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Dr. Salim Akhter Chowdhury Assistant Health Officer Chittagong City Corporation Bangladesh Population and Environment of Chittagong Chittagong is the second largest city of Bangladesh with a population of 1.59 million and is the commercial capital of the country. Located in the southeast of Bangladesh, approximately 260 km away from the capital Dhaka, Chittagong has the country's main seaport close by and the existence of the port meant that the city has been a gateway to the Bay of Bengal for traders, missionaries and invaders alike over the centuries. The city's population is predominantly Muslim. The Chittagong Municipality was established in 1863 and was upgraded to Municipal Corporation status in 1982 and to City Corporation status in 1990. Chittagong City Corporation does not have a separate policy for population control. Rather, the City Corporation authority along with the central government implements government policies on health and population control. Some of the policies are: (i) Contraceptive Logistic Supply (ii) Family Planning services through model clinics, hospitals and urban dispensaries etc. Still, the focus of the urban population control programme has been on the delivery system through local government. Institutions like city corporations were involved actively in order to get sustainable results. Unlike the country's other three city corporations, Chittagong has some special characteristics. By the help of its own manpower, Chittagong City Corporation successfully conducted the Extended Programme of Immunization (EPI) and the National Immunization Day (NID) Programme. It has 19 dispensaries and 1 maternity hospital for providing health care services and these centers have been playing an active role for population control programmes. In the fourth period of Bangladesh, the rate of population growth declined from 2.15 percent in 1991 to 1.85 percent in 1995. The current population figure of Bangladesh is estimated to be 123.8 million as of January 1997 and growing at a rate of 1.75 percent per annum. In 1973, this figure was 74 million and the growth rate was 3.0 percent per annum. In a span of 23 years, the population growth rate was reduced by 1.2 percent. This is because of the determination and commitment of the government of Bangladesh to implement the decisions of the programme of action of the International Conference on Population and Development (ICPD) held in Cairo in 1994. Despite these efforts, the country's population is still growing every year by almost 2.2 million people. This increasing population will have several adverse implications and consequently thwart the prospect of socio-economic development of the country. First, there will be an immediate impact on land. At present, the population density is 850 persons per sq. km (for Chittagong City it is 6,643). This will further increase and adversely affect land per capita. Due to population increases, this situation will further deteriorate by increasing landless people and aggravating the poverty situation further. Secondly, the total land space, of which only two-thirds is presently arable, will be attenuated further. This will lead to adverse impacts on per capita food production and food availability for the growing population. The government's import bill for food will increase substantially and it will have to provide food at the expense of development of other sectors of the economy. Thirdly, a dismal scenario can be observed in the health sector where primary and specialized health care services are still inadequate. The increasing population will frustrate the present target - "Health for all - by the year 2000" program of the government. Fourth, due to population growth momentum, the working age population (15-59 years) will increase further. Hence, the economy will have to create more job opportunities to employ its working age population to generate income and alleviate poverty. Last, the increase in population will adversely affect both GDP and GNP growth per capita. Against this backdrop the nation has no other option but to pursue a population policy which leads to a Net Reproductive Rate (NRR) of 1 by 2005. Family Planning Activities Progress in family planning activities has been made in several crucial areas such as- (1) Adoption of a national population policy (2) Adoption of a multisectoral approach within a broad-based population and development framework (3) Creation of a definite administrative infrastructure from the national headquarters down to the local level (4) Increased policy commitment at the highest level of the government (5) Strong policy commitment at the highest level of the government (6) Development of a large service infrastructure with about 3,500 union health and family welfare centers in the countryside (7) Recruitment, training and development of a large fleet of outreach works (8) Significant headway with respect to nationwide awareness about the family planning programme method and the message of small family norms (9) A modest but not trivial gain in contraceptive dissemination and use Chittagong City Corporation works to successfully implement government programmes to reduce the population growth rate of the city. With the help of the United Nations Children's Fund (UNICEF), Chittagong City Corporation is now going ahead with an urban basic service delivery project. As many as 30 Urban Development Centers (UDC) have already provided basic health care services and education to dropout children. In the near future there will be 106 UDCs for this purpose. The Urban Primary Health Care project, financed by the Asian Development Bank, is going to launch in Chittagong City where 40 primary health care centers and six maternity centers will be constructed and staffed by a qualified doctor, nurse and other health workers. The growing population has created enormous environmental problems in Chittagong City, such as unplanned urbanization, squatter settlements , illegal hill cutting, creation of slums, poor health and sanitation, deforestation and deterioration habitat of flora and fauna etc. Socical
Development Indicators
of Bangladesh
Maternal and Child Health Care The extremely high level of maternal, infant and child mortality in Bangladesh is primarily caused by conditions such as unsanitary birth practices, neonatal tetanus, infantile diarrhea, and other common childhood infections as well as unregulated high fertility. These could be prevented by a comprehensive Maternal and Child Health (MCH) care including family planning services. Accordingly, the Bangladeshi government has adopted policies and strategies for implementing an MCH programme, giving priority to EPI, ORT and Traditional Birth Attendant (TBA) programmes for ensuring safe delivery practices. Until the late 1950s, the MCH services in the country were limited only to urban hospitals and a few privately run maternity centers. In the late 1950s the East Pakistan government initiated an MCH programme through the establishment of Maternal and Child Welfare Centers (MCWCs) run by paramedics. A full-fledged family planning programme was launched in 1960 and MCH care gained some momentum in 1976. The government policy has been to combine family planning and MCH care to reduce infant mortality and also to create favorable conditions for acceptance of family planning as a norm of married life. In 1976, MCH care was shifted from health services to the directorate of population control and MCWCs were transferred later. The government, however, adopted the policy of functional integration of health and family planning services at the thana level and below. The Objectives of the MCH Programmes a) Reduce maternal mortality from 7 to 4.5 per 1000 live births b) Reduce infant mortality from 110 to 80 per 1000 live births c) Reduce neonatal mortality from 84 to 65 per 1000 live births d) Ensure access of women to health care during pregnancy, and during delivery to trained persons e) Reduce mortality, morbidity and disability from early childhood infections diseases through immunizations f) Reduce mortality and morbidity due to diarrheal diseases and malnutrition g) Reduce crude birth rate in high priority groups through family planning h) Develop self-sufficient MCH care as a part of primary health care and increase coverage of comprehensive services to mother and children |
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