Bangladesh Health System and the Millennium Development Goals: Strategic Policy Options for Sustained Progress in Maternal and Child Health

Abstract

Abstract:The timeline set by the United Nations in achieving the Millennium Development Goals (MDGs) pronounced in the year 2000 is coming to end in 2015. While the United Nations has already came up with a new set of 17 Sustainable Development Goals (SDGs) to follow the MDGs, efforts are underway to assess the success and failures of countries in achieving the MDGs. Bangladesh has made tremendous progress in achieving most of the MDGs including those related to maternal and child health. The maternal mortality ratio and the infant mortality rate in Bangladesh declined from 507 and 149 in 1990 to 209 and 53 in 2010 respectively. However, district level review suggests that numerous constraints and challenges confront the health system in sustaining these achievements. Moreover, desegregated data strongly indicate that the progress is even across different regions of the country. Most importantly, significant gaps still persist between the rich and the poor. For example, while the overall IMR is 43 per 1,000 live births among the highest income quintile, the figure is 84 among the lowest income quintile. In other words, Bangladesh must forcefully address regional disparity and rich-poor gap to ensure sustainable and equitable development in all aspects of health. The study identified a few strategic policy directions for this purpose including aggressive pro-poor and sub-national development planning. To ensure availability of and accessibility to primary health care for all, the study strongly argues for the establishment of community clinics throughout the country equipped with skilled midwives and adequate number of community health workers.

Individual and community-level factors associated with skilled birth attendants during delivery in Bangladesh: A multilevel analysis of demographic and health surveys

“…Moreover, Southern Asia has the second-highest maternal mortality rate, leading to the global burden of maternal mortality [ 2 ]. Bangladesh’s maternal health had remarkably improved over the past years based on Millennium Development Goal (MDG) targets in 2015 [ 3 – 5 ]. The country is on track to achieve the Sustainable Development Goals (SDGs) [ 6 , 7 ].…”

Antenatal care and skilled birth attendance in Bangladesh are influenced by female education and family affordability: BDHS 2014

“…For example, the maternal mortality ratio (MMR) and infant mortality rate per 100,000 live births declined from 507 to 149 in 1990 to 209 and 53 in 2010, respectively. 4 As such, the country is also believed to be on the track to achieve the Sustainable Development Goals (SDGs). 5e8 One of the objectives of Bangladesh National Strategy for Maternal Health 2014e2024 is to bring down the current MMR of 176 per 100,000 live births to 50 by 2024.…”

Socio-Economic Inequality of Chronic Non-Communicable Diseases in Bangladesh

“…[10–12] More than 70% of the population currently lives in rural areas, [13] where healthcare resources are most limited, and nearly half of the population subsists on less than US$1.25 per day [14]. Bangladesh spends only 3.5% of its GDP on health, and 63% of all health expenditure is from out-of-pocket expenses [15].…”