Success and its consequences: Bangladesh’s health report card at 50

The only accurate snapshot we had of Bangladesh’s demographics at the point of the nation’s birth was already almost a decade old: the census of 1961. The turmoil of the coming years meant that the next census would not take place until well after the Liberation War, in 1974. The picture in 1974 in the census was grim: Bangladesh was among the poorest nations in the world, with poor capacity to spend where it needed the most, on building its health infrastructure. With per capita income of roughly $US144 (in 1985 dollars, according to World Bank figures) and a population density of around 1400 per square mile (i.e. 2.6 square kilometres) and 90% of the nation’s economy propped up by a system of subsistence agriculture, survival rather than health was the question occupying the minds of administrators. Half the nation was undernourished, life expectancy was estimated at 40 for men and 45 for women (World Bank figures), and 15% of Bangladeshi children died in their first five years (Quddus & Becker, 2000). This chapter shows how far Bangladesh has come in just five decades from this grim beginning.