Facts from Bangladesh Urban Health Survey 2006
In Bangladesh, the rate of urbanization has taken a big leap from 2.46% in 1901 to 23.15% in 2001. Another prediction by United Nations Population Fund (UNFPA) shows that the percentage of population of living in urban areas will reach up to one third of total population by 2030. With an estimation of 300,000 to 400,000 new migrants, mostly poor, arriving to the city annually, Dhaka is the fastest growing mega-city in the world. Currently its population is around 12 million and 37.4% of these population lives in 4,966 slum clusters. Bangladesh has the highest population density in the world (at 2,600 persons per square mile); the population density in the slums is roughly 200 times greater, at 531,000 persons per square mile (Slums of Urban Bangladesh, Mapping and Census 2005).
- The urban areas of Bangladesh provide a contrasting picture of availability of different facilities and services for secondary and tertiary level health care, while primary health care facilities and services for the urban population especially for the urban poor are depressingly inadequate. According to the Non Governmental Organization (NGO) directory 2003, total 384 NGOs work in Bangladesh conducting around 57 programs. In spite of this, in urban areas, good health remains beyond the reach of many of the slum dwellers. Concurrently, uncontrolled urbanization is leading to creation of slums, overcrowding, poor housing, inadequate water supply and poor environmental sanitation, with detrimental effects on quality of life and outbreak of infectious diseases like the dengue outbreak over the last few years.
- Women in the urban slums of Bangladesh have limited access to reproductive health information and care because health centers are not conveniently located; as a result, 93% of married teenagers have begun childbearing, 22% of girls give birth before age 15, 63% of women have never used a modern method of family planning, and 40% became pregnant unwillingly due to a lack of knowledge of services. (State of the World’s Population 2002. UNFPA).
- 58% of currently married women from slums use contraceptive method while it’s 63% among the non-slums women.
- Infant and child mortality rates in urban slums are higher than the national average figures. In urban slums, the infant mortality rate is 63 per 1,000 live births, while it is 29.8 in non-slum urban areas and the national rate is 52.
- Under 5 Mortality Rate (U5MR) was counted 114.3 and 153.2 in urban and rural areas respectively according to Bangladesh Demographic Health Survey (BDHS) data of 1993. This numbers were 92 and 98 for urban and rural areas respectively during 2007. Apparently the rural area lags behind in U5MR, however, if we calculate the rate of decrease in U5MR numbers, it is evident that rural setting has made better progress by reducing the rate by 55.2. In contrast, the urban U5MR has been reduced by only 22.3 in every 1,000 live births.
- The IMR in urban areas of Bangladesh was 81 and 72 during 1993 and 2007 BDHS data respectively with a reduction of only 9 units over the fifteen years. Whereas, it was 103 and 72 respectively in the years 1993 and 2003 for the rural areas showing a distinctive decreased level of 31 units.
- Levels of ANC visits to medically trained providers are highest among women in the non-slums (85%) in comparison to the slum dwellers.
- Approximately 83% of the deliveries take place at home assisted by untrained TBAs, of which 11% are at government hospitals and 1.3% in private clinics.
- Slightly more than half of the non-slum women (51%) receive PNC within 42 days of delivery, compared with 18% in the slums.
- Under-nutrition (BMI< 18.5) is more common among women (27%) and men (35%) in slum than among women (13%) and men (19%) in non-slums.
- In non-slums the obesity is higher (34% of women and 18% of men) than that of slums (15% of women and 7% of men).
- Approximately 46% of children in the slums are underweight while it’s 28% in the non-slums.
- The prevalence of hypertension is higher among non-slum population(≥35 years) (38% women and 25% of men) than slum population (25% of women and 18% of men)
- The prevalence of diabetes is higher among both women and men (≥35 years) in the non-slums (17% and 14% respectively) than their counterparts in slums (6% of women and 8% of men).
- Smoking of cigarettes or bidi is predominant among men in slums (60%) than that of non-slums (46%).
- Non slum households (60%) are twice more likely to obtain their drinking water from a piped source inside the dwelling, compared with 27% of households in slums.
- Open latrines (39%) are predominant in slum households.