Publication: Health and Nutrition in Urban Bangladesh: Social Determinants and Health Sector Governance
Loading...
Files in English
6,774 downloads
Published
2018
ISSN
Date
2017-12-28
Author(s)
Editor(s)
Abstract
Urbanization is occurring at a rapid pace in Bangladesh, accompanied by the proliferation of slum settlements, whose residents have special health needs given the adverse social, economic, and public environmental conditions they face. Over the past 45 years, the country’s health and nutrition policies and programs have focused largely on rural health services. Consequently, equitable access of urban populations—particularly the urban poor—to quality health and nutrition services has emerged as a major development issue. However, the knowledge base on urban health and nutrition in Bangladesh remains weak. To address the knowledge gap, Health and Nutrition in Urban Bangladesh: Social Determinants and Health Sector Governance examines the health and nutrition challenges in urban Bangladesh—looking at socioeconomic determinants in general and at health sector governance in particular. Using a mixed methods approach, the study identifies critical areas such as financing, regulation, service delivery, and public environmental health, among others that require policy attention. The study also proposes specific actions within and outside the health sector to address the issues, providing guidance on their sequencing and the specific responsibilities of government agencies and other actors. This study should be useful to policy makers and practitioners working on urban health and nutrition issues in Bangladesh and in other low- and middle-income countries.
Link to Data Set
Citation
“Frere, Jean-Jacques; Govindaraj, Ramesh; Raju, Dhushyanth; Secci, Federica; Chowdhury, Sadia. 2018. Health and Nutrition in Urban Bangladesh: Social Determinants and Health Sector Governance. Directions in Development—Human Development;. © World Bank. http://hdl.handle.net/10986/29091 License: CC BY 3.0 IGO.”
Associated URLs
Associated content
Other publications in this report series
Publication Strengthening Competitiveness In Bangladesh—Thematic Assessment(Washington, DC: World Bank, 2016-07-15)This is volume 2 of a three-volume publication on Bangladesh’s trade prospects. Bangladesh’s ambition is to build on its very solid growth and poverty reduction achievements, and accelerate growth to become a middle income country by 2021, and share prosperity more widely amongst its citizens. This includes one of its greatest development challenges: to provide gainful employment to the over 2 million people that will join the labor force each year over the next decade. Moreover, only 54.1 million of its 94 million working age people are employed. Bangladesh needs to use its labor endowment even more intensively to increase growth and, in turn, to absorb the incoming labor. The Diagnostic Trade Integration Study identifies the following actions centered around four pillars to sustain and accelerate export growth: (1) breaking into new markets through a) better trade logistics to reduce delivery lags ; as world markets become more competitive and newer products demand shorter lead times, to generate new sources of competitiveness and thereby enable market diversification; and b) better exploitation of regional trading opportunities in nearby growing and dynamic markets, especially East and South Asia; (2) breaking into new products through a) more neutral and rational trade policy and taxation and bonded warehouse schemes; b) concerted efforts to spur domestic investment and attract foreign direct investment, to contribute to export promotion and diversification, including by easing the energy and land constraints; and c) strategic development and promotion of services trade; (3) improving worker and consumer welfare by a) improving skills and literacy; b) implementing labor and work safety guidelines; and c) making safety nets more effective in dealing with trade shocks; and (4) building a supportive environment, including a) sustaining sound macroeconomic fundamentals; and b) strengthening the institutional capacity for strategic policy making aimed at the objective of international competitiveness to help bring focus and coherence to the government’s reform efforts. This second volume provides in-depth analysis across seven cross-cutting themes that underpin most of the findings of pillars 1 and 2 above.Publication Democratic Republic of Congo Urbanization Review(Washington, DC: World Bank, 2018)The Democratic Republic of Congo has the third largest urban population in sub-Saharan Africa (estimated at 43% in 2016) after South Africa and Nigeria. It is expected to grow at a rate of 4.1% per year, which corresponds to an additional 1 million residents moving to cities every year. If this trend continues, the urban population could double in just 15 years. Thus, with a population of 12 million and a growth rate of 5.1% per year, Kinshasa is poised to become the most populous city in Africa by 2030. Such strong urban growth comes with two main challenges – the need to make cities livable and inclusive by meeting the high demand for social services, infrastructure, education, health, and other basic services; and the need to make cities more productive by addressing the lack of concentrated economic activity. The Urbanization Review of the Democratic Republic of Congo argues that the country is urbanizing at different rates and identifies five regions (East, South, Central, West and Congo Basin) that present specific challenges and opportunities. The Urbanization Review proposes policy options based on three sets of instruments, known as the three 'I's – Institutions, Infrastructures and Interventions – to help each region respond to its specific needs while reaping the benefits of economic agglomeration The Democratic Republic of the Congo is at a crossroads. The recent decline in commodity prices could constitute an opportunity for the country to diversify its economy and invest in the manufacturing sector. Now is an opportune time for Congolese decision-makers to invest in cities that can lead the country's structural transformation and facilitate greater integration with African and global markets. Such action would position the country well on the path to emergence.Publication An Investment Framework for Nutrition(Washington, DC: World Bank, 2017-04-12)The report estimates the costs, impacts and financing scenarios to achieve the World Health Assembly global nutrition targets for stunting, anemia in women, exclusive breastfeeding and the scaling up of the treatment of severe wasting among young children. To reach these four targets, the world needs $70 billion over 10 years to invest in high-impact nutrition-specific interventions. This investment would have enormous benefits: 65 million cases of stunting and 265 million cases of anemia in women would be prevented in 2025 as compared with the 2015 baseline. In addition, at least 91 million more children would be treated for severe wasting and 105 million additional babies would be exclusively breastfed during the first six months of life over 10 years. Altogether, achieving these targets would avert at least 3.7 million child deaths. Every dollar invested in this package of interventions would yield between $4 and $35 in economic returns, making investing in early nutrition one of the best value-for-money development actions. Although some of the targets—especially those for reducing stunting in children and anemia in women—are ambitious and will require concerted efforts in financing, scale-up, and sustained commitment, recent experience from several countries suggests that meeting these targets is feasible. These investments in the critical 1000 day window of early childhood are inalienable and portable and will pay lifelong dividends – not only for children directly affected but also for us all in the form of more robust societies – that will drive future economies.Publication At a Crossroads(World Bank, Washington, DC, 2017-05-02)Higher education (HE) has expanded dramatically in Latin America and the Caribbean (LAC) since 2000. While access became more equitable, quality concerns remain. This volume studies the expansion, as well as HE quality, variety and equity in LAC. It investigates the expansion’s demand and supply drivers, and outlines policy implications.Publication Entrepreneurship Education and Training Programs around the World : Dimensions for Success(Washington, DC: World Bank, 2014-04-23)Entrepreneurship has attracted global interest for its potential to catalyze economic and social development. Research suggesting that certain entrepreneurial mindsets and skills can be learned has given rise to the field of entrepreneurship education and training (EET). Despite the growth of EET, global knowledge about these programs and their impact remains thin. In response, this study surveys the available literature and program evaluations to propose a Conceptual Framework for understanding the EET program landscape. The study finds that EET today consists of a heterogeneous mix of programs that can be broken into two groups: entrepreneurship education and entrepreneurship training. These programs target a range of participants: secondary and post-secondary education students, as well as potential and practicing entrepreneurs. The outcomes measured by program evaluations are equally diverse but generally fall under the domains of entrepreneurial mindsets and capabilities, entrepreneurial status, and entrepreneurial performance. The dimensions of EET programs vary according the particular target group. Programs targeting secondary education students focus on the development of foundational skills linked to entrepreneurship, while post-secondary education programs emphasize skills related to strategic business planning. Programs targeting potential entrepreneurs generally are embedded within broader support programs and tend to target vulnerable populations for whom employment alternatives may be limited. While programs serving practicing entrepreneurs focus on strengthening entrepreneurs’ knowledge, skills and business practices, which while unlikely to transform an enterprise in the near term, may accrue benefits to entrepreneurs over time. The study also offers implications for policy and program implementation, emphasizing the importance of clarity about target groups and desired outcomes when making program choices, and sound understanding of extent to which publicly-supported programs offer a broader public good, and compare favorably to policy alternatives for supporting the targeted individuals as well as the overall economic and social objectives.
Journal
Journal Volume
Journal Issue
Collections
Related items
Showing items related by metadata.
Publication Cities, Slums, and Child Nutrition in Bangladesh(Wiley, 2018-11-09)This study uses novel household survey data that are representative of Bangladesh's large cities, and of slum and non-slum areas within the cities, to investigate the effects of demographic and socioeconomic factors on child nutrition status in 2013. The study also decomposes the difference in mean child nutrition status between slum and non-slum areas in 2013, and the increase in mean child nutrition status in slum and non-slum areas from 2006 to 2013. Mother's education attainment and household wealth largely explain the cross‐sectional difference and intertemporal change in mean child nutrition status. Although positive in some cases, the effects of maternal and child health services, and potential health‐protective household amenities, on child nutrition status differ by the type of health facility, household amenity, and urban area (slum or non-slum). Focusing on nutrition‐sensitive programs for slum residents and the urban poor is consistent with the results. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions. https://authorservices.wiley.com/author-resources/Journal-Authors/licensing/self-archiving.htmlPublication Clearing the Global Health Fog : A Systematic Review of the Evidence on Integration of Health Systems and Targeted Interventions(World Bank, 2009-03-01)A longstanding debate on health systems organization relates to benefits of integrating health programs that emphasize specific interventions into mainstream health systems to increase access and improve health outcomes This paper is organized in five chapters. This introduction is followed by the methodology chapter, which includes a brief section on the conceptual framework used to analyze the studies retrieved and the programs presented within these to map the nature and extent of integration into critical health system functions. The results chapter includes: a summary of the outcomes for each study grouped by the disease area or the clinical problem the intervention seeks to address, including the reported success; for each program, analysis and mapping of the nature and extent of integration into critical health system functions; and an analysis of how contextual factors either created opportunities for introducing or integrating a program or influenced the desirability or feasibility of program integration. The discussion chapter provides an overview of the implication of findings for policy makers, practitioners and researchers. The final chapter draws conclusions.Publication Cities, Slums, and Early Child Growth(World Bank, Washington, DC, 2017-06)This study uses novel household survey data that are representative of Bangladesh's large cities, and of slum and nonslum areas within the cities, to investigate the effects of demographic and socioeconomic factors on early child growth in 2013. The study also decomposes the difference in mean child growth between slum and nonslum areas in 2013, and the increase in mean child growth in slum and nonslum areas from 2006 to 2013. Mother's education attainment and household wealth largely explain the cross-sectional difference and intertemporal change in child growth. Although positive in some cases, the effects of maternal and child health services, and potential health-protective household amenities, differ by the type of health facility, household amenity, and urban area. The results suggest that a focus on nutrition-sensitive programs for slum residents and the urban poor is appropriate.Publication Fertility Regulation Behaviors and Their Costs : Contraception and Unintended Pregnancies in Africa and Eastern Europe & Central Asia(World Bank, Washington, DC, 2007-12)The report consists of three parts: global trends in fertility, contraceptive use and unintended pregnancies; studies of two regions (Africa and Eastern Europe/Central Asia) and two countries (Nigeria and Kazakhstan) on the costs of fertility regulation behaviors and provider attitudes towards contraceptive use. Fertility levels have declined steadily over the last three decades but the pace of decline varies among regions. Countries that have achieved a high level of contraceptive use have reached a lower fertility level. A gap continues to exist between actual and desired family size, resulting in unintended pregnancies. More than one-third of the pregnancies that occur are unintended and one in five pregnancies ends in induced abortion. Almost half of all induced abortions are unsafe, and the proportion of all abortions that are unsafe have increased during the last decade. Sixty-six percent of unintended pregnancies occur among women who are not using any method of contraception. Investing in quality family planning programs is a cost-effective way to address unmet need for contraception and reduce the risks of unsafe abortion, thereby improving maternal health. If contraception were provided to the 137 million women who lack access, maternal mortality will decline by 25-35 percent.Publication Bangladesh : Maternal and Reproductive Health at a Glance(World Bank, Washington, DC, 2014-11)Bangladesh is among the most densely populated countries in the world. Poverty remains high at 43 percent of the population subsist on less than United States (U.S.) $1.25 per day (2010). Bangladesh achieved several millennium development goal (MDG) targets in education, health, and poverty reduction. Gender equality and women's empowerment are important determinants of reproductive health. While fertility and contraceptive prevalence rate (CPR) are evenly distributed, wide gaps in access to maternal health services remain. Bangladesh will need to focus on increasing political commitment to adolescent health; focusing interventions on high-fertility and high maternal mortality ratio (MMR) areas; addressing human resources constraints; and harnessing the use of technology.
Users also downloaded
Showing related downloaded files
Publication Morocco Economic Update, Winter 2025(Washington, DC: World Bank, 2025-04-03)Despite the drought causing a modest deceleration of overall GDP growth to 3.2 percent, the Moroccan economy has exhibited some encouraging trends in 2024. Non-agricultural growth has accelerated to an estimated 3.8 percent, driven by a revitalized industrial sector and a rebound in gross capital formation. Inflation has dropped below 1 percent, allowing Bank al-Maghrib to begin easing its monetary policy. While rural labor markets remain depressed, the economy has added close to 162,000 jobs in urban areas. Morocco’s external position remains strong overall, with a moderate current account deficit largely financed by growing foreign direct investment inflows, underpinned by solid investor confidence indicators. Despite significant spending pressures, the debt-to-GDP ratio is slowly declining.Publication World Development Report 2006(Washington, DC, 2005)This year’s Word Development Report (WDR), the twenty-eighth, looks at the role of equity in the development process. It defines equity in terms of two basic principles. The first is equal opportunities: that a person’s chances in life should be determined by his or her talents and efforts, rather than by pre-determined circumstances such as race, gender, social or family background. The second principle is the avoidance of extreme deprivation in outcomes, particularly in health, education and consumption levels. This principle thus includes the objective of poverty reduction. The report’s main message is that, in the long run, the pursuit of equity and the pursuit of economic prosperity are complementary. In addition to detailed chapters exploring these and related issues, the Report contains selected data from the World Development Indicators 2005‹an appendix of economic and social data for over 200 countries. This Report offers practical insights for policymakers, executives, scholars, and all those with an interest in economic development.Publication Classroom Assessment to Support Foundational Literacy(Washington, DC: World Bank, 2025-03-21)This document focuses primarily on how classroom assessment activities can measure students’ literacy skills as they progress along a learning trajectory towards reading fluently and with comprehension by the end of primary school grades. The document addresses considerations regarding the design and implementation of early grade reading classroom assessment, provides examples of assessment activities from a variety of countries and contexts, and discusses the importance of incorporating classroom assessment practices into teacher training and professional development opportunities for teachers. The structure of the document is as follows. The first section presents definitions and addresses basic questions on classroom assessment. Section 2 covers the intersection between assessment and early grade reading by discussing how learning assessment can measure early grade reading skills following the reading learning trajectory. Section 3 compares some of the most common early grade literacy assessment tools with respect to the early grade reading skills and developmental phases. Section 4 of the document addresses teacher training considerations in developing, scoring, and using early grade reading assessment. Additional issues in assessing reading skills in the classroom and using assessment results to improve teaching and learning are reviewed in section 5. Throughout the document, country cases are presented to demonstrate how assessment activities can be implemented in the classroom in different contexts.Publication Lebanon Economic Monitor, Fall 2022(Washington, DC, 2022-11)The economy continues to contract, albeit at a somewhat slower pace. Public finances improved in 2021, but only because spending collapsed faster than revenue generation. Testament to the continued atrophy of Lebanon’s economy, the Lebanese Pound continues to depreciate sharply. The sharp deterioration in the currency continues to drive surging inflation, in triple digits since July 2020, impacting the poor and vulnerable the most. An unprecedented institutional vacuum will likely further delay any agreement on crisis resolution and much needed reforms; this includes prior actions as part of the April 2022 International Monetary Fund (IMF) staff-level agreement (SLA). Divergent views among key stakeholders on how to distribute the financial losses remains the main bottleneck for reaching an agreement on a comprehensive reform agenda. Lebanon needs to urgently adopt a domestic, equitable, and comprehensive solution that is predicated on: (i) addressing upfront the balance sheet impairments, (ii) restoring liquidity, and (iii) adhering to sound global practices of bail-in solutions based on a hierarchy of creditors (starting with banks’ shareholders) that protects small depositors.Publication Argentina Country Climate and Development Report(World Bank, Washington, DC, 2022-11)The Argentina Country Climate and Development Report (CCDR) explores opportunities and identifies trade-offs for aligning Argentina’s growth and poverty reduction policies with its commitments on, and its ability to withstand, climate change. It assesses how the country can: reduce its vulnerability to climate shocks through targeted public and private investments and adequation of social protection. The report also shows how Argentina can seize the benefits of a global decarbonization path to sustain a more robust economic growth through further development of Argentina’s potential for renewable energy, energy efficiency actions, the lithium value chain, as well as climate-smart agriculture (and land use) options. Given Argentina’s context, this CCDR focuses on win-win policies and investments, which have large co-benefits or can contribute to raising the country’s growth while helping to adapt the economy, also considering how human capital actions can accompany a just transition.