In just 30 years, child mortality among children under the age of five in Bangladesh has fallen by 80 percent. This is shown by figures from the World Bank. – In terms of child mortality, Bangladesh is a huge success story, says Iben Rasmine Østergaard Marcussen. Marcussen is a project manager with expertise in public health at the Danish development organization PlanBørnefonden, and has closely followed developments in Bangladesh. Back in 1990, 146 children died per 1,000 births. In 2020, the number had dropped to 29 children. In addition to the decline in child mortality, both the number of stillbirths and infant mortality have fallen by over 70 per cent in the same period. Health clinics An important reason for the decline in child mortality is that women have better access to the health system. – One of the most important things is to get the mothers to give birth in health clinics, says Marcussen. She explains that the tradition in Bangladesh is for women to give birth at home in the villages, and then there are more complications during birth. The first clinics were established in 1998, and Bangladesh today has 14,000 local health clinics that provide free first aid and necessary medicine to people in villages and remote areas. At the same time, they can refer patients to hospitals in larger cities, when more advanced treatment is needed. In 2019, 59 per cent of all births were performed by trained staff. When the women have been in contact with a health clinic during pregnancy, they are more likely to stay in contact with the health care system in the first years, which is important for the child. – Throughout the child’s first five years, there are periods when it is important to put in the shock in order to reduce mortality, says Marcussen. For example, it is important for the child’s health that women breastfeed their children. More and more women in Bangladesh are now breastfeeding their children for the first five months – from 55 per cent in 2014 to 65 per cent in 2018. Another important effort at the clinics is vaccinations against everything from polio to measles. Economic growth The government’s and non-governmental organisations’ work with health, together with an economic upturn in recent years, has been an important recipe for success. – Bangladeshis have become richer, and that means there is more money in the public sector, says Marcussen. That is one of the explanations why development is going so well in Bangladesh compared to other countries in South Asia, where there has not been the same economic boom, she explains. As more children survive and the standard of living gradually improves in Bangladesh, the women also have fewer children. In 1990, a woman in Bangladesh had an average of 4.5 children, while today they have 2. – The development work in Bangladesh is in many ways a success story, says Marcussen. She emphasizes that Bangladesh still has major challenges. From 2009 to 2019, cyclones have destroyed the lives and homes of more than a million people in Bangladesh. Parts of the country are very low-lying, and the risk of flooding is therefore high. Bangladesh is one of the countries most threatened by climate change. In addition, the country houses the world’s largest refugee camp, Cox Bazar, where 900,000 Rohingya live primitively in tents. They fled to Bangladesh in 2017, when brutal violence broke out against the ethnic group in Myanmar. – At the moment, the PlanBørnefonden works particularly in Cox Bazar, where help is needed with everything from nutrition to births and vaccination of children, says Marcussen. – We must be where the need is greatest.
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In just one generation, child mortality has fallen sharply in Bangladesh
