Intervention needed to halt rise in child mortality

The government project styled, 'Sample Vital Registration System (SVRS)' that studies population change at national and district levels has come up with results that are both reassuring and concerning. Actually, as the findings make it evident, the negative social indicators outnumber the positive ones during the study period between 2021 and 2022 under review. The positive developments, for instance, include the maternal mortality rate which came down to 156 per thousand in 2022 from 168 in 2021. This is definitely heartwarming. So is the report that life expectancy of the population went up by a slight margin to 72.4 years from 72.3 years. One may also take heart from the fact that the literacy rate among the adults aged 15 years and above showed a positive trend (increased to 74.4 per cent from 74.1 per cent).

But the mortality figures, fertility rate, population density and child marriage which are on the rise cause disappointment. Seeing that per thousand mortality rate of under-five children rose to 31 from 28, or that of children under one year increased to 25 from 22 in 2021 between the years 2021 and 2022, even the state minister for planning who spoke as the special guest at the event where the report of the BBS survey called, Bangladesh Sample Vital Statics (BSVS), was unveiled, questioned the performance of the health and family welfare ministry. However, as a justification for such a rise in child mortality prevalence of infectious disease like pneumonia as a leading cause including jaundice and different types of fever was put forward by the project (SVRS) chief.  Also, conditions like diarrhoea, malnutrition, acute respiratory infection, even drowning, were mentioned as the potential causes of the rise in child mortality.

But that is about referring to the obvious. Those diseases or conditions are endemic in Bangladesh and therefore responsible for child mortality. Did any such disease take turn for the worse to claim more children's life or their combined fatality rose sharply to push up child mortality last year?   Policymakers in the government as well as the various local and international users could work on the causes of rise in child mortality had those been pinpointed correctly. Now there is a need for paying more attention to the infectious diseases that cause the children's/infants' death so that those can be brought under control.

The same can be said about the negative findings such as the crude birth rate (registering a rise from 18.8 per cent to 19.3 per cent) or the total fertility rate that has demonstrated a rising trend (from 2.05 per cent to 2.15 per cent). One should not be surprised at those results seeing that the use of contraceptives has dropped from 65.6 per cent to 63.8 per cent during the period under review. There has been a kind of revolution in child mortality and health courtesy of the expanded programme on immunisation (EPI).  Vitamin A and A plus campaigns have also helped the cause of child immunity but now the need is to take it to the next level of sustainability. To do that the living condition of the poor and marginalised have to be raised in order to ensure child health from sudden attack from diseases due to unhygienic living.