Why Are Infant and Child Mortality Rates Lower in the MCH-FP Area of Matlab, Bangladesh? Are the Differences Due to Differences in Reproductive Patterns?

Lauren Hale, RAND
Julie DaVanzo, RAND
Abdur Razzaque, ICDDR,B: Centre for Health and Population Research
Mizanur Rahman, Pathfinder International

Infant and child mortality rates are significantly lower in the MCH-FP Area of Matlab, Bangladesh, than in the Comparison Area. The two areas are similar in terms of the socioeconomic and demographic characteristics of their populations, but the MCH-FP Area has better family planning (and maternal and child health) services than the Comparison Area and, as a result, has different reproductive patterns, including lower fertility rates and longer intervals between pregnancies. We use data from the Matlab Demographic Surveillance System on nearly 146,000 pregnancies that occurred between 1982 and 2002 to investigate the extent to which the different reproductive patterns in the MCH-FP Area explain why infant and child mortality rates are lower there. We show that adjusting for differences in reproductive patterns reduces the differences in infant and child mortality between the MCH-FP and Comparison Area, and the size of this reduction is larger in more recent years.