247.Steady but considerable progress has been made in increasing the coverage of EmOC services with an estimated ratio of 1 for every 646,557 persons. A total of 132 EmOC facilities are providing Comprehensive EmOC and another 59 facilities are providing Basic. Met need for EmOC services increased to 13.7 percent in 2005 from 11.9 percent in 2004 and case fatality rate decreased to 1.18 percent in 2005 compared to 1.7 percent in 2004. Health professionals were trained on EmOC services.
248.Family planning: Bangladesh achieved good progress in contraceptive adoption, awareness raising about and controlling of population growth rate. Contraceptive Prevalence Rate (CPR) stood at 57 percent in 2005. Total Fertility Rate (TFR) came down from 3.3 in 2001 to 2.5 in 2005. These two important factors, along with drop in infant mortality rate, increased the mean age of first marriage (16 years), increase in female literacy rate and higher female labour participation rate contributed to slower growth rate of population (1.52 percent), which in turn caused by drop in infant mortality.
249.Significant differences exist in the use of Family Planning (FP) methods with CPR among Divisions, 32 to 68.3 percent. One major concern regarding FP methods is that nearly 50 percent of women, who use contraceptives, discontinue within the first year. There are other problems like inadequate addressing of the marginalized and poor people, ineffective policies and programmes such as more dependence on female. The other weaknesses in FP include: shortage of field staff and contraceptives, traditional beliefs and practices.
250.Adolescent reproductive health: Under aged mothers are more likely to suffer severe complications during delivery, resulting in higher mortality and morbidity among themselves and the children. Dowry still remains the core of marriage negotiations and major cause of violence, and early marriage of girl is still high. Early marriage, son-preference and low status of women in the society affect adolescent girls’ nutrition, education and access to health.
251.In Bangladesh indicated that a substantial portion of adolescent and young people are not aware of causes of menstruation, consequences of unprotected sexual activity, STD, HIV&AIDS and availability of treatment facilities. The State Party has therefore identified adolescent health and education both as a priority and challenge, and incorporated this issue in the HNPSP. Health and other related issues of adolescents will be further incorporated in curriculum of secondary education from 2008.
252.Infant and child mortality: Infant and child mortality are key indicators of the care, health and nutrition status of children as well as the social, cultural and economic progress of country. There has been a steady decline in the infant mortality rate from 87 per thousand live births in 1993-94 to 65 per thousand in 2004 (BDHS, 2004). Under-five mortality rate has come down from 133 in 1993-94 to 94 in 2000, further down to 84 per thousand in 2003 (BBS, 2005). There continue to be urban-rural differences in under-five mortality rate (55 in urban areas compared 78 in rural areas per thousand in 2004).
253.Neonatal death rate of 41 per thousand live births (BDHS 2004) is due to three main causes: infections (pneumonia, neonatal sepsis), birth asphyxia and low birth weight (LBW) and preterm delivery.