What's happening in Bangladesh?

Abstract

Self-assured commentators who saw Bangladesh as a “basket case” not many years ago could not have expected that the country would jump out of the basket and start sprinting ahead even as expressions of sympathy and pity were pouring in. This informative Lancet Series on Bangladesh 1 Chowdhury AMR Bhuiya A Chowdhury ME Rasheed S Hussain Z Chen LC The Bangladesh paradox: exceptional health achievement despite economic poverty. Lancet. 2013; (published online Nov 21.)http://dx.doi.org/10.1016/S0140-6736(13)62148-0 Google Scholar , 2 Ahmed SM Evans TG Standing H Mahmud S Harnessing pluralism for better health in Bangladesh. Lancet. 2013; (published online Nov 21.)http://dx.doi.org/10.1016/S0140-6736(13)62147-9 Google Scholar , 3 El Arifeen S Christou A Reichenbach L et al. Community-based approaches and partnerships: innovations in health-service delivery in Bangladesh. Lancet. 2013; (published online Nov 21.)http://dx.doi.org/10.1016/S0140-6736(13)62149-2 Google Scholar , 4 Adams AM Rabbani A Ahmed S et al. Explaining equity gains in child survival in Bangladesh: scale, speed, and selectivity in health and development. Lancet. 2013; (published online Nov 21.)http://dx.doi.org/10.1016/S0140-6736(13)62060-7 Google Scholar , 5 Cash RA Halder SR Husain M et al. Reducing the health effect of natural hazards in Bangladesh. Lancet. 2013; (published online Nov 21.)http://dx.doi.org/10.1016/S0140-6736(13)61948-0 Google Scholar , 6 Adams AM Ahmed T El Arifeen S Evans TG Huda T Reichenbach L for The Lancet Bangladesh TeamInnovation for universal health coverage in Bangladesh: a call to action. Lancet. 2013; (published online Nov 21.)http://dx.doi.org/10.1016/S0140-6736(13)62150-9 Google Scholar helps to explain what happened—and why. It is important to understand how a country that was extremely poor a few decades ago, and is still very poor, can make such remarkable accomplishments particularly in the field of health, but also in social transformation in general. Bangladesh: innovating for healthWriting earlier this year, as part of a series of country case studies on good health at low cost, Dina Balabanova and her colleagues concluded that “Bangladesh has made enormous health advances and now has the longest life expectancy, the lowest total fertility rate, and the lowest infant and under-5 mortality rates in south Asia, despite spending less on health care than several neighbouring countries”.1 Why is this so? Full-Text PDF Community-based approaches and partnerships: innovations in health-service delivery in BangladeshIn Bangladesh, rapid advancements in coverage of many health interventions have coincided with impressive reductions in fertility and rates of maternal, infant, and childhood mortality. These advances, which have taken place despite such challenges as widespread poverty, political instability, and frequent natural disasters, warrant careful analysis of Bangladesh's approach to health-service delivery in the past four decades. With reference to success stories, we explore strategies in health-service delivery that have maximised reach and improved health outcomes. Full-Text PDF Explaining equity gains in child survival in Bangladesh: scale, speed, and selectivity in health and developmentBy disaggregating gains in child health in Bangladesh over the past several decades, significant improvements in gender and socioeconomic inequities have been revealed. With the use of a social determinants of health approach, key features of the country's development experience can be identified that help explain its unexpected health trajectory. The systematic equity orientation of health and socioeconomic development in Bangladesh, and the implementation attributes of scale, speed, and selectivity, have been important drivers of health improvement. Full-Text PDF Bangladesh's health revolutionMy country, Bangladesh, has seen a health revolution in my lifetime. Maternal mortality has decreased by 75% since 1980,1 infant mortality has more than halved since 1990, and life expectancy has risen to 68·3 years, higher now than in neighbouring India and Pakistan.2 Such rapid changes in health have almost no historical precedent, save perhaps for Japan's breakneck modernisation following the 19th-century Meiji Restoration.3 Full-Text PDF Health care for poor people in the urban slums of BangladeshBangladesh has witnessed substantial success with respect to health, as described in the Lancet Bangladesh Series and elsewhere.1 The daunting challenge now is the health of poor people living in urban areas. Massive and rapid urbanisation is occurring, with rural populations moving to cities in huge numbers, driven by poverty, climate change, and the promise of better economic opportunities.2,3 In the past 40 years the proportion of the population living in urban settings in Bangladesh has increased from 5% to 28%, with roughly 45 million people now living in urban areas. Full-Text PDF