A Tale of Two Bengals: A Comparative Analysis of 23 Indicators of Maternal,Newborn and Child Health

Abstract

Background: Bangladesh and the Indian State of West Bengal form a homogenous geographic and cultural region with distinct administrative and governance structures. Although social and economic indicators are generally better in West Bengal compared to Bangladesh, this article is the first to provide a detailed comparison of indicators of child mortality, maternal and child health, nutrition, and coverage of key interventions in the two regions.

Methodology/Findings: Using data from the 2005–2006 National Family Health Survey for West Bengal and the Bangladesh Demographic and Health Survey (2007), we examined coverage, wealth and Hindu/Muslim inequalities in set of maternal, newborn and child health indicators. Performance across all indicators was broadly similar with comparatively better performance in West Bengal on coverage of antenatal care, postnatal care, and family planning while Bangladesh had higher rates of immunization coverage, vitamin A supplementation, and use of oral rehydration therapy. The nutritional status of children and rates of child mortality in the two Bengals were very similar. Access to improved sanitation was slightly higher in West Bengal with large inequalities by wealth observed in both regions. Rich–poor and educational based inequalities in stunting, wasting and underweight were higher in West Bengal.

Conclusion: Our findings indicate relatively similar performance across a range of maternal and child health indicators in Bangladesh compared to West Bengal despite lower levels of income and levels of literacy in Bangladesh. The two regions share similarities in topography, demography, and culture. Further studies on programme implementation in Bangladesh may lead to the development of a replicable model for resource poor countries.

Keywords

Bangladesh West Bengal maternal and child health sanitation public policy inequalities

Get full access to this article

View all access options for this article.

References

Ahmed

S. M.

Evans

T. G.

Standing

Mahmud

(2013). Explaining equity gains in child survival in Bangladesh: scale, speed, and selectivity in health and development. The Lancet , 382(9909), 2027–2037.

Ahmed

S. M.

Evans

T. G.

(2013). Harnessing pluralism for better health in Bangladesh. The Lancet , 382(9906), 1746–1755.

Ahmed

(2005). State of world population 2005. The promise of equality gender equity, reproductive health and the millennium development goals. New York: United Nations Fund Population. Retrieved from http://www.unfpa.org/swp/2005/pdf/en_swp05.pdf (accessed on 1 August 2015).

Ashford

(2002). Hidden suffering: Disabilities from pregnancy and childbirth in less developed countries . Population Reference Bureau, MEASURE Communication. Washington, DC.

Balarajan

Selvaraj

Subramanian

S. V.

(2011). Health care and equity in India. The Lancet , 377(9764), 505–515.

Bangladesh Bureau of Statistics. (2011). Population and Housing Census 2011. Retrieved from http://www.bbs.gov.bd/PageWebMenuContent.aspx?MenuKey=337 (accessed on 30 October 2015).

Barros

A. J.

Victora

C. G.

(2013). Measuring coverage in MNCH: determining and interpreting inequalities in coverage of maternal, newborn, and child health interventions. PLoS Med , 10(5), e1001390.

Bartram

Cairncross

(2010). Hygiene, sanitation, and water: Forgotten foundations of health. PLoS Med , 7(11), e1000367.

Basu

A. M.

Amin

(2000). Conditioning factors for fertility decline in Bengal: History, language identity, and openness to innovations. Population and Development Review , 26(4), 761–794.

10.

Bateman

O. M.

Smith

Roark

(1993). A comparison of the health effects of water supply and sanitation in urban and rural areas of five African countries . US Agency for International Development. Washington, DC.

11.

Black

R. E.

Morris

S. S.

(2003). Where and why are 10 million children dying every year? The Lancet , 361(9376), 2226–2234.

12.

Bloom

D. E.

Canning

Sevilla

(2001). The effect of health on economic growth: theory and evidence . National Bureau of Economic Research. Washington, DC.

13.

Braveman

Gruskin

(2003). Defining equity in health. Journal of Epidemiology and Community Health , 57(4), 254–258.

14.

Casasnovas

G. L.

Rivera

Currais

(2005). Health and economic growth: Findings and policy implications . MIT Press. Cambridge, MA.

15.

Census of India. (2011). West Bengal Profile. Retrieved from http://censusindia.gov.in/2011census/censusinfodashboard/stock/profiles/en/IND019_West%20Bengal.pdf (accessed on 30 October 2015).

16.

Chowdhury

A. M.

Bhuiya

Chowdhury

M. E.

Rasheed

Hussain

Chen

L. C.

(2013). The Bangladesh paradox: Exceptional health achievement despite economic poverty. The Lancet , 382(9906), 1734–1745.

17.

Corsi

D. J.

Subramanian

S. V.

(2013). Revisiting the discourse on accomplishing MDG-4. International Journal of Epidemiology , 42(3), 648–653.

18.

Corsi

D. J.

Subramanyam

M. A.

Subramanian

S. V.

(2011). Commentary: Measuring nutritional status of children. International Journal of Epidemiology , 40(4), 1030–1036.

19.

Esrey

S. A.

Potash

J. B.

(1990). Health benefits from improvements in water supply and sanitation: survey and analysis of the literature on selected diseases (WASH Technical Report No. 66). United States Agency for International Development. Washington, DC.

20.

Filmer

Pritchett

(2001). Estimating wealth effects without expenditure data—or tears: An application to educational enrollments in states of India. Demography , 38(1), 115–132.

21.

Geruso

Spears

(2015). Neighborhood sanitation and infant mortality (Working Paper).

22.

Ghosh

(2011). Maternal health care in Indian districts. Health Policy , 103(2–3), 290–296.

23.

Henry

F. J.

(1981). Environmental sanitation infection and nutritional status of infants in rural St. Lucia, West Indies. Transactions of the Royal Society of Tropical Medicine and Hygiene , 75(4), 507–513.

24.

Hutton

Haller

(2004). Evaluation of the costs and benefits of water and sanitation improvements at the global level: Water, sanitation, and health, protection of the human environment. World Health Organization.

25.

Reserve Bank of India. (2011–12). Handbook of statistics on Indian economy . 2015.

26.

Johri

Chandra

Subramanian

S. V.

Sylvestre

M. P.

Pahwa

(2014). MDG 7c for safe drinking water in India: An illusive achievement. The Lancet , 383(9926), 1379.

27.

Khadr

(2009). Monitoring socioeconomic inequity in maternal health indicators in Egypt: 1995-2005. International Journal for Equity in Health , 8, 38.

28.

Klugman

(2010). Human development report 2010–20th anniversary edition. The real wealth of nations: Pathways to human development. New York: United Nations Development Programme.

29.

Mara

Lane

Scott

Trouba

(2010). Sanitation and health. PLoS Med , 7(11), e1000363.

30.

Marmot

(2005). Social determinants of health inequalities. The Lancet , 365(9464), 1099–1104.

31.

Marmot

Commission on Social Determinants of Health. (2007). Achieving health equity: From root causes to fair outcomes. The Lancet, 370(9593), 1153–1163.

32.

Oxaal

Cook

(1998). Health and poverty gender analysis (Bridge: Development Gender Report No. 46). Institute of Development Studies, University of Sussex 46.

33.

Reserve Bank of India (2011). Handbook of statistics on the Indian economy . Mumbai: Department of Statistics and Information Management, Reserve Bank of India.

34.

Stockholm International Water Institute (SIW). Making water a part of economic development: The economic benefits of improved water management sanitation . Retrieved from http://www.who.int/water_sanitation_health/waterandmacroecon.pdf (accessed 18 November 2012).

35.

Tinker

Ransom

(2002). Healthy mothers and healthy newborns: The vital link. Policy perspectives on newborn health. Washington, D.C.: Population Reference Bureau and Saving Newborn Lives.

36.

UNICEF. (2006). Progress for children: A report card on water and sanitation . New York: United Nations Children’s Fund.

37.

United Nations Committee for Development Policy. (2009). Implementing the millennium development goals: Health inequailty and the role of global health partnerships. United Nations Publication. New York.

38.

Whitehead

(1991). The concepts and principles of equity and health. Health Promotion International , 6(3), 217–228.

39.

World Bank. (2015). GDP per Capita 2015 . Retrieved from http://data.worldbank.org/indicator/NY.GDP.PCAP.CD/countries (accessed on 1 August 2015).

40.

World Health Organization UNICEF. (2015). Improved and Unimproved Water and Sanitation Facilities . Retrieved from http://www.wssinfo.org/definitions-methods/watsan-categories/ (accessed on 1 August 2015).