Childhood Mortality Dynamics in Bangladesh: Trends, Patterns and Survival of Under-Five Aged Children
Author: Islam, Mohammad Mainul , mainul@du.ac.bd
Department: Institute of Population Research
University: Peking University, China
Supervisor: Zheng Xiaoying
Year of completion: 2009
Language of dissertation: English
Keywords:
Infant
, under-five child mortality
, Child survival
, Bangladesh
Areas of Research:
Population
, Health
, Childhood
Abstract
The Millennium Development Goal is reduce under-five aged childhood mortality by two-thirds by 2015. However, the reductions in most countries are too slow to meet this goal. Indeed, some countries and regions have achieved remarkable reductions, Bangladesh being one example. Moreover, there is a renewed interest in interventions believed to improve survival but childhood mortality may be vulnerable as many biological, environmental, social, cultural and behavioral factors have been responsible for structuring the patterns of mortality. In general, mortality is higher among first birth. However, the relationship between first birth and survival of under-five aged children is not well understood. The general objective of this study is to ascertain clearly the under-five aged childhood mortality dynamics in Bangladesh by studying the trends, patterns, differentials over time and examining the factors' effect on survival of under-five aged children at first birth. This research draws on four rounds of the Bangladesh Demographic and Health Surveys(BDHS), 1993 to 2004 to identify the changes, challenges and future directions and offers possible policy suggestions. The study finds that Bangladesh has done remarkable reduction of childhood mortality under 0-5 aged mortality-the infant, child and under-five aged mortality rate. A projection has been made by the exponential-decline regression based on the estimated levels and trends of the infant, child and under-five mortality as given in the BDHS surveys and predicted for continual rapid declining trends. It indicates that Bangladesh is on the right track to reduce two-third childhood mortality following the Millennium Development Goal 4 by 2015. Staying on the track till 2015 and beyond will require implementation of new initiatives, particularly on early infant health. Differentials in trends and patterns by both bio-demographic as well as social have been observed. The data analysis reveals that tetanus injection before birth is the most dominant determinant on under-five aged child survival at first birth which means receiving more tetanus injections will increase the chances of child survival. Parents' educational attainment, prenatal visits during pregnancy, and tubewell as source of drinking water or water supply, are also factors that have impact. Social, behavioral and environmental factors have had the effect on child survival for under-five aged which can be taken into consideration for effective mortality reductions in Bangladesh. Adopting policies to reduce childhood mortality would include: ensuring more tetanus toxoid injections before pregnancy, ensuring regular prenatal care throughout pregnancy, promoting higher education of the mother and access to safe drinking water, increasing the use of health services during pregnancy and delivery, eliminating the gender gap in child health and health services, promoting child vaccinations and improving nutrition throughout the lifecycle.
