25
BANGLADESH
BANGLADESH
26
BANGLADESH
List of Country Indicators
Selected Demographic Indicators
� Selected demographic indicators � Birth registration
Child Mortality and Nutritional Status
� Trends in neonatal, infant and child mortality rates � Mortality rates by residence
� Distribution of neonatal deaths by day of life � Perinatal mortality
� Causes of under-fi ve and neonatal deaths � Trends in nutritional status of children
� Nutritional status of children by age
Coverage of Core InterventionsNewborn health and related maternal health
� Proportion of neonates protected against � Trends in proportion of women receivingtetanus at birth antenatal care
� Trends in proportion of deliveries assisted � Proportion of births by persons providing by skilled birth attendants assistance during childbirth
Infant and Young Child Nutrition
� Proportion of infants who started breastfeeding � Proportion of children <6 monthswithin one hour of birth exclusively breastfed
� Proportion of infants age 6-9 months receiving � Proportion of children age 6-59 months receiving breast milk and complementary food two doses of vitamin A during calendar year: trends
Immunization
� Trends in immunization coverage
Management of Sick Children
Management of diarrhoea� Proportion of children under age 5 with diarrhoea for � Proportion of children under age 5 with
whom advice or treatment was sought from a diarrhoea who received ORS: trendshealth facility or provider: trends
� Proportion of children under age 5 with diarrhoea whowere given treatment other than ORT
Management of pneumonia� Proportion of children under age 5 with symptoms of � Care-seeking for suspected pneumonia by type of
pneumonia for whom advice or treatment was sought health providerfrom a health facility or provider and receivedantibiotics
Management of malaria� Use of insecticide-treated bed nets � Malaria treatment
Water and Sanitation
� Proportion of population using improved � Proportion of population using improved drinking water sanitation facilities
Coverage across life-course
� Coverage of interventions across the continuum � Missed opportunities for the delivery of lifesaving of care in life course interventions
Socio-economic Diff erentials
� Demographic and Social Differential for Newborn � Differentials in Newborn and Child Health
and Child Health
� Differentials by Geographical Regions
27
BANGLADESH
Selected Demographic Indicators
Source: 1. United Nations Children's Fund. State of the world’s children 2012: children in an urban world. New York: UNICEF, 2012.
2. The UN Inter-agency Group for Child Mortality Estimation (IGME). Levels and Trends in Child Mortality: Report 2013.
3. National Institute of Population Research and Training (NIPORT), Mitra Associates, and ICF International. Bangladesh Demographic and Health Survey 2011. Dhaka, Bangladesh and Calverton, Maryland, USA: NIPORT, Mitra and Associates, and ICF International, 2013.
Total population (000) 148,6921
Total under-fi ve population (000) 14,7071
Annual births (000) 3,0381
Birth registration (%) 101
Neonatal mortality rate (per 1000 live births) 242
Annual number of neonatal deaths 76,0002
Post Neonatal Mortality rate 103
Infant mortality rate (per 1000 live births) 332
Annual number of infant deaths 1020003
Under-fi ve mortality rate (per 1000 live births) 412
Annual under-fi ve deaths 127,0002
Crude birth rate 22.63
Total fertility rate 2.33
•• A small proportion of
births are registered.
Registration of births is
slightly higher in urban
areas as compared to
rural.
Birth registration, 2000-2010
Source: United Nations Children's Fund. State of world’s children 2012: children in an urban world. New York: UNICEF, 2012.
Per
cent
100
908070605040302010
0
10
Total Urban Rural
139
28
BANGLADESH
• Fewer neonates are dying now. Neonatal mortality decreased by 50% over the two decades between 1990 and 2012–more than 2% per year.
• Between 1990 and 2012, infant mortality declined by 67 and under-fi ve mortality by 103 points.
• Millennium Development Goal (MDG 4) target for under-fi ve mortality rate has already been achieved by Bangladesh.
• Under-fi ve mortality rate in
rural areas is 10% higher than
in urban areas, while neonatal
and infant mortality rates are
similar in rural and urban
areas.
Mortality rates by residence
Source: National Institute of Population Research and Training (NIPORT), Mitra Associates, and ICF International. Bangladesh Demographic and Health Survey 2011. Dhaka, Bangladesh and Calverton, Maryland, USA: NIPORT, Mitra and Associates, and ICF International, 2013.
32 33 32
42 43 43
50
5553
60
50
40
30
20
10
0Neonatal
mortality rateInfant
mortality rateUnder-fi ve mortality
rate
Urban Rural Total
Child Mortality and Nutritional Status
Trends in neonatal, infant and
under-fi ve mortality rates, 1990 to 2012
Source: The UN Inter-agency Group for Child Mortality Estimation (IGME). Levels and Trends in Child Mortality: Report 2013.
U5MR IMR NMR Target
144160
140120100
80604020
0
88
4154
1990 1995 2000 2005 2010 2012 2015
24
33
100
MDG Target 48
29
BANGLADESH
Perinatal mortality rate
For 5-year period preceding the survey
Source: National Institute of Population Research and Training (NIPORT), Mitra and Associates, and ICF International. Bangladesh Demographic and Health Survey 2011. Dhaka, Bangladesh and Calverton, Maryland, USA: NIPORT, Mitra and Associates, and ICF International, 2013.
Number of stillbirths 232
Number of early neonatal deaths 220
Perinatal mortality rate 50
Distribution of neonatal deaths by day of life
Source: National Institute of Population Research and Training (NIPORT), Mitra and Associates, and ICF International. Bangladesh Demographic and Health Survey 2011. Dhaka, Bangladesh and Calverton, Maryland, USA: NIPORT, Mitra and Associates, and ICF International, 2013.
Based on 273 neonatal deaths
Number of days
Num
bers
120
100
80
60
40
20
0
101
36
18
< 1 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30
32
19
8 7 83 3 6 5 3 1 2 2 1 0 1 3 2 4 3 0 2 1 1 0 1 1 0 0
31
Of the 273 surveyed neonatal deaths for 2011 DHS in Bangladesh :
• 37% occurred on day 0;
• 50% occurred on days 0 and 1; and
• 81% occurred during the fi rst week of life.
The fi rst week of life is the riskiest for newborns. Most deaths during the neonatal period occur at home and are often unregistered.
30
BANGLADESH
Source: Source: Li Liu, Hope L Johnson, Simon Cousens, Jamie Perin, Susana Scott, Joy E Lawn, Igor Rudan, Harry Campbell, Richard Cibulskis, Mengying Li, Colin Mathers, Robert E Black, for the Child Health Epidemiology Reference Group of WHO and UNICEF, Global, regional, and national causes of child mortality: an updated systematic analysis for 2010 with time trends since 2000, The Lancet, Volume 379, Issue 9832, 9–15 June 2012, Pages 2151-2161
Causes of under-fi ve deaths Causes of neonatal deaths
Malaria, 0.6
Diarrhoeal diseases, 5.9 Measles, 0.6
Other, 4.3
Other, 16.3
Pneumonia, 15.9
Malaria, 10.7
Diarrhoea, 21.5
Neonatal, 27.3
Congenital anomalies, 7.6
Other noncommunicable diseases, 0.3
Injuries, 5.9
Acute lower respiratory
infections, 4.6
Birth asphyxia and birth trauma, 23.1
Sepsis and other infectious conditions of the newborn, 16.2
Prematurity, 44.5
Neonatal, 69.0
Other 13.6
• Neonatal causes, acute lower respiratory infections and diarrhoea are major causes of death among
under-fi ve children.
• Most neonatal deaths are caused by complications of prematurity, infections, birth asphyxia and trauma
and congenital anomalies.
Acute lower respiratory
infections, 13.7
31
BANGLADESH
• At the national level,
two in fi ve children are
stunted and underweight.
• Since 2004, stunting
among children has
declined by 10 percentage
points and underweight
by seven percentage
points.
• Wasting increased by one
percentage point during
the period 2004 to 2011.
Trends in nutritional status of children less than fi ve years
Source: 1. National Institute of Population Research and Training. Bangladesh demographic health survey 2007. Dhaka: NIPORT, 2009.
2. National Institute of Population Research and Training (NIPORT), Mitra Associates, and ICF International. Bangladesh Demographic and Health Survey 2011. Dhaka, Bangladesh and Calverton, Maryland, USA: NIPORT, Mitra and Associates, and ICF International, 2013.
(Based on the WHO Child Growth Standards adopted in 2006)
2004 2007 2011
Per
cent
Stunting Wasting Underweight
100
908070605040302010
0
5143 41
15 17 16
43 4136
Source: National Institute of Population Research and Training (NIPORT), Mitra Associates, and ICF International. Bangladesh Demographic and Health Survey 2011. Dhaka, Bangladesh and Calverton, Maryland, USA: NIPORT, Mitra and Associates, and ICF International, 2013.
Nutritional status of children by age, 2011
Per
cent
100
908070605040302010
0 <6
16.5
16
23.2
52.147.6 47
41.9
6-8 9-11 12-17 18-23 24-35 36-47 48-59
Stunted Wasted Underweight
18
14.8
17.4
13.9 15 16.914.9 15.9 16.2
41.442.939.838.633.6
27.8
24.4
46.4
Age (Months)
• The prevalence of stunting increases with age from 18% of children less than 6 months to 52% of children between ages 18-23 months and decreases thereafter.
• The percentage of children who are underweight increases sharply with age and peaks at 42.9% among children between ages 36-47 months.
32
BANGLADESH
•• The last birth was
protected against
neonatal tetanus for nine
out of ten mothers.
• About three in ten women do not receive any antenatal care. Only one-fourth of women make more than four ANC visits.
• There is a gradual increase in the number of ANC visits during the last decade.
Coverage of Core Interventions
Newborn health and related maternal health
Neonates protected against tetanus at birth
Source: National Institute of Population Research and Training (NIPORT), Mitra Associates, and ICF International. Bangladesh Demographic and Health Survey 2011. Dhaka, Bangladesh and Calverton, Maryland, USA: NIPORT, Mitra and Associates, and ICF International, 2013.
Women receiving 2+ TT injections
Women whose last birth was protected against neonatal tetanus
90%
42%
Trends in proportion of women who received antenatal care
*The value is for 2-3 visits
Source: 1. National Institute of Population Research and Training. Bangladesh demographic health survey 2007. Dhaka: NIPORT, 2009.
2. National Institute of Population Research and Training (NIPORT), Mitra Associates, and ICF International. Bangladesh Demographic and Health Survey 2011. Dhaka, Bangladesh and Calverton, Maryland, USA: NIPORT, Mitra and Associates, and ICF International, 2013.
70
60
50
40
30
20
10
0
Per
cent
63
4439
32
1216 16 15 13 13 14 14*
11 11 13 1116
2126
NoneNumber of ANC visits
1 2 3 4+
1999-2000 2004 2007 2011
33
BANGLADESH
• Three in ten deliveries
are assisted by skilled
birth attendants (SBA).
• The proportion of
deliveries assisted by
SBAs has tripled during
the period between
1993 and 2011.
• More than half of
births in Bangladesh are
assisted by untrained
traditional birth
attendants, and 4%
deliveries are assisted
by relatives, friends or
neighbours.
• About one-third births
are assisted by qualifi ed
health professionals.
Proportion of births by person providing assistance
during childbirth
Source: National Institute of Population Research and Training (NIPORT), Mitra Associates, and ICF International. Bangladesh Demographic and Health Survey 2011. Dhaka, Bangladesh and Calverton, Maryland, USA: NIPORT, Mitra and Associates, and ICF International, 2013.
TBA: Traditional Birth Attendants
Qualifi ed doctor
Nurse/midwife
Trained TBA
Untrained TBA
Relatives/friends
No one
100
908070605040302010
0
Per
cent
22.2
8.9 10.9
52.5
3.80.4
Deliveries assisted by skilled birth attendants
Trends in proportion of deliveries assisted by skilled
birth attendants
Source: 1. National Institute of Population Research and Training. Bangladesh demographic health survey 2007. Dhaka: NIPORT, 2009.
2. National Institute of Population Research and Training (NIPORT), Mitra Associates, and ICF International. Bangladesh Demographic and Health Survey 2011. Dhaka, Bangladesh and Calverton, Maryland, USA: NIPORT, Mitra and Associates, and ICF International, 2013.
1993-94 1996-97 1999-2000 2004 2007 2011
Period
100
908070605040302010
0
Per
cent
9.5 8 12 1318
32
34
BANGLADESH
• Almost half of children
are breastfed within one
hour of birth, which
increased from 9% in
1993 to 47% in 2011.
• Only a little less thantwo-thirds of children below 6 months are exclusively breastfed.
• Exclusive breastfeeding rate has practically remained constant since 1996 till 2007, and sharply increased afterwards.
Infant and Young Child Nutrition Trends in proportion of infants less than age 12
months who were initiated into breastfeeding within
one hour of birth
Source: 1. National Institute of Population Research and Training. Bangladesh demographic health survey 2007. Dhaka: NIPORT, 2009.
2. National Institute of Population Research and Training (NIPORT), Mitra Associates, and ICF International. Bangladesh Demographic and Health Survey 2011. Dhaka, Bangladesh and Calverton, Maryland, USA: NIPORT, Mitra and Associates, and ICF International, 2013.
9
1993-94 1996-97 1999-2000 2004 2007 201113 17
24
43 47Per
cent
100
80
60
40
20
0
Trends in proportion of infants less than age 6 months
who were exclusively breastfed
Source: 1. National Institute of Population Research and Training. Bangladesh demographic health survey 2007. Dhaka: NIPORT, 2009.
2. National Institute of Population Research and Training (NIPORT), Mitra Associates, and ICF International. Bangladesh Demographic and Health Survey 2011. Dhaka, Bangladesh and Calverton, Maryland, USA: NIPORT, Mitra and Associates, and ICF International, 2013.
Per
cent
100
9080706050403020100
45 4642 43
64
1996-1997 1999-2000 2004 2007 2011
35
BANGLADESH
• Almost all children, 6-59
months old, had received
two doses of vitamin- A
supplement and this
proportion increased by 15
percentage points between
2005 and 2008.
Trends in proportion of infants age 6-9 months
receiving breast milk and complementary food
*Age 7-9 months
Source: 1. National Institute of Population Research and Training. Bangladesh demographic health survey 2007. Dhaka: NIPORT, 2009.
2. National Institute of Population Research and Training (NIPORT), Mitra Associates, and ICF International. Bangladesh Demographic and Health Survey 2011. Dhaka, Bangladesh and Calverton, Maryland, USA: NIPORT, Mitra and Associates, and ICF International, 2013.
1999-2000* 2004 2007 2011
Period
Per
cent
100
9080706050403020100
59 62
74
67
• Among children 6-9
months old, seven in ten
receive complementary food
along with breast milk.
• Increasing trend in
complementary feeding
was observed from 59% to
74% between 1999-2007.
However, in 2011 a decline
has been observed.
Trends in proportion of children under age 5
receiving two doses of vitamin A during calender year
Per
cent
2005 2006 2007 2008
100
80
60
40
20
0
8289 94 97
Source: United Nations Children’s Fund (UNICEF). Maternal, newborn & child survival: country profi le. New York: UNICEF, 2010.
36
BANGLADESH
• Eighty-six per cent children,12-23 months old, had received all the recommended vaccinations.
• Almost all children had received BCG vaccination.
• The level of coverage for three doses of DPT, three doses of polio, and three doses of hepatitis vaccine is above 93%. Coverage is little low for measles vaccination.
• The vaccination coverage has doubled since 1993.
• Only one-fourth children with diarrhoea were taken to a health facility or a provider for advice or treatment.
ImmunizationTrends in proportion of children age 12-23 months
vaccinated
Source: 1. National Institute of Population Research and Training. Bangladesh demographic health survey 2007. Dhaka: NIPORT, 2009.
2. National Institute of Population Research and Training (NIPORT), Mitra Associates, and ICF International. Bangladesh Demographic and Health Survey 2011. Dhaka, Bangladesh and Calverton, Maryland, USA: NIPORT, Mitra and Associates, and ICF International, 2013.
All
5954
60
BCG DPT 3 Polio 3 Measles Hepatitis B
Per
cent
100
9080706050403020100
1993-1994 1996-1997 1999-2000 2004 2007 2011
73
8286 8586
919397 98
6669
72
81
9193
6762
71
82
9193
69707176
8388
81
93
Management of sick childrenManagement of diarrhoea
Trends in proportion of children under age 5 with
diarrhoea for whom advice or treatment was sought from
a health facility or provider
Source: 1. National Institute of Population Research and Training. Bangladesh demographic health survey 2007. Dhaka: NIPORT, 2009.
2. National Institute of Population Research and Training (NIPORT), Mitra Associates, and ICF International. Bangladesh Demographic and Health Survey 2011. Dhaka, Bangladesh and Calverton, Maryland, USA: NIPORT, Mitra and Associates, and ICF International, 2013.
1993-1994 1996-1997 1999-2000 2004 2007 2011
Per
cent
100
9080706050403020100
20 22 24
1620
25
37
BANGLADESH
• 29% children under age fi ve
who had diarrhoea were
given zinc syrup and 20%
were given zinc tablets.
Trends in proportion of children under age 5 who
had diarrhoea in the past 2 weeks and were treated
with ORS
50 48
6167
77 78
1993-1994 1996-1997 1999-2000 2004
Source: 1. National Institute of Population Research and Training. Bangladesh demographic health survey 2007. Dhaka: NIPORT, 2009.
2. National Institute of Population Research and Training (NIPORT), Mitra Associates, and ICF International. Bangladesh Demographic and Health Survey 2011. Dhaka, Bangladesh and Calverton, Maryland, USA: NIPORT, Mitra and Associates, and ICF International, 2013.
Per
cent
100
9080706050403020100 2007 2011
• In 2011, 78% children
with diarrhoea, who
were brought to a health
facility, received ORS.
• The proportion of
children receiving
ORS increased by 28
percentage points between
1993 and 2011.
Proportion of children under age 5 who had
diarrhoea in the past 2 weeks and were given
treatment other than ORT
Source: National Institute of Population Research and Training (NIPORT), Mitra Associates, and ICF International. Bangladesh Demographic and Health Survey 2011. Dhaka, Bangladesh and Calverton, Maryland, USA: NIPORT, Mitra and Associates, and ICF International, 2013.
Per
cent
100
9080706050403020100
29
20
11
Zinc syrup Zinc tablet No treatment
38
BANGLADESH
• One-third of children with symptoms of ARI were taken to a health facility or a medically trained provider for treatment and 71% received antibiotics as treatment from various sources.
• A substantial number of children with suspected pneumonia were taken to a traditional unqualifi ed doctor (29%), and pharmacy (22%), 17% such children did not seek any treatment.
Management of pneumonia
Trends in proportion of children under age 5 with
suspected pneumonia, who were taken to an appropriate
health care provider and received antibiotics
Source: National Institute of Population Research and Training (NIPORT), Mitra Associates, and ICF International. Bangladesh Demographic and Health Survey 2011. Dhaka, Bangladesh and Calverton, Maryland, USA: NIPORT, Mitra and Associates, and ICF International, 2013.
*Bangladesh Bureau of Statistics (BBS), United Nations Children’s Fund (UNICEF). Bangladesh Multiple Indicator Cluster Survey 2006. Bangladesh: BBS, 2007.
Per
cent
3525
3022
100
60
80
40
20
0
2833
2720
37
1993-1994DHS
1996-1997DHS
1999-00DHS
2004 DHS
2006MICS*
2007DHS
2011 DHS
% under-fi ves with suspected pneumonia taken to an appropriate health-care provider
% under-fi ves with suspected pneumonia receiving antibiotics
Care-seeking for suspected pneumonia by type of
health provider
Source: National Institute of Population Research and Training (NIPORT), Mitra Associates, and ICF International. Bangladesh Demographic and Health Survey 2011. Dhaka, Bangladesh and Calverton, Maryland, USA: NIPORT, Mitra and Associates, and ICF International, 2013.
Per
cent
100
908070605040302010
0Pharmacy Traditional
Doctor
Other No one
2229
1
17
39
BANGLADESH
• Slightly more than half of
the total population is using
improved sanitation facilities.
Use of insecticide-treated bed nets
Data not available
Proportion of population using improved drinking
water sources
Source: Progress on Sanitation and Drinking Water 2013 Update; WHO and UNICEF Joint Monitoring Programme (JMP 2013)
Per
cent
100
908070605040302010
0Urban Rural Total
85.382.4 83.2
Water and sanitation
• 83% population is using improved drinking water sources.
• The coverage of urban and rural populations is quite similar.
Urban Rural Total
Proportion of population using improved sanitation
facilities
Source: Progress on Sanitation and Drinking Water 2013 Update; WHO and UNICEF Joint Monitoring Programme (JMP 2013)
Per
cent
100908070605040302010
0
55.3 54.5 54.7
40
BANGLADESH
Coverage across life-course
Coverage of interventions across the life-course continuum
Source: National Institute of Population Research and Training (NIPORT), Mitra Associates, and ICF International. Bangladesh Demographic and Health Survey 2011. Dhaka, Bangladesh and Calverton, Maryland, USA: NIPORT, Mitra and Associates, and ICF International, 2013.
Pre-
pregnancy
Pregnancy Birth Postnatal Infancy
Per
cent
100
908070605040302010
0
52
2632
29 30
47
7164
Contraceptive prevalence
rate
ANC 4+ Skilled attendant at
birth
Delivery in a health
facility
PNC (within 2 days)
Breastfeeding initiated
within 1 hour of birth
Immunization Oral rehydration
for diarrhoea
Care seeking for pneumonia
Exclusive breastfeeding
(for fi rst 6 months)
86
78
• Around three in ten mothers receive skilled care before, during and immediately after birth which
can allow for early detection and management of problems leading to neonatal mortality.
• Proper medical attention and hygienic conditions during delivery can reduce the risk of
complications and infections that may cause death or serious illness to the baby. Only three out
of ten births took place in health facilities.
41
BANGLADESH
Missed opportunities for the delivery of lifesaving interventions
Source: National Institute of Population Research and Training (NIPORT), Mitra Associates, and ICF International, Bangladesh demographic and Health Survey 2011. Dhaka, Bangladesh and Calverton, Maryland, USA: NIPORT, Mitra Associates, and ICF International, 2013.
Vitamin A supplementation 97
Protection against neonatal tetanus 90
Breastmilk + complementary feeding 67
All vaccinations 86
Children having diarrhoea treated with ORS 78
Exclusive breastfeeding 64
Early initiation of breastfeeding 47
Care-seeking for pneumonia 35
Delivery by SBAs 32
PNC (within 2 days) 30
ANC4+visits 26
Given antibioties for suspected pneumonia 25
Care seeking for diarrhoea 25
0 10 20 20 40 50 60 70 80 90 100
Per cent
Missed opportunities
•• Low coverage for interventions during pregnancy and immediately surrounding birth, such as visits for antenatal care, services of skilled birth attendants, ensuring early initiation of breastfeeding and early postnatal check on health of the mother and newborn are the missed opportunities which have the potential for achieving higher levels of coverage and prevention of deaths.
• Focused interventions in the form of campaigns or outreach services, such as vitamin A supplementation, immunization and distribution of ORS packets have resulted in higher
levels of coverage.
• In comparison, those interventions that require 24-hour access to skilled health providers, such as treatment of childhood pneumonia or diarrhoea also have a large potential to contribute to saving of precious lives.
42
BANGLADESH
Sour
ce:
Nat
iona
l Ins
titut
e of
Pop
ulat
ion
Rese
arch
and
Tra
inin
g (N
IPO
RT),
Mitr
a A
ssoci
ates
, and
IC
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tern
atio
nal.
Ban
glad
esh
Dem
ogra
phic
and
Hea
lth S
urve
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11. D
haka
, Ban
glad
esh
and
Cal
vert
on, M
aryl
and,
USA
: N
IPO
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itra
and
Asso
ciat
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nd I
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Inte
rnat
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Dem
og
rap
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oci
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iff e
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ewb
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Mot
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Mot
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age
(ye
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Dif
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# Fo
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e gr
oup
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Rem
arks
• M
othe
r’s e
duca
tion
is a
maj
or d
eter
min
ant
of n
ewbo
rn a
nd c
hild
hea
lth. I
f the
m
othe
rs a
re n
ot e
duca
ted,
thei
r ch
ildre
n ar
e co
nsid
erab
ly d
isad
vant
aged
com
pare
d to
th
ose
who
se m
othe
rs a
re e
duca
ted
beyo
nd
seco
ndar
y le
vel:
- In
fant
s an
d ch
ildre
n un
der-
fi ve
year
s ar
e al
mos
t tw
ice
mor
e lik
ely
to d
ie e
arly
.
- T
hey
are
also
like
ly to
be
twic
e m
ore
stun
ted,
and
thre
e ti
mes
mor
e un
derw
eigh
t.
- T
hey
are
brea
stfe
d fo
r ha
lf th
e m
edia
n du
rati
on.
- T
hey
are
twic
e le
ss li
kely
to b
e ta
ken
to
a he
alth
faci
lity
or p
rovi
der
whe
n si
ck
wit
h di
arrh
oea
or h
ave
sym
ptom
s of
A
RI.
• C
hild
mor
talit
y is
link
ed d
irec
tly to
the
age
of th
e m
othe
r in
as
muc
h as
thos
e bo
rn to
yo
unge
r m
othe
rs (
< 20
yea
rs)
are
1.8
to 1
.5
tim
es m
ore
likel
y to
die
as
neon
ates
, inf
ants
an
d un
der-
fi ve
child
ren
com
pare
d to
thos
e bo
rn to
old
er m
othe
rs in
the
age
grou
p 20
–
29 y
ears
.
• C
hild
ren
born
in p
oor
fam
ilies
are
at a
hi
gher
ris
k of
dea
th a
s co
mpa
red
to th
ose
born
in r
ich
fam
ilies
.
Neo
nata
l mor
talit
y ra
te
32
39
26
32
33
45
26
34
23
Infa
nt m
orta
lity
rate
43
48
37
55
33
57
34
50
29
Und
er-fi
ve
mor
talit
y
53
57
50
71
39
66
43
64
37ra
te
Stun
ting
, %
41
41
42
51
23
- -
54
26
Und
erw
eigh
t, %
36
34
39
49
18
-
- 50
21
Prot
ecti
on a
gain
st
42
- -
42
39
48
40#
40
46ne
onat
al t
etan
us
(2+
TT
)
Del
iver
ies
assi
sted
32
-
- 13
71
32
32
# 12
64
by S
BA
s, %
Ear
ly in
itia
tion
of
47
48
46
47
40
- -
50
41br
east
feed
ing,
%
Med
ian
dura
tion
of
3.5
3.4
3.5
2.9
4.4
- -
3.0
3.5
brea
stfe
edin
g,(m
onth
s)
Chi
ldre
n re
ceiv
ing
all
86
87
85
76
97
- -
77
94ba
sic
vacc
inat
ions
, %
Chi
ldre
n w
ith
diar
rhoe
a 25
25
25
19
41
-
- 20
49
brou
ght
to h
ealt
hfa
cilit
y/ p
rovi
der,
%
Chi
ldre
n w
ith
diar
rhoe
a 78
82
72
79
88
-
- 81
82
trea
ted
wit
h O
RS,
%
Chi
ldre
n w
ith sy
mpt
oms
35
40
29
25
58
- -
25
58of
AR
I tak
en to
hea
lth
faci
lity/
prov
ider
, %
Chi
ldre
n w
ith sy
mpt
oms
71
76
66
63
75
- -
69
83of
AR
I tak
en to
hea
lthfa
cilit
y/pr
ovid
er a
ndgi
ven
antib
iotic
s, %
So
cio
-eco
no
mic
Diff
ere
nti
als
43
BANGLADESH
Socio-economic Diff erentials
Diff erentials in Newborn and Child HealthDiff erentials in neonatal, infant and under-fi ve mortality rates
Neonatal Mortality Rate Infant Mortality Rate Under - Five Mortality Rate
Mother's education 33 Sec+ 55 No Edn43
Mother's age 34 (20-29 Years) 57 (< 20 Years)43
Wealth quintile 29 Highest 50 Lowest43
Mother's education 39 Sec+ 71 No Edn53
Mother's age 43 (20-29 years) 66 (< 20 Years)53
Wealth quintile 37 Highest 64 Lowest53
Mother's age 26 (20-29 years) 45 (< 20 years)32
Wealth quintile 23 Highest 34 Lowest32
Mother's education 33 Sec+32 No Edu32
Per cent
Mother's education
Stunting Underweight
0 10 20 30 40 50 60 70 80
Mother's education 18 Sec+ 49 No Edn36
Wealth quintile 21 Highest 50 Lowest36
Wealth quintile 26 Highest 54 Lowest
Mother's education 51 No Edn23 Sec+41
41
Per cent
0
0
g
4
a
t
N
c
a
2
g
u
s
3
3
5
e
5
5
w
y
d
0
6
4
N
0
t
0 10 20 30 40 50 60 70 80 90 100
Diff erentials in nutritional status of children
44
BANGLADESH
Diff erentials in the deliveries by SBAs
Diff erentials in immunization of children
Deliveries assissted by SBAs
Wealth quintile 12 Lowest 64 Highest32
Per cent 0 10 20 30 40 50 60 70 80 90 100
Mother's age 32 (20-34 years) 32 (<20 years)32
Mother's education 13 No Edn 71 Sec+32
Children with symptoms of ARI brought
to health facility/provider
Wealth quintile
Per cent 0 10 20 30 40 50 60 70 80 90 100
Mother's education 25 No Edn 58 Sec +
35
25 Lowest 58 Highest35
Children receiving all basic vaccinations
Wealth quintile 77 Lowest 94 Highest
Per cent 0 10 20 30 40 50 60 70 80 90 100
Mother's education 76 No Edn 97 Sec+86
86
Diff erentials in care seeking for children with symptoms of ARI
Diff erentials in care-seeking by children sick with diarrhoea
Brought to health facility/provider
Children sick with Diarrhoea
Treated with ORS
0 10 20 30 40 50 60 70 80 90 100
Mother's education 19 No Edn 41 Sec +25
25Wealth quintile 20 Lowest 49 Highest
Per cent
E
L 4
e
h
Mother's education79 No Edn
88 Sec+78
78Wealth quintile 81 Lowest
82 Highest
Source: National Institute of Population Research and Training (NIPORT), Mitra Associates, and ICF International, Bangladesh demographic and Health Survey 2011. Dhaka, Bangladesh and Calverton, Maryland, USA: NIPORT, Mitra Associates, and ICF International, 2013.
45
BANGLADESH
Diff
ere
nti
als
by
Geo
gra
ph
ical
Reg
ion
s
Sour
ce:
Nat
iona
l Ins
titut
e of
Pop
ulat
ion
Rese
arch
and
Tra
inin
g (N
IPO
RT),
Mitr
a A
ssoci
ates
, and
IC
F In
tern
atio
nal,
Ban
glad
esh
dem
ogra
phic
and
Hea
lth S
urve
y 20
11. D
haka
, Ban
glad
esh
and
Cal
vert
on, M
aryl
and,
USA
: N
IPO
RT, M
itra
Asso
ciat
es, a
nd I
CF
Inte
rnat
iona
l, 20
13.
Indi
cato
rs
Pla
ce o
f Res
iden
ce
Div
isio
n
U
rban
R
ural
B
aris
al
Chi
ttag
ong
Dha
ka
Khu
lna
Raj
shah
i Sy
lhet
NM
R
32
33
38
21
36
32
39
45
IMR
42
43
49
35
44
36
51
59
U5M
R
50
55
62
50
54
40
63
71
Stun
ting
%
36
43
45
41
43
34
34
49
Und
erw
eigh
t %
28
39
40
37
37
29
34
45
Neo
nate
s pr
otec
ted
agai
nst
teta
nus
(2+
TT
) %
47
40
55
41
45
34
43
29
Del
iver
ies
by S
BA
%
54
25
28
30
32
49
31
24
Init
iati
on o
f bre
astf
eedi
ng w
ithi
n on
e ho
ur
44
48
44
46
43
46
54
54
afte
r bi
rth
%
Med
ian
dura
tion
of e
xclu
sive
bre
astf
eedi
ng (
Mon
ths)
3.
5 3.
5 2.
3 4.
0 3.
0 4.
0 2.
9 2.
9
Imm
uniz
atio
n %
87
86
83
82
85
94
90
80
% w
ith
diar
rhoe
a fo
r w
hom
tre
atm
ent
was
sou
ght
45
20
34
20
26
19
19
35
from
a h
ealt
h fa
cilit
y
% w
ith
diar
rhoe
a w
ho r
ecei
ved
OR
S 84
76
73
77
88
67
56
85
% w
ith
susp
ecte
d pn
eum
onia
for
who
m t
reat
men
t
54
31
40
24
38
45
31
43
was
sou
ght
from
a h
ealt
h fa
cilit
y
% w
ith
susp
ecte
d pn
eum
onia
who
rec
eive
d an
tibi
otic
s*
78
70
70
70
72
74
74
72
46
BANGLADESH