of children with stunted growth caused by malnutrition has reduced.
The rate of underweight children has also gone down. In 2007 it was 41 per cent and is now 22 per cent.