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Under-Five Mortality

John Richards and Aidan R. Vining

In this monograph we address under-five mortality among a sample of 77 low-income countries, with an emphasis on six countries in South Asia. We examine mortality levels at two periods a decade apart: early in the 2000s immediately following launch of the Millennium Development Goals (MDGs) and the most recent data, covering years early in the present decade. The factors we consider as potentially explaining national mortality rates fall into four broad categories:

health sector “inputs”;

public health institutions;

social determinants of health;

perceived effectiveness of national governments.

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Does More Money Mean Better Health?

Qayam Jetha

The goal of the MAP is to improve the health and nutritional status of mother and child. Is the program actually improving outcomes, relative to mothers who do not receive the MAP benefit? The answer: in many aspects, such as better ante- and postnatal care, it does improve outcomes, but in other aspects, such as lowering the incidence of disease, it does not. In this, the 11th monograph of the Centre for Policy Analysis, Qayam summarizes his research and his results. I thank Qayam for his interest in the social conditions of our country, and am delighted to make this monograph available to others who share this interest.

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Advancing Nurse Education in Bangladesh

Alex Berland

Many previous reports have documented both the need for better nurse education in Bangladesh and the obstacles to realizing it. This report summarizes the current situation, introduces potential solutions from other countries and suggests a made-in-Bangladesh strategy. The author has spent many years supporting an innovative nurse education program in Bangladesh. This monograph follows that experience, as well as discussions with dozens of nurse educators, physicians and hospital managers.

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Education Success and Nutrition: Is there a link?

John Richards and Afifa Shahrin

The answer from many international studies is “yes.” This monograph provides evidence on the extent of the link among a random sample of nearly 600 low-income families in Bangladesh. Of the total, slightly over 200 families had children in the relevant age range to measure school completion.

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Improving Nutritional Status for Women in Low-Income Households

Afifa Shahrin, John Richards

This monograph reports on the nutritional status of a sample of 600 women in two sites: four villages near Jamalpur, in northern Bangladesh, and slum dwellers in the Dhaka metropolitan area. While some suffer inadequate calorie intake, the major nutritional problem is inadequate consumption of protein, vitamins and micronutrients.

The authors assess the importance of factors that influence nutrition. In general, women’s nutrition is better in households with higher education levels; most women do not smoke, but their nutrition is worse if other family members use tobacco.

The recommendation to government is to pursue two programs: rice fortification, and setting of tube wells in slum neighbourhoods (where groundwater is not affected by arsenic). NGOs are invited to improve training of community health workers, and encourage household vegetable gardens in rural villages.

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Benchmarking the Nutritional Status of Women in the Tongi-Ashulia Road Slums

John Richards, Afifa Shahrin, Karen Lund

This Commentary reports on the nutritional status of shanty dwelling women in Uttara (near the Turag River). Data were collected by nursing students at IUBAT—International University of Business Agriculture and Technology. Most women have an adequate caloric intake. However, most lack adequate servings from the full range of food groups. Inflation in rice prices may have induced them to sacrifice other foods in order to maintain rice consumption.

The majority use non-boiled tap water from the Dhaka Water and Sewage Authority. Due to contamination from ground water, it may contain high levels of pathogens. Tobacco and betel nut are widely used by family members. Both pose serious health hazards if consumed on a long-term basis. The ability of women to read, and receiving one-on-one advice from a health worker had positive impacts on aspects of nutrition.

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A New Mandate for the Rural Electrification Board: Area-Based Planning Initiatives to Relieve Power Shortages

B.D. Rahmatullah, Nancy Norris, and John Richards

A lack of reliable electrical power is severely impeding Bangladesh economic development. Seventy-eight percent of Bangladeshi firms cite poor electricity service as a “major” or “severe” obstacle to expansion.

Successful reform requires building on a foundation of administrative credibility. The most credible of the major agencies in the power sector is the Rural Electrification Board (REB). Over the last decade, it has doubled the number of customer connections, and now distributes 40 percent of all power generated in Bangladesh. The authors of this monograph recommend an expansion of the REB mandate to enable the REB and its network of rural cooperatives (Palli Biddyut Samitee) to create generating capacity independent of the national grid, capacity whose power would be distributed on a priority basis to customers in the local participating PBS.

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Barriers to Girls’ Secondary School Participation in Rural Bangladesh

Jennifer Hove

Over the last 15 years, secondary school enrolment rates among both boys and girls have risen dramatically. However, girls’ rates of progression and completion of the secondary cycle (from grades six through ten) are disturbingly low – albeit the comparable rates for boys are also low. At grade six there is near parity between the number of boys and girls enrolled. By grade ten, boys are significantly ahead of girls in participation in public examinations and promotion to higher secondary school. Only 13 per cent of girls who complete the tenth grade transition to the higher secondary grades of eleven and twelve. There are powerful forces at work within schools, families and the broader society that dissuade girls from staying in school. Based on interview responses among teachers, students and parents in four rural schools, this study analyses why girls drop out of school, and offers policy recommendations to increase completion rates.

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What Parents Think of Their Children’s Schools: A Survey of School Quality Among Parents in Uttara, Suburban Dhaka, Bangladesh

Sandra Nikolic and John Richards

Over the last decade, Bangladesh has made impressive gains in the quantity of education available. As of 2004, there were 18 million children enrolled in 110,000 primary schools. The majority attend government schools but a sizeable minority, approximately one third, attend either private schools where parents pay, nonformal NGO-run schools, or madrasas. The popularity of these non-government school types suggests that parents have concerns about school quality – as well as the availability of school spaces.

To assess parental attitudes to problems of school quality, student researchers from IUBAT surveyed residents in Uttara, a suburb in northern Dhaka. This study reports their findings. The study also assesses broad strategies for improving education outcomes.

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Energy Policy for Bangladesh

Dr. M Alimullah Miyan and Dr. John Richards

It is hard to exaggerate the importance of adequate supplies of commercial energy for the future development of Bangladesh. In May 2004, the Government of Bangladesh released a draft National Energy Policy, and invited public commentary. The government report acknowledges the serious shortcomings of present policy and the dilemmas in designing new policy.

In this third report of the Centre for Policy Research, Dr. Alimullah Miyan, Vice-Chancellor and Founder of IUBAT – International University of Business Agriculture and Technology, and Dr. John Richards, Professor at Simon Fraser University in Canada and Visiting Professor at IUBAT, respond to the draft National Energy Policy and offer a series of recommendations. The recommendations cover major issues from export of natural gas to improvements in the utilisation of biomass fuels.

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Electricity for all: Electrification and Development in Rural Bangladesh

Rose Murphy, Nuruddin Kamal, John Richards

Only one in five Bangladeshis has access to power; among those in rural areas the ratio is about one in seven. What can be done to improve access? This report assesses the barriers to accelerated electrification – rural electrification in particular – and offers practical recommendations.

The Rural Electrification Board (REB) and its network of cooperatives – Palli Biddyut Samitees – now distribute nearly a quarter of electricity consumed in the country. Despite this impressive accomplishment, they need to do more.The authors recommend that the REB place a high priority on power generation independent of the national transmission grid. This expansion will require private investment and higher average tariffs for REB customers.

Securing major new investment and revising tariffs will not be easy, but the goal of increased electrification is sufficiently important to justify the required reforms.

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Natural Gas Options for Bangladesh

Mark Jaccard, Mujibur Rahman Khan, John Richards

The very low level of available commercial energy is a serious constraint on economic development in Bangladesh. Fortunately, there is one bright prospect – sizeable discoveries of natural gas.

This report explores three options for how Bangladesh might use its natural gas endowment: exporting gas to provide public revenues that could be directed to many other development needs; expanding the many possible end-uses for gas in domestic industry, agriculture and households; or concentrating natural gas use on accelerated electrification. After assessing the three options, the authors conclude that rapid electrification should have the highest priority.

In addition, the report discusses institutional reforms to foster private investment and to improve the transparency, efficiency and consistency of government corporations, ministries and agencies. There is an important case to be made for integrated resource planning that includes environmental and social objectives.