SBUMC STUDY SHOWS CHILD MORTALITY RATES LOWER IN AREA OF BANGLADESH WITH INTENSIVE FAMILY PLANNING, HEALTH SERVICES

Reported in Studies in Family Planning, the Study Analyzes Data from 126,000 Births

STONY BROOK, N.Y., January 11, 2007 – A comparison study of two areas in the Matlab subdistrict of Bangladesh published in the December 2006 issue of Studies in Family Planning by Lauren Hale, Ph.D., Assistant Professor of Preventive Medicine, Stony Brook University Medical Center and colleagues, reveals that the area which provided better maternal child health and family planning services had a significantly lower infant and child mortality rate over a 20-year period than the other area. The study also reveals that program-induced changes in reproductive behavior may affect infant and child mortality.

Dr. Hale and colleagues from the RAND Corporation, Pathfinder International, and the International Centre for Diarrhoeal Disease Research in Bangladesh, used data from nearly 126,000 singleton live births between 1982 and 2002 from the Matlab, Bangladesh, Demographic Surveillance System (DDS). They investigated the extent to which the different reproductive patterns in the Maternal and Child Health—Family Planning (MCH-FP) area explain why infant and child mortality rates are lower there than in an area of comparable socioeconomic characteristics, yet provides only standard government and non-government services.

“We discovered that some of the differences in mortality rates are due to better reproductive patterns, such as birth spacing, maternal age, and number of children, but the majority is due to the quality of the maternal and child health services,” says Dr. Hale.

According to Dr. Hale, both areas include standard government and health and family welfare centers, but the MCH-FP area also has subcenters providing substantially better services regarding contraceptive use, antenatal care, child immunization, and other child health services. In addition, in 1996 four health centers were established in the MCH-FP area. These centers provide basic emergency obstetric care, are staffed by a trained nurse-midwife and a paramedic who provide antenatal care, and refer cases with serious complications to Matlab Hospital. In recent years, however, Dr. Hale says that services in both areas have improved.

Regarding reproductive patterns, in general, women in the MCH-FP area had fewer births overall and fewer children at an older age, and duration between births was longer for these women in than the comparison area.

Dr. Hale points out that there may be other reasons why the MCH-FP area promotes the survival of infants and children. For example, one possible reason is that fewer unintended pregnancies occur there because of higher contraceptive-use rates, and wanted children may receive better care than unwanted children. She says, however, that this theory was not addressed in the study because data were not available to investigate this possibility.

Dr. Hale says future research should include an investigation of certain components of MCH-FP services that reduce child mortality, such as specific antenatal-care services, immunization and breastfeeding.

Co-investigators of the study include Julie DaVanzo, Ph.D., Senior Economist, RAND Corporation; Abdur Razzaque, Ph.D., Scientist, International Centre for Diarrhoeal Disease Research, Bangladesh, and Mizanur Rahman, Ph.D., Senior Research Advisor, Pathfinder International.

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