title: Explaining equity gains in child survival in Bangladesh: scale, speed, and selectivity in health and development.
abstract: By disaggregating gains in child health in Bangladesh over the past several decades, significant improvements in gender and socioeconomic inequities have been revealed. With the use of a social determinants of health approach, key features of the country's development experience can be identified that help explain its unexpected health trajectory. The systematic equity orientation of health and socioeconomic development in Bangladesh, and the implementation attributes of scale, speed, and selectivity, have been important drivers of health improvement. Despite this impressive pro-equity trajectory, there remain significant residual inequities in survival of girls and lower wealth quintiles as well as a host of new health and development challenges such as urbanisation, chronic disease, and climate change. Further progress in sustaining and enhancing equity-oriented achievements in health hinges on stronger governance and longer-term systems thinking regarding how to effectively promote inclusive and equitable development within and beyond the health system.
authors.affiliation: Centre for Equity and Health Systems, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh. Electronic address: aadams@icddrb.org.
authors.forename: Alayne M
authors.initials: AM
authors.lastname: Adams
authors.affiliation: Department of Economics, University of Dhaka, Dhaka, Bangladesh.
authors.forename: Atonu
authors.initials: A
authors.lastname: Rabbani
authors.affiliation: WaterAid, Dhaka, Bangladesh.
authors.forename: Shamim
authors.initials: S
authors.lastname: Ahmed
authors.affiliation: Centre for Equity and Health Systems, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh.
authors.forename: Shehrin Shaila
authors.initials: SS
authors.lastname: Mahmood
authors.affiliation: National Institute of Population Research and Training (NIPORT), Dhaka, Bangladesh.
authors.forename: Ahmed
authors.initials: A
authors.lastname: Al-Sabir
authors.affiliation: James P Grant School of Public Health, BRAC University, Dhaka, Bangladesh.
authors.forename: Sabina F
authors.initials: SF
authors.lastname: Rashid
authors.affiliation: World Bank, Washington, DC, USA.
authors.forename: Timothy G
authors.initials: TG
authors.lastname: Evans
mesh_terms: D001459:Bangladesh; D002648:Child; D046688:Child Mortality / Q000639:trends*; D002669:Child Welfare / Q000639:trends*; D002675:Child, Preschool; D057217:Economic Development / Q000639:trends; D005193:Family Planning Services / Q000639:trends; D005260:Female; D054625:Healthcare Disparities / Q000639:trends; D006801:Humans; D017589:Immunization Programs / Q000639:trends; D007223:Infant; D008297:Male; D017063:Outcome Assessment, Health Care; D011203:Poverty / Q000517:prevention & control / Q000639:trends; D012111:Residence Characteristics / Q000706:statistics & numerical data; D017678:Sex Distribution; D012959:Socioeconomic Factors; D014146:Training Support / Q000639:trends; D019472:Universal Health Insurance / Q000639:trends; D016387:Women's Health / Q000639:trends