The dedicated efforts of the government of Bangladesh have enabled significant improvements in the health sector since 1990:
- The total fertility rate dropped from 4.55 to 2.2 children per woman;
- The infant mortality rate plummeted from 100 to 33 deaths per 1,000 live births;
- The under-five mortality rate fell from 144 to 41 deaths per 1,000 live births (UNICEF, 2012); and,
- The maternal mortality rate dropped from 550 to 176 deaths per 100,000 live births (Countdown, 2015).
Despite such significant strides, RMNCAH service delivery challenges remain, and geographic and economic disparities persist. For instance, only 25 percent of women in rural areas deliver with a skilled health provider compared to 54 percent of women in urban areas (UNICEF, 2012). These challenges are further exacerbated by heavy reliance on out-of-pocket expenditures, which heighten the risk of catastrophic health expenditures for Bangladesh’s poor and vulnerable populations (World Bank, 2015).
Bangladesh has strong existing partnerships and coordination mechanisms, including a health Sector-Wide Approach. These mechanisms will be used to engage a wide range of RMNCAH stakeholders, comprising development partners and financiers, as well as civil society and the private sector.
The government of Bangladesh is leading the development of a Sector Investment Plan and will be operationalizing this through a Program Implementation Plan to address key health sector priorities. Rooted in a longstanding Sector-Wide Approach mechanism, the Sector Investment Plan and the Program Implementation Plan will provide the foundations for the definition of the RMNCAH Investment Case.
Health financing strategy
The Sector Investment Plan and the Program Implementation Plan, which are under development, will also guide the health sector financing strategy.