Academic journal article Bulletin of the World Health Organization

Trends in Sociodemographic and Health-Related Indicators in Bangladesh, 1993-2007: Will Inequities Persist?

Academic journal article Bulletin of the World Health Organization

Trends in Sociodemographic and Health-Related Indicators in Bangladesh, 1993-2007: Will Inequities Persist?

Article excerpt

Objective To assess levels, trends and gaps between the poorest and the richest in selected health and human development indicators in Bangladesh.

Methods Data for selected indicators associated with sociodemographic characteristics among ever-married women, contraception use, child vaccination, antenatal care practices and health conditions were extracted from the Bangladesh Demographic and Health Surveys conducted in 1993-94, 1996-1997, 1999-2000, 2004 and 2007. Results for the whole sample and for the poorest and the richest wealth quintiles are presented.

Findings Positive trends were noted in urbanization, availability of electricity, age at first marriage, use of modern contraception, access to skilled antenatal caro, child vaccination, knowledge of human immunodeficiency virus (HIV) infection and acquired immunodeficiency syndrome and overweight and obesity. In contrast, negative trends were seen in factors such as literacy, infant and child mortality, fertility rate, home delivery and malnutrition and underweight. However, changes in these indicators differed between the poorest and richost quintiles. For instance, only the richest quintile experienced rapid urbanization, whereas illiteracy declined more among the poorest. Noteworthy gaps were found in almost all factors. Rich-poor gaps in urbanization, age at marriage, fertility, condom use, home delivery and overweight increased; in contrast, gaps in education, water and sanitation, use of contraception (except condoms) and child vaccination declined.

Conclusion Persistent inequities in Bangladesh endanger equitable and sustainable human development in the country. Pro-poor development strategies based on the principles of equity and quality should be implemented to narrow existing gaps and further promote holistic and equitable human development.

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Resume

Evolutions des indicateurs sociodemographiques et sanitaires au Bangladesh, 1993-2007: les inegalites persisteront-elles?

Objectif Evaluer les niveaux, les evolutions et les ecarts entre les plus pauvres et les plus riches, pour des indicateurs sanitaires et de developpement humain selectionnes au Bangladesh.

Methodes Les donnees pour les indicateurs selectionnes, associes aux caracteristiques sociodemographiques des femmes deja au moins une fois mariees, I'utilisation de la contraception, la vaccination des enfants, les pratiques de soins prenatals et les conditions de sante ont ete extraites des enquetes demographiques et sanitaires bangladaises menees en 1993-94, 1996-1997, 1999-2000, 2004 et 2007. Les resultats de I'ensemble de I'echantillon et des quintiles les plus pauvres et les plus riches sont presentes.

Resultats Des evolutions positives ont ete observees en termes d'urbanisation, d'acces a I'electricitea d'age Iors du premier mariage, d'utilisation de la contraception moderne, d'acces a des soins prenatals qualifies, de vaccination infantile, de connaissance de I'infection par le virus d'immunodeficience humaine (VlH), du syndrome d'immunodeficience acquise, ainsi que du surpoids et de I'obesite. En revanche, des evolutions negatives ont ete observees en termes d'alphabetisation, de mortalite infantile et juvenile, de taux de fecondite, d'accouchement & domicile, de malnutrition et d'insuffisance ponderale. Cependant, I'evolution de ces indicateurs differe entre les quintiles les plus riches et les plus pauvres. Par exemple, seul le quintile le plus riche a connu une urbanisation rapide, tandis que I'analphabetisme a diminue plus fortement parmi les plus pauvres. Des ecarts notables ont ete constates dans presque tous les facteurs. Les ecarts entre riches et pauvres en matiere d'urbanisation, d'age au mariage, de fecondite, d'utilisation du preservatif, d'accouchement a domicile et de surcharge ponderale ont augmente; en revanche, les ecarts en termes d'education, d'eau et d'assainissement, d'utilisation de la contraception (a I'exception des preservatifs) et de vaccination des enfants ont diminue. …

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