Bangladesh “On the Move to Better Health”
On April 17, 2012, the preliminary results of the 2011 Bangladesh Demographic and Health Survey (BDHS) were announced and celebrated. The 2011 BDHS is the sixth national survey designed to provide representative information on demographic and maternal and child health. Data are collected through household and community surveys. The DHS series is conducted regularly in over 80 countries worldwide. To learn more about the survey design, sampling strategy, and implementation of the 2011 BDHS, read the Preliminary Report.
The preliminary results indicate that Bangladesh is indeed on the move to better health with notable progress in family planning, maternal and child health, and nutrition, but there are also still significant gaps and areas for improvement.
Fertility continued to decline to 2.3 children per woman in 2011, down from 2.7 in 2007. Two generations ago, the average woman had six or seven children, but the modern woman now has on average only two. Social norms are changing, and 82% of women with two children do not want to have any more. In one of the most densely populated countries in the world, declining fertility is great news. Families with fewer children are healthier, can more effectively prioritize their resources, and have less impact on the environment.
However, the BDHS also reveals gaps and needs. Women want fewer children, but the use of highly effective long-acting and permanent methods (LAPMs) is still low. The majority of women of reproductive age (65%) do not want to have more children, but only 8% are using LAPMs. Implants, IUDs, and male and female sterilization are available, but underutilized. There is a huge need in Bangladesh for information and communication around LAPMs. Communication has had an important role in influencing the increasing preference for small families, and it can also influence the way families achieve and maintain their preferences. The message that LAPMs are safe, highly effective, and convenient for maintaining small families should be reinforced through a variety of channels, including TV, radio, folk songs, and health provider counseling, in order to increase the demand for these methods.
Norms are also changing with regard to childbirth and delivery. Nearly a third of births in the three years prior to the survey were assisted by a skilled provider, twice as many as in 2004. However, there is still a significant equity gap; 60% of women in the highest wealth quintile delivered with a skilled provider, whereas only 10% of women in the lowest wealth quintile did.
Childhood mortality is decreasing, and Bangladesh is on track to achieve the MDG 4 target for under-5 mortality by the year 2015. Though trends are positive, currently, one in nineteen children born in Bangladesh dies before their fifth birthday, which is still quite high.
The preliminary report of the 2011 BDHS revealed both advances and gaps in health. With coordinated communication, improved training for health providers, and strengthened service delivery, Bangladesh will continue and accelerate its improvements for a healthier and more prosperous nation.