Levels, trends and causes of mortality in children below 5 years of age in Bangladesh: findings from a national survey

Abstract

A nationwide survey, conducted in 1992-93 by the Control of Diarrhoeal Disease Programme, Government of Bangladesh, made national estimates of levels and causes of child mortality. A gradual downward trend in infant and child mortality was observed from the mid 1980s. Current mortality rates among infants and children below 5 years were estimated to be around 100 and 150 per 1,000 live births respectively. More than a quarter of deaths in children below 5 years were found to be associated with diarrhoea. Acute respiratory tract infections were also shown to be a major killer of young children.

PIP: Staff of the National Control of Diarrhoeal Disease Programme conducted interviews with 8171 urban and 3135 rural women, 13-50 years old, in Dhaka, Khulna, Rajshahi, and Chittagong divisions of Bangladesh during 1992-1993 to determine levels, trends, and leading causes of child mortality. Between 1978-1984 and 1991, child mortality fell from 200 to 155/1000 live births and infant mortality fell from 125 to 105/1000 live births. The leading symptoms in the two weeks before the death of the child were fever (42.7% rural and 44.7% urban) and inability to ingest breast milk or other food (38.1% and 30.3%, respectively). Other common symptoms included convulsions, diarrhea, breathing difficulties, and cough. Diarrhea alone contributed to 18.4% of all child deaths. 34% of diarrhea-related deaths were associated with bloody diarrhea. Diarrhea plus acute respiratory infection (ARI) accounted for 25.8% of all child deaths. ARI alone accounted for 15.5% of all child deaths. More than 50% of diarrheal deaths and more than 60% of ARI deaths had had a fever. 21.3% of all child deaths occurred during the first three days postpartum.