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We investigated the macroeconomic determinants of neonatal, infant, and under-five mortalities in Bangladesh for the period 1991-2018 and discuss implications of the United Nations' Sustainable Development Goal 3 (SDG 3) and Millennium Development Goal 4 (MDG 4) for developing countries. We used annual time series data and the econometric techniques of Fully Modified Ordinary Least Squares (FMOLS) and Dynamic Ordinary Least Squares (DOLS) regressions for analysis. Determinants most effective in combating neonatal, infant, and under-five mortalities include variables such as 'protecting newborns against tetanus', 'increasing healthcare expenditure', and 'making sure births are attended by skilled healthcare staff'. Employing more healthcare workers and assuring more and improved healthcare provisions can further reduce the neonatal, infant, and under-five mortalities. Developing countries with similar macroeconomic profiles can achieve similar SDG 3 and MDG 4 outcomes by emulating the policies and strategies Bangladesh applied to reducing child mortalities over the last three decades., (© 2023. The Author(s).)

A rapid reduction in under-five mortality has put Bangladesh on-track to reach Millennium Development Goal 4. Little research, however, has been conducted into neonatal reductions and sub-national rates in the country, with considerable disparities potentially masked by national reductions. The aim of this paper is to estimate national and sub-national rates of neonatal mortality to compute relative and absolute inequalities between sub-national groups and draw comparisons with rates of under-five mortality. Mortality rates for under-five children and neonates were estimated directly for 1980-1981 to 2010-2011 using data from six waves of the Demographic and Health Survey. Rates were stratified by levels of rural/urban location, household wealth and maternal education. Absolute and relative inequalities within these groups were measured by rate differences and ratios, and where possible, slope and relative indices of inequality. National mortality was shown to have decreased dramatically although at differential rates for under-fives and neonates. Across all equity markers, a general pattern of declining absolute but constant relative inequalities was found. For mortality rates stratified by education and wealth mixed evidence suggests that relative inequalities may have also fallen. Although disparities remain, Bangladesh has achieved a rare combination of substantive reductions in mortality levels without increases in relative inequalities. A coalescence of substantial increases in coverage and equitable distribution of key child and neonatal interventions with widespread health sectoral and policy changes over the last 30 years may in part explain this exceptional pattern.

Objective: The aim of this study was to identify factors associated with mortality in children under 5 years of age using a nationally representative sample of singleton births for the period of 2004-2011., Design, Setting and Participants: Pooled 2004, 2007 and 2011 cross-sectional data sets of the Bangladesh Demographic and Health Surveys were analysed. The surveys used a stratified two-stage cluster sample of 16,722 singleton live-born infants of the most recent birth of a mother within a 3-year period., Main Outcome Measures: Outcome measures were neonatal mortality (0-30 days), postneonatal mortality (1-11 months), infant mortality (0-11 months), child mortality (1-4 years) and under-5 mortality (0-4 years)., Results: Survival information for 16,722 singleton live-born infants and 522 deaths of children <5 years of age included: 310 neonatal deaths, 154 postneonatal deaths, 464 infant deaths, 58 child deaths and 522 under-5 deaths. Multiple variable analysis showed that, over a 7-year period, mortality reduced significantly by 48% for postneonatal deaths, 33% for infant deaths and 29% for under-5 deaths, but there was no significant reduction in neonatal deaths (adjusted OR (AOR) = 0.79, 95% CI 0.59 to 1.06) or child deaths (AOR = 1.00, 95% CI 0.51 to 1.94). The odds of neonatal, postneonatal, infant, child and under-5 deaths decreased significantly among mothers who used contraceptive and mothers who had other children aged 3 years or older. The risk of neonatal, postneonatal, infant, child and under-5 deaths was significantly higher in mothers who reported a previous death of a sibling., Conclusions: Our study suggests that family planning is needed to further reduce the overall rate of under-5 deaths in Bangladesh. To reduce childhood mortality, public health interventions that focus on child spacing and contraceptive use by mothers may be most effective., (Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.)

This article uses the Bangladesh famine of 1974 as a natural experiment to estimate the impact of intrauterine malnutrition on sex of the child and infant mortality. In addition, we estimate the impact of malnutrition on post-famine pregnancy outcomes. Using the 1996 Matlab Health and Socioeconomic Survey (MHSS), we find that women who were pregnant during the famine were less likely to have male children. Moreover, children who were in utero during the most severe period of the Bangladesh famine were 32 % more likely to die within one month of birth compared with their siblings who were not in utero during the famine. Finally, we estimate the impacts of the famine on subsequent pregnancy outcomes. Controlling for pre-famine fertility, we find that women who were pregnant during the famine experienced a higher number of stillbirths in the post-famine years. This increase appears to be driven by an excess number of male stillbirths.

To reduce infant mortality through improved family planning, a better understanding of the factors driving contraceptive use and how this decision affects infant survival is needed. Using dynamic panel-data models of infant deaths, birth intervals, and contraceptive use, this study analyzes the causal effects of birth spacing on subsequent infant mortality and of infant mortality on the use of contraceptives and the length of the next birth interval. Data are drawn from the Health and Demographic Surveillance System in Matlab, Bangladesh, where almost 32,000 births have been observed from 1982 to 2005. Our main finding is that complete contraceptive use could reduce infant mortality of birth order two and higher by 7.9 percent. The net effect of complete contraceptive use on the total infant mortality rate is small (2.9 percent), however, because the favorable effect on higher order births is partly offset by the rise in the proportion of high-risk first births., (© 2013 The Population Council, Inc.)

Bangladesh has made commendable progress in achieving Millennium Development Goals (MDGs) 4 and 5. Since 1990, there has been a remarkable reduction in maternal and child mortality, with an estimated 57% reduction in child mortality and 66% in maternal mortality. This review highlights that, whereas Bangladesh is on track for achieving MDG 4 and 5A, progress in universal access to reproductive health (5B) is not yet at the required pace to achieve the targets set for 2015. In addition, Bangladesh needs to further enhance activities to improve newborn health and promote skilled attendance at birth., (© 2011 The Authors BJOG An International Journal of Obstetrics and Gynaecology © 2011 RCOG.)

The study assessed the achievements in, critically reviewed the relevant issues of, and put forward recommendations for achieving the target of the Millennium Development Goal relating to mortality of children aged less than five years (under-five mortality) in Bangladesh within 2015. To materialize the study objectives, a thorough literature review was done. Mortality of under-five children and infants decreased respectively to 65 from 151 and to 52 from 94 per 1,000 livebirths during 1990-2006. The immunization coverage increased from 54% to 81.9% during the same period. The projection shows that Bangladesh will achieve targeted reduction in under-five mortality and infant mortality within the time limit, except immunization coverage. Neonatal mortality contributed to the majority of childhood deaths. Contribution of neonatal mortality to child mortality was the highest. There were remarkable differences in child mortality by sex, division, and residence. To progress further for achieving the target of MDG relating to child mortality, some issues, such as lower use of maternal healthcare services, hazardous environmental effects on childhood illness, high malnutrition among children, shorter duration of exclusive breastfeeding practices, various child injuries leading to death, low healthcare-use of children, probable future threat of financial shortage, and strategies lacking area-wise focus on child mortality, need to be considered. Without these, the achievement of MDG relating to child mortality may not be possible within 2015.

Background: Child deaths are decreasing throughout South East Asia, yet the rate remains high and is a cause of considerable anguish. In Bangladesh, there is also a great deal of variation in child mortality between different regions., Method: Reported in this paper is the analysis of a survey of 613 Bangladeshi women who live in six rural villages and have reported on their experience of child death. Factors obtained from an interview based questionnaire were investigated to ascertain their association with child death. Multilevel Poison regression models were developed to relate these factors to the number and proportion of child deaths to children ever born while allowing for variation between the villages., Results: It was found that communicative action, especially women's power as the degree of social connectedness, is important in reducing child mortality. Also important in reducing child mortality is the level of women's education. No evidence could be found of sex preference when comparing male and female child deaths., (© 2010 Blackwell Publishing Ltd.)

In this paper we have attempted to demonstrate the relationship between birth spacing and child survival in Bangladesh using data from the 2004 Bangladesh Demographic Health Survey (BDHS). We used standard life table techniques to estimate the probability of child survival and appropriate spacing of births. Logistic regression models were used to investigate the covariates, along with the birth interval that has significant influence on child survival. Study results showed that the probability of child survival was much lower when the preceding birth interval was less than 12 months, and it may be also impeded by a higher birth interval. Child survival probability was highest for a preceding birth interval of 5 years; thereafter, the probability declined. Results of the logistic regression model clearly showed that preceding birth interval was an important and strongly significant factor in explaining infant and child mortality. While education, current age, breastfeeding status and birth order were substantial and highly significant factors both in infant and child mortality, socio-economic factors such as occupation and socio-economic status showed a significant effect only on child mortality. Postponing another child (for a birth interval of 5 years and above) and proper spacing of births would have a noticeable effect in reducing the level of mortality.

Bangladesh is currently one of the very few countries in the world, which is on target for achieving the Millennium Development Goal (MDG) 4 relating to child mortality. There have been very rapid reductions in mortality, especially in recent years and among children aged over one month. However, this rate of reduction may be difficult to sustain and may impede the achievement of MDG 4. Neonatal deaths now contribute substantially (57%) to overall mortality of children aged less than five years, and reductions in neonatal mortality are difficult to achieve and have been slow in Bangladesh. There are some interesting attributes of the mortality decline in Bangladesh. Mortality has declined faster among girls than among boys, but the poorest have not benefited from the reduction in mortality. There has also been a relative absence of a decline in mortality in urban areas. The age and cause of death pattern of under-five mortality indicate certain interventions that need to be scaled up rapidly and reach high coverage to achieve MDG 4 in Bangladesh. These include skilled attendance at delivery, postnatal care for the newborn, appropriate feeding of the young infant and child, and prevention and management of childhood infections. The latest (2007) Bangladesh Demographic and Health Survey shows that Bangladesh has made sustained and remarkable progress in many areas of child health. More than 80% of children are receiving all vaccines. The use of oral rehydration solution for diarrhoea is high, and the coverage of vitamin A among children aged 9-59 months has been consistently increasing. However, poor quality of care, misperceptions regarding the need for care, and other social barriers contribute to low levels of care-seeking for illnesses of the newborns and children. Improvements in the health system are essential for removing these barriers, as are effective strategies to reach families and communities with targeted messages and information. Finally, there are substantial health-system challenges relating to the design and implementation, at scale, of interventions to reduce neonatal mortality.

In this article, we examine the relationship between child mortality and subsequent fertility using prospective longitudinal data on births and childhood deaths occurring to nearly 8000 Bangladeshi mothers observed over the 1982-1993 period, a time of rapid fertility decline. Generalized hazard-regression analyses are employed to assess the effect of infant and child mortality on the hazard of conception, with controls for birth order and maternal age and educational attainment. Results show that childhood mortality reduces the time to subsequent conception if the death occurs within a given interval, representing the combined effect of biological and volitional replacement. The time to conception is also reduced if a childhood death occurs during a prior birth interval, a finding that signifies an effect of volitional replacement of the child that died. Moreover, mortality effects in prior birth intervals are consistent with hypothesized insurance (or hoarding) effects. Interaction of replacement with elapsed time suggests that the volitional impact of child mortality increases as the demographic transition progresses. This volitional effect interacts with sex of index child. Investigation of higher-order interactions suggests that this gender-replacement effect has not changed over time.

Background: Although the recent decline in child mortality in Bangladesh is remarkable, death from causes other than infectious diseases and malnutrition remains an important component of child mortality. Death from drowning of children can be expected to be a problem in Bangladesh given the geographical features of the country., Objective: The objectives of this study are to determine the trend, pattern, and correlates of drowning deaths., Methods: Data are presented on deaths of children (1-4 years) due to drowning derived from a longitudinal, population-based surveillance system in operation in a rural area of Bangladesh in 1983-1995. Moreover, a case-control study was carried out to identify the risk factors associated with drowning., Results: Deaths due to drowning ranged from about 10% to 25% of child deaths during 1983-1995. The absolute risk of dying from drowning remained almost the same over the study period but the proportion of drownings to all causes of death has increased. Drowning is especially prevalent in the second year of life. Age of the mother and parity have a significant impact on drowning. The risk of dying from drowning increases with the age of mother and much more sharply with the number of living children in the family. Two socioeconomic variables did not have an influence on the risk of drowning., Conclusions: A substantial proportion of child deaths could be averted if parents and other close relatives paid more attention to the safety of children. The Child Health Programme of the Ministry of Health and Family Welfare of Bangladesh should develop health education programmes for villagers alerting them to the dangers of drowning and measures to prevent it.

This study examines whether mortality of two adjacent siblings in families is age-specific and is modified by the MCH-FP programme and fertility and mortality declines in Matlab, Bangladesh, using data for singleton births during 1977-78, 1985-86 and 1989-90 in the treatment (MCH-FP) and comparison areas. Logistic regression was used to estimate the net effects of survival status of elder siblings on mortality of younger siblings in the neonatal, postneonatal and toddler periods, controlling for birth order, previous birth interval, maternal age, education and religion, household possession of valuable items and sex of the child. Odds of neonatal and postneonatal deaths of younger siblings were found to be higher if the elder sibling had died at the same age than if the sibling had survived infancy. Toddler mortality was lower if the elder sibling had died in infancy. The association between two siblings'mortality risks did not decline over time in either area. The results suggest that a family history of child deaths by age is important to identify when subsequent infants would be at a higher risk of dying.

A growing number of non-governmental organizations (NGOs) are adopting the collateral-free credit programs by anchoring them with their social development programs aimed at improved program effectiveness and sustainability. Drawing upon a sample of 3,564 targeted poor households covered by five small NGOs in rural Bangladesh, this study finds that the NGO credit-members as well as those who reside in the NGO program area are higher adopters of child immunization than those in the non-program area. Similarly, the study found that infant and child mortality is lower among the NGO credit members than among the non-members and that under five-year deaths of children progressively decline with the increase in the doses of vaccines. Implications of these findings are discussed in the study.

To examine the effects of birth spacing on early childhood mortality, 3729 singleton births in 1983-84 were followed for 3 years in rural Bangladesh. Logistic regression analyses were used to assess whether the survival of older siblings modifies the effect of preceding birth intervals and to see if the effects of preceding and succeeding birth intervals are inter-related, controlling for the effects of sex of the child, mother's age and household economic status. With the exception of the neonatal period, birth spacing effects were highly significant. A preceding birth interval of < 15 months was associated with a greater mortality risk in the post-neonatal period for children with an older sibling who survived infancy. However, a short preceding birth interval did not adversely affect post-neonatal mortality if the older sibling died in infancy. Neonatal and post-neonatal deaths were higher if older siblings had died in respective age intervals. A pregnancy interval of < 12 months after childbirth raised the risk of death at ages 1-2 years considerably if the child was born after a short birth interval (< 15 months). The results suggest that the high mortality risks of closely spaced children are due to sibling competition for parental resources.

Infant and child mortality levels and trends in Bangladesh are examined using data from the 1989 Bangladesh Fertility Survey. Both infant and child mortality declined from the mid 1970s but infant mortality declined more quickly. The level of infant mortality in 1989 was around 100 per 1000 live births while child mortality (5q0) was 200 per 1000 live births. Life table analysis confirms the change in infant and child mortality. The decline in infant mortality is attributed to the introduction of improved public health measures and access to maternal and child health services.

"This study attempts to estimate by indirect estimation technique the levels of infant and child mortality in Bangladesh using the 1989 Bangladesh Fertility Survey (BFS). The levels of infant and child mortality obtained from the 1989 BFS indicate substantial improvements in child survival, although the fall in infant mortality has been faster than the fall in child mortality.", (excerpt)

Differentials in child survival in Bangladesh have been examined using a number of socioeconomic and environmental factors on data from the 1989 Bangladesh Fertility Survey. Multivariate analysis reveals that both wife's and husband's education and household electricity show a significant positive association with child survival. The respondent's working status exerts a significant negative influence. Wife's education has a greater influence on child survival in Bangladesh than that of husband's education.

This study based on the 1975-76 Bangladesh Fertility Survey showed that the mortality of sons, and not daughters, was associated with a lower rate of female contraceptive initiation of use and a higher rate of discontinuation.

The 1975-76 Bangladesh Fertility Survey data show little evidence that breast-feeding is the intermediate factor through which birth intervals influence child survival in Bangladesh. Preceding birth interval, subsequent pregnancy and breast-feeding duration each have an independent influence on early mortality risk. Within a specific interval the risk of dying decreases with increase in duration of breast-feeding, and also with an increase in the time between the index birth and the next pregnancy. The death of the immediately preceding child in infancy has a significant negative effect on the survival chance of the index child at ages 1-5 months. However, death of the preceding child appears to have a significantly positive effect on the survival chance of the index child between ages 9 months and 5 years; this may be related to competition between siblings.

"This paper examines how the level of child mortality and rate of out-migration, and their covariates were affected during the 1974 famine and the periods immediately following the famine in Bangladesh." The authors examine several variables affecting mortality and out-migration, including socioeconomic status, sex factors, age factors, educational status, and religion. Data are from the Matlab Demographic Surveillance System., (excerpt)

"The present study was undertaken to identify the levels and age patterns of mortality in one rural area of Bangladesh. Some of the most recently developed nontraditional methods were applied to the...data set for obtaining estimates of infant and child mortality and adult mortality. The validity of estimates was assessed by making a comparison with a few indicators of mortality available from various sources. Although the basic data from local studies might have been deficient, the application of nontraditional methods to such information on mortality could still provide consistent and plausible estimates both at regional and national levels." Data are from a survey conducted in 1986., (excerpt)

The effect of breast feeding on nutritional state, morbidity, and child survival was examined prospectively in a community in rural Bangladesh. Every month for six months health workers inquired about breast feeding and illness and measured arm circumference in an average of 4612 children aged 12-36 months. Data from children who died within one month of a visit were compared with those from children who survived. Roughly one third of the deaths in the age range 18-36 months were attributable to absence of breast feeding. Within this age range protection conferred by breast feeding was independent of age but was evident only in severely malnourished children. In communities with a high prevalence of malnutrition breast feeding may substantially enhance child survival up to 3 years of age.

"This paper examines the factors that affect child mortality [in rural Bangladesh] by using a multivariate technique. The results suggest that mother's access to education and health care facilities are important determinants of child mortality. The access to maternal and child health programs and visit by the health workers were also related to low childhood mortality...." (SUMMARY IN FRE AND ITA), (excerpt)

"This paper presents a microanalytic stochastic model of human reproduction with special features for use in examining reproduction in high mortality populations. The model builds on prior work by including (a) a beta distribution for fecundability, permitting variations between women and during a woman's childbearing years, (b) fetal deaths and stillbirths that vary with a woman's age, and (c) sterility that varies as a function of two random probability distributions. New to this model is inclusion of a Weibull survival function for infant and child mortality and a model schedule of postpartum amenorrhoea that depends on the length of breastfeeding." Consideration is given to the interaction of breast-feeding and early mortality and their effects on human reproduction. "Input parameters are selected for the population of Bangladesh, and initial results from a Monte Carlo simulation, in which age at marriage varies, are given.", (excerpt)

Background: The prevalence of Short Birth Interval (SBI) is higher in Low- and Middle-Income countries (LMICs), including Bangladesh. Previous studies in LMICs have estimated the effects of SBI on child mortality by comparing two unequal groups of mothers based on their socio-economic status. This approach may lead to overestimation or underestimation of the true effect of birth interval on child mortality, particularly when sample sizes are relatively small. Objective: We determined the effects of SBI on several forms of child mortality in Bangladesh by comparing two equal groups created by applying the propensity score matching technique. Methods: This study analyzed data from 5,941 mothers and 1,594 health facilities extracted from the 2017/18 Bangladesh Demographic and Health Survey and the 2017 Bangladesh Health Facility Survey. The exposure variable was SBI (defined as the interval between two subsequent births <33 months: yes, no), while the outcome variables were neonatal mortality (defined as mortality within 28 days of birth: yes, no), infant mortality (defined as mortality within 1 year of birth: yes, no), and under-five mortality (defined as mortality within 5 years of birth: yes, no). Multilevel Poisson regression based on inverse probability treatment weights was used to determine the association between exposure and outcome variables. Results: The prevalence rates of neonatal, infant, and under-five mortality were 48.8, 30.8, and 23.1 per 1000 live births, respectively. Newborns of SBI mothers were found to have a 63% higher likelihood of neonatal mortality (aPR, 1.63; 95% CI, 1.08–2.46) compared to newborns of non-SBI mothers. Furthermore, the prevalence of infant mortality and under-five mortality was 1.45 times higher (aPR, 1.45; 95% CI, 1.01–2.08) and 2.82 times higher (aPR, 2.82; 95% CI, 2.16–3.70), respectively, among babies born in a short interval of their immediately preceding sibling as compared to babies born in a normal interval of their immediately preceding sibling. Conclusions: Findings of this study indicate that SBI is an important predictor of child mortality. Consequently, around 1 million children born in a short interval every year in Bangladesh are at risk of dying before reaching their fifth birthday. This indicates a challenge for Bangladesh to achieve the SDG 3 target to reduce neonatal and under-five mortality to 12 and 25 deaths per 1000 live births, respectively. Hence, awareness-building programs about the adverse effects of SBI and strengthening existing healthcare facilities are important. [ABSTRACT FROM AUTHOR]

Background: Skilled birth attendants (SBAs) play a crucial role in reducing infant and maternal mortality. Although the ratio of skilled assistance at birth has increased in Bangladesh, factors associated with SBA use are unknown. The main goal of our study was to reveal the individual- and community-level factors associated with SBA use during childbirth in Bangladesh. We also showed the prevalence and trend of SBA use and related independent variables in Bangladesh over the past decade. Methods: This study utilized the Bangladesh Health and Demographic Survey (BDHS) 2017–2018, a cross-sectional study. We used binary logistic regression to examine the extent of variation in SBA use attributable to the individual- and community-level variables. Results: Overall, 53.35% of women received assistance from SBAs during childbirth. The average annual rate of increase (AARI) in the number of SBA-assisted births over the past 10 years was 8.88%. Respondents who gave birth at or above 19 years had 1.40 times (AOR = 1.40; 95% CI: 1.21–1.62) greater odds of having skilled delivery assistance than respondents aged 18 years old or less. Women and their husband's education levels were significantly associated with using skilled assistance during delivery, with odds of 1.60 (AOR = 1.60; 95% CI: 1.45–2.01) and 1.41 (AOR = 1.41; 95% CI: 1.21–1.66), respectively compared to those with education up to primary level. Women from rich families and those receiving better antenatal care (ANC) visits were more likely to have professional delivery assistance. Community-level factors also showed significance towards having professional assistance while giving birth. Women from urban communities and those who utilized more than four ANC visits and had completed secondary or higher education showed a greater tendency to use an SBA during childbirth than their counterparts. Conclusion: The use of SBAs during delivery was significantly associated with some individual- and community-level factors. To reduce maternal and child mortality, there is a need to focus on rural and uneducated people who are less likely to access these facilities. Special programs could increase awareness and help the poor community obtain the minimum facility in maternal care. [ABSTRACT FROM AUTHOR]

This paper examines the effect of maternal education on child mortality in Bangladesh by exploiting quasi‐experimental variations in the duration of exposure to a school stipend project for identification. Results from the instrumental variable estimation indicate that an additional year of maternal schooling reduces both under‐five and infant mortality by about 20 percent. The findings are statistically significant and robust to a number of model specifications, including survival models controlling for right censoring of child mortality. Analysis of potential mechanisms suggests that maternal education reduces child mortality through greater wealth and literacy, positive assortative mating, lower fertility, delayed marriage and childbearing, greater health‐related knowledge, better health‐seeking behaviors, and female empowerment, but not through female employment. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to assess the impact of sociodemographic factors on child mortality in urban and rural areas of Bangladesh. Methods: The research was performed using cross-sectional survey data from the Bangladesh Multiple Indicator Cluster Survey (MICS) 2012–2013. The impact of sociodemographic factors on child mortality was estimated using a Poisson regression model for both urban and rural areas of Bangladesh. Results: The findings of the study demonstrate that division, religion, women's education, women's age, contraception use, age at first marriage, birth interval, and number of children ever born had notable effects. Among these factors, poverty, women's age, age at first marriage, birth interval, and number of children ever born had significant effects on child mortality in both urban and rural areas. The risk was significantly lower among women with secondary or higher education than in women with no formal education in both urban and rural areas of Bangladesh, and a negative association was found between wealth status and child mortality in rural areas. Conclusions: The government should not only take the necessary steps to reduce child deaths in the rural zones of Dhaka, Rajshahi, Rangpur, and the Sylhet Division, but should also consider stopping the practice of early marriage by increasing women's education in both urban and rural areas of Bangladesh. It will implement the program to fulfill the 11th national election manifesto of the ruling government of Bangladesh. [ABSTRACT FROM AUTHOR]

Aims: Mortality in children aged under two years is a severe public health problem in many developing countries. The aims of the study were to reveal the prevalence and factors associated with mortality in children under two years in Bangladesh. Methods: Data were analyzed using the Bangladesh Demographic and Health Survey 2014. A total of 7886 participant data used in this study. The chi-square test of association was performed with dependent and independent variables to measure the prevalence rate, while the final model binary logistic and log-binomial regressions were used to identify the potential risk factors for under-two mortalities. Results: The prevalence of under-2 mortalities in Bangladesh was 3.9%. Regression analysis revealed that a lower level of paternal education, succeeding birth interval less than 24 months, multiple birth babies, and smaller than the average size at birth were significantly associated with children's mortality under two years in Bangladesh. Conclusions: Despite improvements in the reduction of child mortality in Bangladesh, many children died within the first 24 months of life, mostly preventable. Programs towards increasing education levels and pregnancy intervals might help in preventing infant mortality in Bangladesh. [ABSTRACT FROM AUTHOR]

Background: Despite the substantial decline in child mortality globally over the last decade, reducing neonatal and under-five mortality in Bangladesh remains a challenge. Mothers who experienced multiple child losses could have substantial adverse personal and public health consequences. Hence, prevention of child loss would be extremely desirable during women's reproductive years. The main objective of this study was to determine the risk factors associated with multiple under-five child loss from the same mother in Bangladesh.Methods: In this study, a total of 15,877 eligible women who had given birth at least once were identified from the 2014 Bangladesh Demographic and Health Survey. A variety of count regression models were considered for identifying socio-demographic and environmental factors associated with multiple child loss measured as the number of lifetime under-five child mortality (U5M) experienced per woman.Results: Of the total sample, approximately one-fifth (18.9%, n = 3003) of mothers experienced at least one child's death during their reproductive period. The regression analysis results revealed that women in non-Muslim families, with smaller household sizes, with lower education, who were more advanced in their childbearing years, and from an unhygienic environment were at significantly higher risk of experiencing offspring mortality. This study also identified the J-shaped effect of age at first birth on the risk of U5M.Conclusions: This study documented that low education, poor socio-economic status, extremely young or old age at first birth, and an unhygienic environment significantly contributed to U5M per mother. Therefore, improving women's educational attainment and socio-economic status, prompting appropriate timing of pregnancy during reproductive life span, and increasing access to healthy sanitation are recommended as possible interventions for reducing under-five child mortality from a mother. Our findings point to the need for health policy decision-makers to target interventions for socio-economically vulnerable women in Bangladesh. [ABSTRACT FROM AUTHOR]

Under five child mortality is one of the serious public health issues in all over the world especially in South Asian region. Significant achievements have been made in last ten decades to reduce child mortality globally, but South Asian region still has one of the highest child mortalities in the world (51 deaths per 1000 live births). Out of ten child deaths, three occur in South Asian region. Various risk factors influence this high mortality rate, however, some of the risk factors show similarities and other varies time to time across countries in the South Asian region. Parents literacy, occupation, household wealth, health care accessibility and utilization, poverty and inadequate food intake, poor access to information, mother’s age and several socio-cultural factors contributes mostly to the high number of mortalities in young children. However, it is imperative to study the country specific reasons and useful comparison of contexts might be useful to address the immediate, underlying and basic causes of child malnutrition. There, this paper aimed to study the difference in under five child mortality in different South Asian countries and determine whether the associated risk factors are similar or different across those eight countries. For increasing the under-five child survival and achieving the Sustainable Development Goals, South Asian regional countries needs to give serious efforts on maternal and child health sector as it affects national development. Country specific strategies and interventions should be based on most prevalent risk factors. [ABSTRACT FROM AUTHOR]

In the article, the author discusses issues on the use of both live vaccines like measles vaccine and bacille Calmette-Guerin (BCG) and nonlive vaccines such as diphtheria-tetanus-pertussis (DTP). Other topics include why live vaccines reduce mortality from other infections like sepsis while nonlive vaccines increase all-cause mortality, as well as a study on the interaction between DTP and measles vaccines.

Background: Child and neonatal mortality is a serious problem in Bangladesh. The main objective of this study was to determine the most significant socio-economic factors (covariates) between the years 2011 and 2014 that influences on neonatal and child mortality and to further suggest the plausible policy proposals.Methods: We modeled the neonatal and child mortality as categorical dependent variable (alive vs death of the child) while 16 covariates are used as independent variables using χ2 statistic and multiple logistic regression (MLR) based on maximum likelihood estimate.Findings: Using the MLR, for neonatal mortality, diarrhea showed the highest positive coefficient (β = 1.130; P < 0.010) leading to most significant covariate for both 2011 and 2014. The corresponding odds ratios were: 0.323 for both the years. The second most significant covariate in 2011 was birth order between 2-6 years (β = 0.744; P < 0.001), while father's education was negative correlation (β = -0.910; P < 0.050). In general, 10 covariates in 2011 and 5 covariates in 2014 were significant, so there was an improvement in socio-economic conditions for neonatal mortality. For child mortality, birth order between 2-6 years and 7 and above years showed the highest positive coefficients (β = 1.042; P < 0.010) and (β = 1.285; P < 0.050) for 2011. The corresponding odds ratios were: 2.835 and 3.614, respectively. Father's education showed the highest coefficient (β = 0.770; P < 0.050) indicating the significant covariate for 2014 and the corresponding odds ratio was 2.160. In general, 6 covariates in 2011 and 4 covariates in 2014 were also significant, so there was also an improvement in socio-economic conditions for child mortality. This study allows policy makers to make appropriate decisions to reduce neonatal and child mortality in Bangladesh.Conclusions: In 2014, mother's age and father's education were also still significant covariates for child mortality. This study allows policy makers to make appropriate decisions to reduce neonatal and child mortality in Bangladesh. [ABSTRACT FROM AUTHOR]

Background: Socioeconomic inequality in health and mortality remains a disturbing reality across nations including Bangladesh. Inequality drew renewed attention globally. Bangladesh though made impressive progress in health, it makes an interesting case for learning. This paper examined the trends and changing pattern of socioeconomic inequalities in under-five mortality in rural Bangladesh. It also examined whether mother's education had any effect in reducing socioeconomic inequalities. Methods: Data from rural samples of seven Bangladesh Demographic Health Surveys, carried out so far, were used. Children born alive during 5 years preceding the surveys were included in the analysis. Univariate, bivariate and multivariate analyses were carried out. Results: Under-five mortality rate steadily declined over the years from 128/1000 in 1994 to 48 in 2014. Females had 8% lower mortality rates than males. Children of mothers with no schooling had 1.88 times higher mortality than those whose mother had six or more years of schooling. Similarly, children from low asset category households had on an average 1.17 times higher mortality rate than those from high asset category households. Inequality by mother's education disappeared in the recent years, and inequality by household socioeconomic condition persisted all through. The pattern of inequality by sex, mother's education, and household socioeconomic status was not changed statistically significantly over the years, and mothers' education did not reduce socioeconomic inequalities. Discussion: The reduction in mortality was consistent with changes in the proximate determinants of child survival in the country. Proximate determinants included maternal factors, environmental contamination, nutrient deficiency, personal illness control, and injury. Health and population programmes have been effective in increasing immunization coverage, use of ORS for managing diarrhoeal diseases, and increasing contraceptive use. Development activities on the other hand raised the literacy, especially among females, demand for modern health services, and reduction of poverty. However, socioeconomic inequality still exists in both under-five mortality and proximate determinants of child survival. Conclusions: The socioeconomic inequality in under-five mortality is showing resistance against further reduction. An assessment of the adequacy of the existing programmes taking the proximate determinants of child survival into consideration will be useful for further improvement. [ABSTRACT FROM AUTHOR]

Reducing child mortality is a Sustainable Development Goal yet to be achieved by many low-income countries. We applied a subnational and spatial approach based on publicly available datasets and identified permanent insolvency, urbanicity, and malaria endemicity as factors associated with child mortality. We further detected spatial clusters in the east of Bangladesh and noted Sylhet and Jamalpur as those districts that need immediate attention to reduce child mortality. Our approach is transferable to other regions in comparable settings worldwide and may guide future studies to identify subnational regions in need for public health attention. Our study adds to our understanding where we may intervene to more effectively improve health, particularly among disadvantaged populations. [ABSTRACT FROM AUTHOR]