C ommo nwe a l t h memb e r c o u n t r i e s For Bangladesh to achieve the target for the reduction of child mortality, which form MDG 4, Bangladesh should have reduced under-five deaths per 1,000 live births to 48 and increase measles immunisation to 100 per cent by 2015. In 2013 under-five mortality stood at 41 deaths per 1,000 live births, so this target has been achieved. Measles immunisation was 93 per cent in 2012, which suggests that with continued good progress the country could achieve MDG 4. The global MDG 5 target for maternal health is to reduce the number of women who die in pregnancy and childbirth by threequarters between 1990 and 2015. When applying this target to Bangladesh, maternal mortality should fall to 200 cases per 100,000 live births. In 2013 Bangladesh had an adjusted maternal mortality ratio of 170 deaths per 100,000 live births (the figure was estimated at 240 deaths per 100,000 live births by UN agencies/World Bank in 2010). Based on the data reported by the country, the maternal mortality target has already been achieved. Part of the goal also stipulates that 100 per cent of births must be attended by a skilled health professional. In 2011 this figure stood at 31 per cent, suggesting that this target is highly unlikely to have been met. MDG 6 aims for a reduction in the prevalence of HIV, malaria and other diseases. HIV prevalence is low in Bangladesh and the number of confirmed deaths from malaria has dropped significantly between 2000 and 2011. However, other diseases such as rubella and TB are present at considerable levels, indicating that this goal is unlikely to be achieved when the final data is analysed. For definitions, sources and explanations on the MDGs see page 314. Universal health coverage Roughly two-thirds of health care in Bangladesh (66 per cent) was paid for by patients or funded by other non-governmental entities – such as private insurers, charities or employers – in 2012. Total health expenditure constituted 3.6 per cent of GDP in 2012, of which 34 per cent (US$9 per capita) was covered by the government. Bangladesh’s public spending on health was 1.2 per cent of GDP in 2012, equivalent to US$9 per capita. In recent years the government of Bangladesh has made moves towards strengthening the country’s health sector. This can be seen in the implementation of the National Health Policy in 2011 and the National Population Policy in 2012. Additionally, the government has established professional regulatory and statutory bodies responsible for ensuring the provision of standardised and quality health services, and protecting citizens’ rights to gain access to health services. The World Health Organization (WHO) Country Cooperation Strategic Agenda (2014–17) for Bangladesh identifies the promotion of universal health coverage with strengthened health systems based on primary health care as one of five strategic priorities for WHO co-operation. Bangladesh was not an original signatory to the International Covenant on Economic, Social and Cultural Rights, but acceded to it in 1998 and has written the covenant into law. It includes ‘the right of everyone to the enjoyment of the highest attainable standard of physical and mental health’. The covenant commits signees to providing healthy and hygienic environmental conditions, controlling epidemic diseases, improving child health and facilitating access to health services without discrimination. Care of the elderly: Approximately 7.4 million people in Bangladesh are over the age of 65 – five per cent of the population (2013). At the age of 60 a person living in Bangladesh can be expected to live for an additional 18 years, on average. Bangladesh’s Old Age Allowance dates back to 1998. Today, monthly pension credits are paid by the state at a rate of US$4 per person on a means-tested basis. Care of the elderly in Bangladesh, as is traditional in Bangladeshi society, is generally carried out by the family and members of the community. There are several international charities operating in the country that seek to provide care and assistance to the elderly and their families, the most notable of which is the UK-based Sir William Beveridge Foundation. Further information Ministry of Health and Family Welfare: www.mohfw.gov.bd Commonwealth Health Online: www.commonwealthhealth.org/health/asia/bangladesh 144 Commonwealth Health Partnerships 2015 Population over 65 5%
Commonwealth Health Partnerships 2015
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