Bangladesh Achieved Great Strides in Population Health

Despite a weak health system, low spending on health and widespread poverty, Bangladesh achieved great strides in population health. The development in life expectancy, TB control, vaccination rates, and a child's chances of surviving past the age of five is evident, as per a series of focus papers published in the Lancet.

This success, in the eighth most populous country in the world, comes due to specific health programs which have focused on such issues like family planning, gender equality, immunization, and diarrhea treatment, said the researchers. Another positive factor has been the wide use of health workers going out into communities.

Mushtaque R Chowdhury, a professor of population and family health at BRAC University said life expectancy in general  had increased to 68.3 years which is above than neighboring India and Pakistan. Maternal mortality had dropped by 75 percent since 1980's and infant mortality has more than halved since 1990, said Mr. Chowdhury.

Three biggest drivers of change are cited, access to medicines, scaling up treatment for TB and improved access to primary care. Though primary care is still problematic and attempts to increase access to essential drugs has usually been market driven, another approach which involved using community health workers saw  treatment completion rates rise from less than 50 percent in the 1990's to more than 90 percent now on the highest rates  in the world.

In bringing about changes in communities women  have played a key role. Through the massive and unprecedented deployment of diverse cadres of mostly female front-line health workers reaching every household and empowered women to control of their own health and reproduction these changes come.

A rapid fall in fertility from seven births per woman in 1970 to 2.3 in 2010 becomes possible for the female health health workers, recruited to deliver door to door family planning services. Contraceptive use also rose from 10 percent in 1970 to around 62 percent which is contributing to the speed and magnitude of improvement in mortality, particularly in women.

Bangladesh still suffers from other health problem including "persistent malnutrition" in children and mother, though success in birth rate reduction and child mortality have applauded.