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Meena -- her perspective on "EPI Plus"

, : Meena -- her perspective on "EPI Plus". Integration: 12-15

The mean age at marriage in Bangladesh with a population of 110 million has increased from 13 to 1931 to 18 in 1992. Yet 80% of women give birth during their teens. 80% live in the countryside, only 35% complete primary school, and only 22% of women are literate (44% of men). By 1990, girls primary school attendance increased to 45% from 31% in 1970. Between 1960 and 1990 per capita calorie consumption had declined from 2300 calories/day. Maternal mortality was 600/100,000 live births. The projection of a population of 220 million people by 2025 could result in even more dire health prospects for these women. Since independence in 1971, family planning (FP) using paramedics has expanded in rural areas. Nongovernmental organizations supported urban efforts by promoting pills and condoms under the largest social marketing project. The contraceptive prevalence rate (CPR) increased to 40% by 1991, and the average number of children dropped from 7 in 1971 to 4 in 1990. The main components of child survival are breast feeding, oral rehydration therapy (ORT), and immunization. 300,000 children die annually from diarrhea, but ORT use has surged in recent years curtailing expected deaths in the wake of the 1988 and 1991 natural disasters. In 1991, immunization coverage reached 85% from under 5% in 1985. The expanded program of immunization (EPI) also integrated FP in pilot upazilas (districts) with a simultaneous increase of both CPR and EPI coverage resulting in improved child survival. There are 100,000 EPI outreaches contracting 80% of mothers with FP counseling, iron supplementation, screening risk delivery, vitamin A supplementation, oral rehydration solution distribution, and nutritional counseling. 3 phases of the classical demographic transition have taken place in Bangladesh but the population will keep increasing until stability is reached with fertility and mortality in balance that EPI and FP can help ensure.


PMID: 12285549

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