MDG Report 2012 - United Nations in Bangladesh

percent). Thus there has been a steady increase in immunization coverage especially afteradoption of the Reach Every District (RED) strategy targeting the low performing districts.While further efforts are needed to ensure full coverage and remove regional disparities in thevertical programmes such as EPI, this needs to be supplemented by better access to andutilization of health services especially by the poorer quintiles.5.3 Challenges to Achieving the TargetsAlthough Bangladesh has high prospects of achieving the MDG 4 targets, the country has toovercome a number of challenges. Drowning in water is the leading cause of deaths among children of age between 1-4years (42%). Thus efforts are needed to test and scale up effective interventions forpreventing drowning related deaths.Lack of quality services is the major bottleneck in facility-based child and newbornhealthcare. Quality service is frequently inadequate in health facilities because ofinsufficient number of skilled or trained personnel. Moreover, a lack of routinesupportive supervision and monitoring is a major cause of poor quality of services.Reducing the neonatal mortality remains a challenge and which may also impact oninfant and under-5 mortality. Thus high evidence based intervention for newbornservices need to be scaled up rapidly across the country.Adequate availability of essential drugs is a major impediment in providing relevantservices. The Bangladesh Health Facility Survey 2009 (World Bank 2010) found that,on average, only 58 percent of 19 essential drugs were present in health facilities.Moreover, a mere 9 percent of all facilities surveyed at the district level and belowhad more than 75 percent of essential drugs in stock.The achievements of universal health coverage, the removal of rural-urban, rich-poorand other form of equities and the provision of essential services for the vast majorityof the population are the key concerns for which effective strategies are to be adopted.The issues such as poverty related infectious diseases, mothers suffering fromnutritional deficiency, children suffering from malnutrition, pregnant women notreceiving delivery assistance by trained providers, poor maternal and child health,unmet need for family planning and the rise in STD infections constitute majorchallenges for achieving the health related targets.5.4 Way ForwardThe government needs to improve the health and development of children through universalaccess and utilization of quality newborn and child health services. In this context, thegovernment‟s plan covers the following measures:Establish an enabling policy environment and advocate for adequate resourceallocation for neonatal and child health interventions, including injury prevention.Rapid scaling up of evidence based effective intervention for prevention of majorkillers of under five children i.e. pneumonia and drowning are high on the agenda.Increase valid immunization coverage of all vaccine preventable diseases andmaintain polio free status, maternal and neonatal tetanus elimination status and reducemeasles morbidity by (i) keeping continued focus on low performing districts andurban municipalities; (ii) undertaking NIDs, measles and other supplementary59