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Experience Using Data from DHSto Shape Policy and Planning at

National Level in Bangladesh

SESSION 3D-1

17 April 2013

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Bangladesh

Population (2011) 150 million

Density 1015 per sq KM Per capita income US$848

Births per year 3.4 million

Newborn deaths per year 105 thousand

Maternal deaths per year 7,300

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Bangladesh Demographic and Health

Survey (BDHS)

A nationally representative survey provides estimates for

The whole country

Urban and rural areas

Administrative divisions 6 rounds of BDHS since 1993 with an interval of 3-4 years,

last one in 2011

All surveys collected information on newborn survival

Data on causes of deaths were collected in 2004 and 2011

Last 2 surveys (2007 & 2011) collected data on newbornhealth

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52 4842 41 37 32

3534

24 24

1510

46

34

2823

13

11

12-59 Month Deaths/1,000 LB

1-11 Month Deaths/1,000 LB

Neonatal Deaths/1,000 LB

D

eathsper1,0

00

liv

e-births

1989-93 1992-6 1995-9 1999-2003 2002-6 2007-11

133

116

9488

65

53

39%

60%

Source: BDHS 2011 policy briefs

Reducing neonatal mortality is key to

future progress

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Source: BDHS 2011 policy briefs

0-28 d

Possible

serious

infection24%

Birth

Asphyxia

21%

BirthInjury

4%

Other

7%

Pneumonia13%

Prematurity

/LBW 11% Undefined

20%

Infection and

pneumonia 38,000

Birth asphyxia 21,500

Preterm birth 12,000

Annual number of deaths:

Neonatal Deaths

Causes of neonatal deaths

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Use of BDHS data for decision making

Monitoring of health sector program

Neonatal mortality: Baseline 2011 32/1,000 LB

Target 2016 21/1,000 LB

Plan and implement interventions

piloting of kangaroo mother care

prevention and treatment of newborn sepsis

helping baby breath

designing community-based programs

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62

17

43

51

33

28

47

Dried within 5

minutes of birth

Wrapped within 5

minutes of birth

Bathed 72+ hours

after birth

Breastfed wthin 1

hour of birth

2007 BDHS 2011 BDHS

Percent non-institutional births

in the three years preceding the survey

Monitoring implementation of nationalneonatal health strategy

Source: BDHS 2011 final report 7

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Forum or venue of data use

National dissemination of survey results Policy presentation at national level

Regional dissemination

Targeted audience Policy discussion with policy makers, program

managers and development partners

Sharing results with: Health sector program review team

Professional bodies Media: Health reporter

Medical students and private practitioners

Discussion with program personnel and opinionleaders in low performing areas

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Outcome of data use

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Data showed that to reachMDG 4, Bangladesh needed toreduce neonatal mortality

This led to:

advocacy for developmentof the Bangladesh NeonatalHealth Strategy 2009

introduction of programsto improve newborn care

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Outcome of data use

Causes of death data helped scale up of

interventions at national level

Promote facility deliveries and home deliverieswith skilled assistance to reduce asphyxia deaths

Rolled out the Helping Babies Breathe initiative

nationally

Strengthen community mobilization for

management of neonatal sepsis10

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High level response

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BUDGET SPEECH 2012:

According to BDHS 2011, under-5 mortality rate has been reducedto 53 from 65 per thousand over the past four years. Currently, one

third of women receive the assistance of the trained health workersduring child birth. To increase this number further,

taking initiative to train 40,000 health workers of various tiers

Maternal Health Voucher Scheme will be expand to another

27 sub-districts

24-hour emergency maternal care service will be provided in

96 sub-district health complexes.

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Lessons learned

Highly acceptable: BDHS addresses country specific needof health sector program and national strategies

Quality: Survey design and implementation is a collective

responsibility of technical working group and data users

Useful: Policy discussion by program experts

Easily accessible: Reach various stakeholders for ensuringwide utilization of data

Challenging: Advocacy for shaping evidence-based policyand programs

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