Millennium Development Goal
INTRODUCTION
The Millennium Development Goals (MDGs) are eight international development goals that all 193 United Nations member states and at least 23 international organizations have agreed to achieve by the year 2015. The aim of the MDGs is to encourage development by improving social and economic conditions in the world's poorest countries. They derive from earlier international development targets, and were officially established following the Millennium Summit in 2000, where all world leaders present adopted the United.
The Millennium Summit was presented with the report of the Secretary-General entitled ‘We the Peoples: the Role of the United Nations in the Twenty-First Century’. Additional input was prepared by the Millennium Forum, which brought together representatives of over 1,000 non-governmental and civil society organizations from more than 100 countries. The Forum met in May 2000 to conclude a two-year consultation process covering issues such as poverty eradication, environmental protection, human rights and protection of the vulnerable.
A major conference was held at UN headquarters in New York on 20–22 September 2010 to review progress to date, with five years left to the 2015 deadline. The conference concluded with the adoption of a global action plan to achieve the eight anti-poverty goals by their 2015 target date. There were also major new commitments on women's and children's health, and major new initiatives in the worldwide battle against poverty, hunger and disease.
Child mortality continues to decline worldwide. The total number of deaths of children below five years of age fell from 12.4 million in 1990 to 7.7 million in 2010. Mortality in children below five years of age (under-five mortality) has fallen from 89 per 1000 live births in 1990 to 60 per 1000 live births in 2009, representing a reduction of about one-third, and the rate of decline has accelerated over the period 2000–2010 compared to the 1990s. Despite these figures, much more needs to be done to achieve Target 4, a two-thirds reduction in mortality from 1990 levels by the year 2015. Pneumonia and diarrheal diseases are the two biggest killers of children below five years of age, with pneumonia accounting for 18% of all deaths and diarrheal diseases for 15%. These rates include deaths that occur during the neonatal period. Deaths in that period increasingly make up an important proportion of deaths among children below five years of age, accounting for about 40% of all deaths. By 2009, measles immunization coverage was 82% globally, up from 73% in 1990, among children aged 12–23 months. However, the coverage of crucial child health interventions against fatal diseases remains inadequate. These interventions include oral rehydration therapy and zinc for diarrhea and case management with antibiotics for pneumonia. Most child deaths due to pneumonia could be avoided if effective interventions were implemented on a broad scale to reach the most vulnerable populations. Six countries including Bangladesh received the UN Millennium Development Goal (MDG) Awards for their significant achievements towards attaining the goal. Three of these countries are from Asia and three from Africa.
Table-01: List of countries which received UN MDG Awards in 2010 Country | Progress made for MDGs | Bangladesh | MDG 04 | Nepal | MDG 05 | Cambodia | MDG 06 | Sierra Leone | MDG 06 | Liberia | MDG 03 | Rwanda | MDG 04 & 05 |

In September 2000, world leaders endorsed the Millennium Declaration, a commitment to work together to build a safer, more prosperous and equitable world. The Declaration was translated into a roadmap setting out eight time-bound and measurable goals to be reached by 2015, known as the Millennium Development Goals (MDGs): They include goals and targets on poverty, hunger, maternal and child mortality, disease, inadequate shelter, gender inequality, environmental degradation and the Global Partnership for Development. When only 3 years are ahead to reach the dateline of year 2015 for meeting the targets of MDGs, assessment is ongoing throughout the world to find the answer whether or not the countries crossed sufficient road. The answer, in general, is no, although progress has been made in some areas. The same is true also for Bangladesh. The interesting well-known fact is: about 40% of the under-5 child deaths occur in the first month of the newborns’ life and most in the first week. The rest 60% of under-5 deaths occur due to malnutrition, HIV, vaccine preventable and other communicable diseases including pneumonia, diarrhea, and other causes. Bangladesh has achieved remarkable progresses in reducing under-five mortality rate and infant mortality rate in the last two decades. The under-five mortality decreased significantly from 143.4 to 47.8 per 1000 live births between 1990 and 2010, which means Bangladesh has achieved the Millennium Development Goal -04(MDG-04) by reducing child mortality by two third from 1990 to 2010. United Nations awarded Bangladesh for its remarkable achievements in attaining the Millennium Development Goals (MDGs) particularly in reducing child mortality rate. Prime Minister Sheikh Hasina accepted the award at a colorful function at Astoria Hotel in New York in 20th September, 2010. The award was conferred upon Bangladesh and five other countries a day ahead of the MDG conference on the sidelines of the 65th UN General Assembly (UNGA).

FINDINGS (MAIN BODY)
Methodology
Infant and child mortality rates reflect a country’s level of socioeconomic development and quality of life. They are used for monitoring and evaluating population and health programs and policies. The rates are also important for monitoring progress towards the United Nations Millennium Development Goal to reduce child mortality by two-thirds by the year 2015.
The data for mortality estimates were collected in the birth history section of the Women’s Questionnaire. The 2007 Bangladesh Demographic and Health Survey (BDHS) asked all ever-married women age 15-49 to provide a complete history of their live births, including the sex, month, and year of each birth, survival status, and age at the time of the survey or age at death. Age at death was recorded in days for children dying in the first month of life, in months for children dying before their second birthday, and in years for children dying at later ages. The following direct estimates of infant and child mortality were used:
Neonatal mortality: the probability of dying within the 1st month of life;
Post-neonatal mortality: the difference between infant and neonatal mortality;
Infant mortality: the probability of dying before the 1st birthday;
Child mortality: the probability of dying between the 1st and 5th birthday;
Under-five mortality: the probability of dying between birth and the 5th birthday.
All rates are expressed per 1,000 live births except for child mortality, which is expressed per 1,000 children surviving to their 1st birthday (12 months of age).

Background
The target of MDG-04 is to reduce child mortality by two-thirds, from 93 children of every 1,000 dying before age five in 1990 to 31 of every 1,000 in 2015. Child deaths have been halved over the last few decades due to better nutrition, health care, and standards of living. In 1990, 12 million children in developing countries died before the age of 5. By 2010 that number had dropped to 7.7 million. Yet about 29,000 children under the age of five – 21 each minute – die every day, mainly from preventable causes. More than 70 % of almost 8 million child deaths every year are attributable to six causes: * Diarrhea * Malaria * Neonatal infection * Pneumonia * Preterm delivery or * Lack of oxygen at birth.
These deaths occur mainly in the developing world.

Figure-01: Causes of deaths among children under age five
An Ethiopian child is 30 times more likely to die by his or her fifth birthday than a child in Western Europe. Among deaths in children, South-central Asia has the highest number of neonatal deaths, while sub-Saharan Africa has the highest rates. Two-thirds of deaths occur in just 10 countries.

Figure-02: The 10 countries with the most under-five deaths
And the majorities are preventable. Some of the deaths occur from illnesses like measles, malaria or tetanus. Others result indirectly from marginalization, conflict and HIV/AIDS. Malnutrition and the lack of safe water and sanitation contribute to half of all these children’s deaths.
But disease isn’t inevitable, nor do children with these diseases need to die. Research and experience show that half of the almost 8 million children who die each year could be saved by * Low-tech, evidence-based * Cost-effective measures such as vaccines * Antibiotics * Micronutrient supplementation * Insecticide-treated bed nets and * Improved family care and breastfeeding practices. Bangladesh has made significant progress in improving the health of its children. Bangladesh is among only six countries in the world that have reduced by half or more their child mortality rate since 1990 (from 143.4/1000 in 1990 to 47.8 in 2010).
Despite these inroads, challenges remain. While the mortality rates have improved overall, major inequalities among the population need to be addressed. The under-five mortality rate is 86/1000 for the poorest quintile while the richest quintile records only 43/10001. The recent Multiple Indicator Cluster Survey conducted in 2009 also shows huge geographical disparities with the least performing district, Sherpur, recording 102 deaths per 1,000 live births and the best performing one, Pabna, recording only 43 per 1,000. Infant and neonatal mortality rates remain high and have not decreased substantially for the past five years. Today, neonatal mortality makes up more than half of all under-five deaths.

Figure-03: Statistics of MDG-04 of Bangladesh from 1960 to 2010.
Issues
Survival is an enormous challenge for children younger than one year of age and especially those younger than one month, the neonates. In Bangladesh, 14 babies under one month of age die every hour and 120,000 every year.
3/4th of these newborn babies die within their first week of life and almost 50% die within the first 24 hours of birth, with most of these deaths occurring at home. The main causes of these deaths are: * Infection (about 50 %) * Birth asphyxia and * Low birth weight or pre-term deliveries.
The knowledge of caregivers plays a crucial role. Simple life saving newborn care practices could save those babies, such as * Drying and wrapping * Early initiation of exclusive breastfeeding * Tactile stimulation and resuscitation * Care of eyes * Skin and umbilical cord * Special care of low birth weight babies and early referral to a trained provider when they are sick.
However, most families do not know about these simple care practices. After the neonatal period, acute respiratory infections (ARI), diarrhea and injuries - especially drowning - are the leading causes of death among children under five.
ARI: In Bangladesh, it is estimated that one in five deaths of children under-five is due to pneumonia (21%, BDHS 2004). Only 37 % of children affected by ARI were taken to a facility or to a health worker in rural areas in 2007 (BDHS 2007). Many parents simply do not know what services are available, or they are unsure about the quality of care offered. They also tend to think that childhood illnesses are a "natural" part of growing up. The challenge is to reach families with a package of high-impact essential services for child survival using a community-based approach.
Diarrhea: In 1993-1994, only 50% of children with diarrhea received oral rehydration therapy, while in 2007 that figure had increased to 77 %( BDHS 2007). The greatest improvements have taken place in rural areas. In the future, vaccines for rotavirus and cholera as well as zinc treatment (already introduced) could play a critical role in reducing the number of diarrhea-related deaths.
Injuries: Injuries are another major challenge for Bangladeshi children. Injuries account for nearly two in every five deaths for children aged 1 to 17. Drowning alone is the leading cause of death for children between one and four years of age (BHIS 2005). Other causes of injury deaths in Bangladesh are: * Road traffic accidents * Falls * Burns * Poisoning * Animal bites * Suicide and * Violence. Of the children who do survive injuries, many are burdened with disabilities and face an uncertain future with extremely limited support. About 36 children become disabled every day from injuries.
Malnutrition: With more than 46% children under five years of age being underweight(BDHS 2007), Bangladesh also records a high rate of malnutrition which contributes to weakening the immune system and ultimately results in higher child mortality. Disparities in health and nutritional status of children are closely associated with income inequity, inequity in access to good quality nutrition, education, and health services. For instance, more than half of malnourished children in Bangladesh are also among the poorest.
Immunization: Immunization has made good progress with 75% of one-year-olds now fully immunized (CES 2009). Some 98% of babies receive BCG, the first antigen given to newborns. An outbreak of polio in March 2006 prompted increased immunization activities that have helped keep Bangladesh polio-free since November 2006. Neonatal tetanus (NT) was eliminated in Bangladesh in May 2008. However for people in the remotest areas, accessing vaccines can be difficult. It is a continual challenge to reduce the number of children dropping out after the first immunization visit.

Levels and Trends in Infant and Child Mortality
Mortality rates for children under five years of age are presented in Table 02 for the three five-year periods preceding the survey.
Table02: Early Childhood Mortality Rates Years precedingthe survey | Neonatalmortality | Post-neonatalmortality | Infantmortality | Childmortality | Under-fivemortality | 0-4 | 37 | 15 | 52 | 14 | 65 | 5-910-14 | 42 | 21 | 62 | 21 | 82 | | 57 | 32 | 89 | 31 | 117 |

Childhood mortality rates obtained for the five years preceding successive DHS surveys conducted in Bangladesh since 1993-1994 confirm a declining trend in mortality (Figure 8.1). Between the periods 1989-1993 and 2002-2006, infant mortality declined by 40 percent from 87 deaths per 1,000 live births to 52 per 1,000.

Figure-04: Trends in Infant and Childhood Mortality 1989 to 2006

Socioeconomic Differentials in Infant and Child Mortality
Differentials in childhood mortality for the ten years preceding the survey by selected background characteristics are presented in Table 03 and Figure 05.
Table 03: Early childhood mortality rates by Socio-economic Characteristics Background Characteristic | Neonatalmortality | Post-neonatalmortality | Infantmortality | Childmortality | Under-fivemortality | Residence | | | | | | Urban | 33 | 17 | 50 | 13 | 63 | Rural | 41 | 18 | 59 | 19 | 77 | Division | Barisal | 31 | 19 | 50 | 23 | 71 | Chittagong | 34 | 20 | 54 | 27 | 79 | Dhaka | 38 | 18 | 55 | 14 | 69 | Khulna | 32 | 16 | 49 | 10 | 58 | Rajshahi | 46 | 12 | 58 | 14 | 71 | Sylhet | 53 | 31 | 84 | 25 | 107 | Mother’s educationNo education | | 47 | 24 | 71 | 23 | 93 | Primary incomplete | 35 | 23 | 58 | 19 | 76 | Primary complete | 44 | 14 | 59 | 10 | 68 | Secondary incomplete | 39 | 10 | 48 | 13 | 61 | Secondary complete or higher | 21 | 5 | 26 | 6 | 32 | Wealth quintile | Lowest | 48 | 18 | 66 | 22 | 86 | Second | 44 | 23 | 67 | 19 | 85 | Middle | 40 | 23 | 63 | 22 | 8362 | Fourth | 32 | 14 | 46 | 16 | | Highest | 27 | 9 | 36 | 8 | 43 |

The 2007 BDHS data show wide variations in mortality by division. Infant mortality ranges from 50 deaths per 1,000 live births in Barisal to 84 per 1,000 in Sylhet. Under-five mortality is lowest in Khulna (58 per 1,000) and highest in Sylhet (107 per 1,000). Sylhet has the highest mortality rates for all mortality indicators except child mortality; this was also true in previous BDHS surveys. Child mortality is highest in Chittagong. Khulna has the lowest rates for infant, child, and under-five mortality, while Barisal has the lowest rates for neonatal mortality. Post-neonatal mortality is lowest in Rajshahi division.

Figure-05: Under-Five Mortality Rates by Socioeconomic Characteristics
Mother’s level of education is inversely related to her child’s risk of dying. Higher levels of educational attainment are generally associated with lower mortality risks, since education exposes mothers to information about better nutrition, use of contraception to limit and space births, health care during pregnancy, and childhood illnesses, vaccinations, and treatments.
A child’s risk of dying is also associated with the economic status of the household. All childhood mortality rates are lowest for those in the highest wealth quintile, and the risk of dying by age five in the top quintile is about half that of the bottom quintile. The relationship between childhood mortality and household wealth is especially notable for infant and child mortality.

Demographic Differentials in Infant and Child Mortality
This section examines differentials in early childhood mortality by demographic characteristics of the child and the mother. Table-04 and Figure-06 present mortality rates for the ten-year period preceding the survey by sex of the child, age of the mother at birth, birth order, and previous birth interval.
Table-04: Early childhood mortality rates by demographic characteristics Demographic Characteristic | Neonatalmortality | Post-neonatalmortality | Infantmortality | Childmortality | Under-fivemortality | Child’s sex | | | | | | Male | 42 | 19 | 61 | 16 | 76 | Female | 36 | 17 | 54 | 20 | 72 | Mother’s age at birth | <20 | 55 | 20 | 75 | 17 | 90 | 20-29 | 30 | 16 | 45 | 18 | 63 | 30-39 | 38 | 21 | 59 | 18 | 76 | 40-49 | * | * | * | * | * | Birth order1 | | 52 | 15 | 67 | 14 | 80 | 2-3 | 31 | 18 | 49 | 16 | 65 | 4-6 | 37 | 20 | 58 | 23 | 80 | 7+ | 37 | 25 | 62 | 25 | 85 | Previous birth interval | < 24 months | 67 | 38 | 105 | 36 | 137 | 24-35 months | 31 | 18 | 49 | 22 | 70 | 36-47 months | 29 | 15 | 44 | 12 | 5644 | 48 months or more | 20 | 13 | 33 | 12 | |

Male children experience higher neonatal mortality than female children. In contrast, rates that do not include the first month of life, such as post-neonatal mortality, are similar for male and female children. The pattern of gender differentials in neonatal mortality is expected because neonatal mortality (which reflects largely congenital conditions) tends to be higher for boys than girls.

Figure-06: Under-Five Mortality Rates by Demographic Characteristics

Actions by UNICEF
UNICEF's child survival program focuses on three main areas: a) The Expanded Program on Immunization (EPI) b) The Integrated Management of Childhood Illness (IMCI) including newborn care c) The prevention of child injuries. (On neonatal care, see Factsheet ‘Maternal and Neonatal health’).
Expanded Program on Immunization (EPI)
The Expanded Program on Immunization aims: * To achieve full immunization coverage for 85 % of children younger than 12 months in low performing areas * To eradicate poliomyelitis (polio) * To eliminate maternal and neonatal tetanus (achieved in Bangladesh) * To expand Heamophilus Influenzae type b (Hib) vaccination against severe forms of pneumonia and meningitis * To reduce measles mortality and morbidity.
To achieve these goals, UNICEF procures vaccines, cold chain equipment (such as refrigerators, cold boxes, ice packs) and other supplies (such as syringes and safety boxes). UNICEF supports the Government in improving routine EPI coverage through its ‘Reach Every District’ strategy, focusing on 15 chronically low performing or hard-to-reach districts including the Chittagong Hill Tracts (CHT) and urban slums.
Integrated Management of Childhood Illness (IMCI)
UNICEF supports the Government of Bangladesh and NGOs to implement Integrated Management of Childhood Illness (IMCI) interventions with the objective to reduce child deaths due to major childhood killers: neonatal infections, pneumonia, diarrhea, malaria and malnutrition. IMCI interventions take place both in health facilities and at community level.
In health facilities, the objective is to ensure quality treatment, counseling, follow-up and referral care for newborns and children under five. Major initiatives undertaken are: * Provision of appropriate training through establishing training centers * Orientation of health managers on planning, implementing and monitoring * Provision of job aids and logistics * Regular supply of essential drugs * Regular performance reviews through monitoring visits, district/divisional review meetings and feedback * Development of information systems and data collection.
UNICEF contributed to the development of all the training packages. In communities, major activities include: * Counseling at household level by trained community health workers or promoters, including antenatal care; * Postnatal care visits carried out 48 hours after birth and provision of essential newborn care; * Identification and referral of sick newborn babies and sick and children; * Training of village doctors to help them improve treatment by rational use of drugs and timely referral; * Mobilization of local opinion leaders to enlist their support to improved caring practices; * Communication activities using appropriate channels such as folk theatre, etc.
Prevention of Child Injury
UNICEF is supporting an injury prevention operational research project that covers about 800,000 rural and 200,000 urban people. The project has three broad components: home safety, school safety and community safety programs. An inbuilt surveillance system was established to measure the effectiveness. Two evaluations conducted in 2009 confirmed the effectiveness of the injury prevention strategies put in place through this pilot project.
WHO Strategies
WHO promotes four main strategies to reduce child mortality: * Appropriate home care and timely treatment of complications for newborns; * Integrated management of childhood illness for all children under five years old; * Expanded program on immunization; * Infant and young child feeding.
World Bank strategies
World Bank promotes following ideas to reduce child mortality: * Strengthening national health systems * Expanding immunization programs * Enhancing growth monitoring of children * Ensuring the survival and improved health of mothers * Supporting better nutrition for child and mother * Investing in improved reproductive health * Making infrastructure investments

CONCLUSION
The Millennium Development Goals (MDGs) were officially established in the Millennium Summit in 2000, where all world leaders have agreed to achieve the goals by the year 2015. UN awarded Bangladesh for achieving MDG-04 as Bangladesh reduce child mortality by two third during 1990-2010 period. Still 14 babies under 1 month of age die every hour in Bangladesh mainly from preventable causes. So, the country has several critical challenges with regard to child health to keep the child mortality rate low. Those include reduction in rural-urban, rich-poor, and regional disparities in child mortality, ensuring access to essential child health care services to people in the remote rural areas and poor migrant populations in urban areas, creating awareness for breastfeeding and skilled birth delivery and improving overall child health quality services across the country. In order to recommend effective strategies to overcome the existing challenges in child mortality reduction, and to contribute to the achievement of Millennium Development Goals (MDG), Ministry of Health (MoH), WHO, UNICEF and World Bank jointly undertook the review of Reducing Child Mortality strategies.

RECOMMENDATIONS
According to UNICEF and WHO this has been possible due to increase in proper health care service and vaccination programs. Yet about 21,000 children under the age of five die every day, which can be reduced.
The major recommendations for Bangladesh’s perspectives are:
1. Taking Care of Mother’s Health:
Poor neonatal conditions are the most prominent cause of young deaths. A mother’s health is also critical to newborns. Research suggests that a sound neonatal environment is an important predictor of future health. So the mother should get appropriate home care and timely treatment during her pregnancy period.
2. Rural-Urban Disparities:
Disparities in health and nutritional status of children are closely associated with rural and urban lifestyle. Child death due to malnutrition is much higher in rural areas than urban areas of Bangladesh. This is due to illiteracy, unconsciousness, carelessness of village mothers. Creating awareness among rural mothers through counseling at household level by trained community health workers or promoters about child nutrition can reduce the death rate.
Health and outreach workers are enabled to support better parenting, the care of mothers, infant feeding, care-seeking practices among families and communities in favor of disease prevention, and optimal management of childhood illness.
3. Free Treatment for Child and Mother:
Africa’s Sierra Leon is one of the poorest countries in the world. This country has developed a lot in reducing child mortality rate through the last decade. This success has been possible because the country bears all the medical costs for child and mother care. If we want to reduce child mortality rates our Government should follow the same way.
4. Improving Family Care Practices:
About 80% of health care in developing countries occurs in the home – and the majority of children who die, do so at home, without being seen by a health worker. As many as 40% of child deaths could be prevented with improved family and community care – not by high-tech health equipment, but by access to solid knowledge, support and basic supplies.
The knowledge of caregivers plays a crucial role. Simple life saving newborn care practices could save those babies, such as drying and wrapping, special care of low birth weight babies.
However, most families do not know about these simple care practices.
5. Use of Mosquito Nets:
Another target should be increase in the rate of children sleeping under mosquito nets. Malaria is responsible for 10 % of all under-five deaths in developing countries.
6. Births should be attended by Skilled Personnel:
In our country, births attended by skilled personnel are only 24.4% (BBS & UNICEF, 2009) which is a major reason for neonatal death. Increase in awareness about skilled birth delivery can develop the rate.
7. Creating Awareness for Breastfeeding from 0-15 Months:
The strongest foundation of baby health is nutrition, and the best food for newborns is breast milk. Breastfeeding protects babies from diarrhea and acute respiratory infections, stimulates their immune systems and improves response to vaccinations, and contains many hundreds of health-enhancing molecules, enzymes, proteins and hormones.
But according to UNICEF, 2009 the rate of exclusive breastfed (0-6 months) is only 37%, which is very low. So, awareness should be raised especially among less educated people to breastfed their newborn babies up to 15 months from their birth.
8. Primary Health Programs: Population using sanitary latrines | 62.23% (SVRS, 2008, BBS) |
Govt. should run more awareness programs for hygiene promotion, sanitation, cost-effective water supply options and water quality, particularly for poor rural and urban families.

BIBLIOGRAPHY 1. A Situation Analysis Report on Health, UNDP Bangladesh. 2. Progress for Children (Achieving the MDGs with Equity), UNICEF, September, 2010. 3. Bangladesh Demographic and Health Survey, 2007. 4. Bangladesh Development Series, Paper no. 14, The World bank Office, Dhaka, January, 2007. 5. Report on Child Survival in Bangladesh, UNICEF, 2009. 6. Report on Levels and Trends in Child mortality, UNICEF, WHO, World Bank, UN Population Division, 2010. 7. The Millennium Development Goals Report 2011, United Nations. 8.

APPENDICES
Table A-01: Population Trend of Bangladesh, 1981-2011

Table A-02: Bangladesh Population & Housing Census Key features

Table A-03: Probability of Dying by Age 5 per 1000 Live birth

Table A-04: Number of Govt. Hospitals, Dispensaries, Doctors, Nurses and Bed

Table A-05: Child Death Rate per 1000 Children of Ages 1-4 Years by Sex and Residence

Year | Residence | Both Sex | Male | Female | 2000 | National | 4.2 | - | - | | Urban | 3.8 | - | - | | Rural | 4.5 | - | - | 2001 | National | 4.1 | - | - | | Urban | 3.6 | - | - | | Rural | 4.4 | - | - | 2002 | National | 4.6 | 4.7 | 4.4 | | Urban | 3.9 | 4.4 | 3.3 | | Rural | 4.7 | 4.8 | 4.6 | 2003 | National | 4.6 | 5.1 | 4.3 | | Urban | 4.4 | 5.4 | 3.4 | | Rural | 4.7 | 5.0 | 4.6 | 2004 | National | 4.5 | 4.4 | 4.5 | | Urban | 3.8 | 3.4 | 4.3 | | Rural | 4.6 | 4.7 | 4.5 | 2005 | National | 4.1 | 4.1 | 4.0 | | Urban | 2.6 | 3.2 | 2.0 | | Rural | 4.5 | 4.4 | 4.6 | 2006 | National | 3.9 | 4.0 | 3.7 | | Urban | 3.3 | 3.0 | 3.5 | | Rural | 4.1 | 4.3 | 3.8 | 2007 | National | 3.64 | 3.65 | 3.62 | | Urban | 2.31 | 1.94 | 2.70 | | Rural | 4.02 | 4.15 | 3.89 | 2008 | National | 3.1 | 3.1 | 3.0 | | Urban | 2.2 | 2.1 | 2.4 | | Rural | 3.4 | 3.6 | 3.3 | 2009 | National | 2.7 | - | - | | Urban | 2.6 | - | - | | Rural | 2.9 | - | - |

Table A- 06: Facts and Status about Child Health

<5 Children with diarrhea treated with ORT | 81.2% | BCG Vaccination (valid by 1 year of age) | 99% | OPV (Oral Polio Vaccine) 3 Vaccination (valid by 1 year of age) | 92.5% | DPT 3 Vaccination (valid by 1 year of age) | 85.5% (Bangladesh EPI) | HepB Vaccination (valid by 1 year of age) | 85.5% (Bangladesh EPI) | Measles Vaccination (valid by 1 year of age) | 82.8% (Survey, 2009) | Vitamin A coverage (0-59 Month) | 97% | Births attended by skilled personnel | 24.4% (BBS & UNICEF, 2009) | Exclusive breastfed (0-6 months) | 37% (UNICEF,2009) | Smear-positive pulmonary TB cases cured under DOTS | 92% | Child malnutrition | | Chronic malnutrition: stunting | 43% (UNICEF, 2009) | Acute malnutrition: wasting | 13% (UNICEF, 2009) | Underweight | 48% (UNICEF, 2009) | Population using safe drinking water (Tap & Tube well) | 98.23% (SVRS, 2008, BBS) | Population using sanitary latrines | 62.23% (SVRS, 2008, BBS) |