Bangladesh

Question 1

Population

Answer 1

168 mil, 8th in the world
peak at 192 mil in 2053

Question 2

Population Density

Answer 2

highest in the world at 1278 people

Question 3

growth rate

Answer 3

1967 - 3.3%
2021 - 1%

Question 3

TFR

Answer 3

1971 - 7 per women
2020 - 2 per women

Question 4

LE

Answer 4

1972 - 41.8
2020 - 72.8

Question 5

BR

Answer 5

1971 - 47 per 1000
2020 - 17.5 per 1000

Question 6

DR

Answer 6

1971 - 19.3
2020 - 5.5

Question 7

IMR & CMR

Answer 7

IMR - 26
CMR - 31

Question 8

Education

Answer 8

years of schooling 11.6
in the alums only 18% attend school

Question 9

DTM and population pyramids

Answer 9

stage 3 (late expanding)
dependency ratio of 45.1
narrow base, bulge in the middle, tapering top suggesting a increased LE, decreasing BR and bulge from previous increased BR

Question 10

contraception use

Answer 10

66%

Question 11

push and pull factors

Answer 11

Pull Factors
55% of internal migration due to search for better employment
10% of internal migration is to reunite with family

Push factors
27% of internal migration due to environmental reasons such as river erosion and soil salinity
Increased urbanisation places pressure on the government to provide infrastructure – can’t keep up.

Question 12

MATLAB

Answer 12

Matlab local response Overview:
The Matlab project started in 1963 in the region of Matlab, 55km SE Dhaka. Initially a program to provide treatment for diarrhoeal diseases, the International Centre for Diarrhoeal Disease Research Bangladesh (ICDDR,B), later developed into a community based maternal & child-health & family planning (MCH-FP) program. Strategy involved advice from community workers to individual households, and the distribution of contraceptives. Married women in the treatment area were visited 2x/ month by trained workers chosen from high status families, consulted about their contraceptive needs and provided with contraceptive care. The previous Contraceptive Distribution Project (CDP) from 1975 -1977 had failed, demonstrating that ‘supply’ is not just the provision of pills, but requires working with existing social systems.Aim: to reduce diarrhoea and cholera but then evolved into contraception and immunisation
S: increased contraceptive use, reduced TFR - The annual number of childhood deaths has been reduced by around 75% in the last 25 years, due to the combined programmes in child health and family planning. - Life expectancy has increased from 50 years to around 65 years in the past 40 years thanks to interventions that have improved child survival and lowered fertility. - The MCH/FP treatment area subsequently experienced increased contraceptive use, reduced fertility, and reductions in maternal and child mortality. By 1981 modern contraceptive prevalence rose from 5% to 35% and fertility declined by 25%. - The result has been reflected in Bangladesh’s : dramatically lowered TFR (TFR was 7 in 1970 and now is under 2 in 2022) and dramatically increased contraceptive use (6% in 1976 to 62% in 2020)
O: methods adopted internationally - Work at Matlab showed that 63% of deaths in childhood were due to vaccine-preventable disease and could be prevented almost completely by effective immunisation campaigns. More broadly, the 1981 Matlab Annual Report documented the program’s success. As a result ICDDR,B was requested by the Bangladesh Government to expand Matlab activities to other areas of the country, but to utilise government resources, mechanisms and procedures wherever possible.
S: the Matlab project found that families in communities where the program was implemented became wealthier and healthier than similar families who lived in other communities.Increased contraceptive usage (5% to 35%) and decreased fertility rates (25% decrease) so yes effective

Question 13

MCHFP

Answer 13

MCHFP extension program, national response
Overview: Maternal/Child Health and Family Planning (MCHFP) Project was extended out of Matlab and was funded by governments. It aimed to tailor the matlab program to specific regional needs to not just extend Matlab to the public sector, but to identify and remove specific barriers to the transfer of the approach to new regions. Launched 1982. Aims: included lowering MMR, IMR and CMR Strategies: - Launched extensive vaccination programs (6 essential program on immunisation diseases were included) - Maternal and Child health support, interventions and local training - Oral rehydration therapy provision - Safe birth kit distribution - Training of local
S: whether it met its goals or not, extremely successful. TFR has decreased from 6.22 in 1981 to 1.979 in 2022 After the failure of the Contraceptive Distribution Project of 1975 - 1977, the Bangladesh government realised that supplying contraceptives involves more than just giving out pills. The MCHFP program managed to raise contraception use from 6% in 1976 to 66% today.
GIS: HDSS (Health and Demographic Surveillance System)
Overview:Records births, deaths, migrations, marriages, divorces and maternal and child health info. Indicators recorded include:TFR, age at marriage, population structure, mortality, cause of death, life expectancy and population movements are recorded in individual local government sub-districts (Upazilas). This is then transferred to a central system in Dhaka for longitudinal matching. Data is mapped and used as a basis for government and NGOs to implement strategies (eg health planning).
S: Decreased TFR MMR, IMR and CMR, Increased female education and vaccination rates
The detail and quality of HDSS data has allowed national policy makers to recognise which programs and interventions have been successful so that they could be scaled up as part of the MCHFP Extension Project.
Further, the long time frame of HDSS data collection has allowed high quality
longitudinal studies of the impacts and effects of programs and interventions over
time.
Arose from matlab project in 1966 - due to written information from going door to do, done to evaluate
1978 - developed record keeping system
1994 - developed GISenabled them to record location of data collection to produce maps.
1996 - MATLAB produced a survey that Matlab Health and socio economic survey (MHSS) that allocated an individual ID number everyone ir to 141 villages
Allowing for comparison of future data (survey contacted again in 20212)
2000 - all systems merged together forming HDSS allowing for detailed data going to policy makers to be evaluated for effectiveness, leading detailed maps for visual data analysis