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AUICK
Study Course on ICPD and Health Care 1998
Report
on Chittagong City
Dr.
Salim Akhter Chowdhury 1. 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 260km away from 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. Unlike
the country's other three city corporations, Chittagong has got
some special characteristics. By the help of its own manpower,
Chittagong City Corporation successfully conducted Extended Programme
of Immunization (EPI) and National Immunization Day (NID) Programme. It
has got 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% in 1991 to 1.85% 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% per annum. In
1973, this figure was 74 million and the growth rate was 3.0% per
annum. In a span of 23 years, the population growth rate was reduced by
1.2%. 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
several efforts, country's population is still growing every
year by adding almost 2.2 million people. This increasing number of
population will have several adverse implications and consequently
thwart the prospect of socio-economic development of the country. Secondly,
the total land space of which only two third is presently
arable will be attenuated further. This will lead to adverse impact on
per capita food production and food availability of the growing
population. Government's import bill for food stuffs will increase
substantially and it will have to provide food at the expenses of
development of other sector 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 trend of population will frustrate the present target -
"Health for all �\by the year 2000" Program of the government. 2. Family Planning Activities Progress
in family
planning activities has been made in
several crucial areas such as:
Chittagong City Corporation always remains alert and successfully implementing Government programmes to reduce population growth rate of the city into tolerable positions. With the help of the United Nations International Children s Emergency Center (UNICEF), Chittagong City Corporation is now going ahead with urban basic service delivery project. As many as 30 Urban Development Centers (UDC) have already functioned and provided basic health care services and basic education to dropout children. In near future there will be 106 UDC to this purpose. The Asian Development Bank financed Urban Primary Health Care project 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. This growing population created enormous environmental problems in Chittagong City, such as unplanned urbanization, squatter settlements by illegal hill cutting, creation of slums, poor health and sanitation,deforestation and deterioration habitat of flora and funa etc. 3. Maternal and Child Health Care The
extremely high level of maternal, infant and
child mortality in
Bangladesh are primarily caused by a few conditions such as insanitary
birth practices, neo-natal tetanus, infantile diarrheal, and other
common childhood infections as well as unregulated high fertility.
These could be preventive by a comprehensive Maternal and Child Health
(MCH) care including family planning services. Accordingly, the
Bangladeshi Government has adopted policies and strategies for
implementing MCH programme, giving priority to EPI, ORT and Traditional
Birth Attendant (TBA) reigning for ensuring safe delivery practices. Until the late 1950s, the MCH services in the country were limited only to the urban-based hospitals and in 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 the MCH care gained some momentum in 1976. The Government policy has been to combine family planning and MCH care in a package to reduce intent mortality and also to create favorable conditions for acceptance of family planning as a norm of married life. In the year of 1976, the MCH care was shifted from health services to the directorate of population control and MCWCs were transferred the later. The Government, however, adopted the policy of functional integration of health and family planning services at the thana level and below. 4. Objectives of MCH Programmes
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