The last few decades have brought significant improvements in child health in Bangladesh. The mortality rate in children under-five declined from 152 deaths per 1,000 live births to 94 deaths per 1,000 live births, but these rates are still high, and have remained constant for several years. Pneumonia, diarrhoea, measles, malaria, malnutrition, injuries and the high number of neonatal deaths, and poor care-seeking behaviour, all contribute to the high levels of child mortality.
The Ministry of Health and Family Welfare has, for the last decade, implemented several vertical programmes – centrally organized services focused on single issues such as the control of diarrhoeal diseases (CDD) and the control of acute respiratory infections (ARI). From 1998, though, the Government started to adopt a more holistic, sector-wide approach to implementing the programmes.
The Child Health Programme, promotes the rights of children to survival and well-being through interventions under four categories:
The project aims to meet the following targets by the year 2005:
The project is designed to be implemented by bringing together essential services: immunization; ORT; detection, treatment and referral of ARI, diarrhoea and other common illnesses through community outreach and local health facilities. A central aspect of this strategic planning is the adaptation and implementation of IMCI so that the interventions through individual programmes like ARI and CDD can be gradually merged into IMCI programmes.
To reduce levels of vaccine-preventable diseases, specific strategies include routine vaccination through a nationwide network of 120,000 community outreach sites and health facilities, Supplementary Immunization Activities (SIAs) such as National Immunization Days (NIDs) for polio eradication, and area-based multi-antigen campaigns to eliminate neonatal tetanus and control of measles.