Bangladesh’s under-five mortality rate drops 79% in 30 years

Bangladesh has made outstanding progress in child survival in the past three decades, and thousands of children now have a better chance of survival compared to 1990.

The under-five mortality rate in Bangladesh has dropped by 79 percent since 1990–from 143.8 deaths per 1,000 live births in 1990 to 30.8 in 2019–according to new mortality estimates.

UNICEF, the World Health Organization (WHO), the Population Division of the United Nations Department of Economic and Social Affairs, and the World Bank Group jointly released the new mortality estimates on Wednesday.

Even before the pandemic, newborns were at a higher risk of death. In 2019, a newborn baby died every 13 seconds globally.

In the case of Bangladesh, despite the progress of reducing the under-five mortality rate, nearly 90,000 thousand children died in 2019 before reaching age five, though the number was around 512,896 in 1990.

Meanwhile, in 2019, the neonatal – defined as aged from born to exactly 28 days – mortality rate fell to 19.1 deaths per 1,000 live births in Bangladesh from 64.2 in 1990 and 42.8 in 2000; a 70% and 55% decline, respectively.

Responding to a query, former director of the Institute of Health Economics at Dhaka University Prof Syed Abdul Hamid said, "It is difficult to showcase any single point that reflects this remarkable progress. 

"However, the results reflected the country's overall progress with socio-economic and demographic elements, and revealed the benefits of ensuring proper and easy-to-access health services during and after pregnancy."

Second most improved in South Asia

In reducing the under-five mortality rate and neonatal mortality, Bangladesh ranked in the second best position in South Asia. Only the Maldives did better than Bangladesh.

From 1990 to 2019 in 30 years, the Maldives reduced by 91% the under-five mortality rate and 87% the neonatal mortality rate. However, the Maldives has the smallest population size.

Nepal and Bhutan (78%) were jointly in third place in terms of reducing the under-five mortality rates, followed by India (75%), Sri Lanka (68%) and Afghanistan (66%).

Pakistan (52%) progressed the least in the region.

Lagging behind in reducing adolescent death

Although Bangladesh made progress in the under-five and neonatal mortality rates, the progress in reducing the adolescent mortality rate was the third lowest in South Asia in 30 years; from 1990-2019. 

Even in the two decades from 2000-2019, the adolescent deaths per 1,000 increased from 9.4 to 9.7 in the country. As a result, during the period, the adolescent death rate increased 3.2%, while from 1990 to 2000 the rate declined 48%.
In 2019, more than 30,000 adolescents died in Bangladesh, the death toll is only 13,000 less than in 1990.

Discussing the lack of progress in reducing adolescent deaths, Prof Syed Abdul Hamid said, "Road accidents and suicides can be two major causes behind adolescent deaths. However, there is a need for study to find out the exact reasons behind this issue."

Prof Hamid added that cyber-bullying can be a key reason behind female adolescent suicides, and drug addiction can cause male adolescent suicides.

Globally, under-five mortality rates were 38 lives per 1,000, accounting for 5.2 million deaths of children aged below five in 2019. Moreover, half, or 2.4 million, of them died between birth and 28 days old.

Additionally, one million adolescents died in 2019. Most of the causes of their deaths were preventable or treatable.

The agencies have highlighted the need for urgent action to restore and improve childbirth services, and antenatal and postnatal care for mothers and babies; including having skilled health workers to care for them at birth. 

The WHO Director General, Dr Tedros Adhanom Ghebreyesus said, "The fact that today more children live to see their first birthday than any time in history is a true mark of what can be achieved when the world puts health and well-being at the centre of our response."

"Now, we must not let the Covid-19 pandemic turn back remarkable progress for our children and future generations. Rather, it's time to use what we know works to save lives, and keep investing in stronger, resilient health systems," he added.