Health is the first priority for a underdeveloped children

WHO has been supporting Bangladesh for it to achieve highest standards of health and development for children and adolescents, whereby they are nurtured to live their life to its full potential while ensuring that their needs and rights are fulfilled and respected. Child and Adolescent health unit of WHO Bangladesh is supporting Bangladesh to achieve MDG-4 and 5 by Strengthening/formulating /developing, health policies/ strategies related to newborn, child and adolescent health based on evidence based interventions using the human right framework. In addition provision for continuum of care throughout the life course is supported to achieve universal access on an equitable basis for quality health services for mothers, newborn, children and adolescents. The Child and Adolescent health activities of the country are being supported using approaches including Integrated Management of Childhood Illness, Infant and Young Child Feeding, Newborn Care, and Youth Friendly Health Service.

Country situation

Bangladesh has made significant advances in the survival of infants and children under five years. Bangladesh is one of the 16 countries in the world that are on track to reduce child mortality. The major contributors to the reduction in mortality over the last decades are immunization, vitamin A supplementation, oral rehydration therapy (ORT), improved education (especially of mothers), as well as safe water provision, which has had a positive impact on diarrhoea and other water-borne diseases. About 34 million adolescents aged 10-19 constitute 21% of total population of Bangladesh. Early marriage is a social norm in Bangladesh.

Bangladesh is second only to Niger in having the highest percentage of adolescent brides in the world. Early pregnancy is common in Bangladesh. An estimated 2 million births (17% of total births) were attributed to adolescents between the age 15 and 19 in a period of 2005-20101.

The fertility rate among the 15-19 years old age group is one of the highest rates, in the world. One of the major challenges in achieving MDG 4 is the slow progress in preventing neonatal deaths, which now account for 57 percent of all under-five deaths and 70 percent of infant deaths. There is strong evidence linking early childbearing with higher perinatal and neonatal death rates.

Bangladesh DHS 2007 reported that the risk of dying in first month of life is double among births occurring to adolescent women as compared with women aged 20-29. The latter is associated with a low rate of institutional delivery, low birth attendance by skilled personnel, high incidence of low birth weight and low utilization of antenatal care services.

These along with low rates of essential newborn care practices such as immediate drying and wrapping, coupled with the fact that only 19 percent of mothers received postnatal care from a medically trained provider within the first two days of delivery presents major challenges for increasing demand and improved provision of services. The high prevalence of under-nutrition presents an additional serious challenge to the continuing progress in reaching the child survival goals.

The BDHS 2007 found that 41 percent of children under-five years of age were underweight. Accelerating the slow rate of malnutrition reduction and improving stagnant breast feeding practices is another challenge for Bangladesh. While the mortality rates have improved overall, major inequalities among the population still need to be addressed. Diarrheal Diseases and Acute Respiratory Infections (ARI) still threaten the lives of countless children and are responsible for more than one-quarter of under-5 deaths. Childhood injuries, especially drowning, have emerged as a considerable public health problem responsible for a full quarter of the deaths among children 1-4 years of age. IMCI has been expanded to more than 350 Upazilas and community level acivities initiated in around 30 upazilas.

Expansion of IMCI with maintainance of quality is a challenege for the programme. Provision of Adolescent and youth friendly services of acceptable quality and increasing age of marriage with delayed child birth based on developed strategy and standards jointly by various departments are some of the additional challenges.