Stark inequalities in child survival and maternal care remain
The latest Multiple Indicator Cluster Survey (MICS) 2025 lays bare an unsettling truth: poverty and low education are shaping life-and-death outcomes in Bangladesh. Children from the poorest households are almost twice as likely to die before their fifth birthday compared to those from the richest homes. Among mothers with little or no schooling, the under-five mortality rate rises to 48 per 1,000 live births—more than double that among women with higher education. This is not just a health issue; it reflects deep-rooted social and economic inequities. Development over recent decades has not been inclusive enough, leaving poorer families on the margins of essential services.
Maternal care remains one of the biggest fault lines. While 99 percent of pregnant women in wealthier households receive at least one antenatal care (ANC) visit, this drops to 84 percent among the poorest. The gap widens further for proper, repeated care as only 23 percent of pregnant women in the poorest quintile receive the recommended four or more ANC visits, compared to 68 percent in the richest group. With limited public investment in health and nutrition, low-income families are often forced to rely on private facilities they can hardly afford. The economic strain has only intensified since the pandemic, as rising inflation and food prices have compromised both nutrition and healthcare access. These pressures are reflected in child stunting and wasting rates, which are far higher among poorer households. Moreover, only 21 percent of children from low-income families complete upper secondary schooling, compared with 66 percent among those from wealthier families.
Other indicators reinforce the extent of these disparities. After decades of decline, the total fertility rate has climbed to 2.4, with significantly higher rates among poorer and less-educated women. Adolescent births are also far more common among low-income households—120 per 1,000 women, compared with 61 per 1,000 in the richest group. These trends are linked closely to widespread child marriage, with 65 percent of women in the poorest households married off before 18, while the rate drops to 13 percent among the richest. Education once again emerges as a decisive factor, as adolescent fertility is sharply lower among women with higher levels of schooling.
The survey's findings demand urgent, targeted action. Improving maternal healthcare, expanding nutrition programmes, and ensuring access to quality education for girls—particularly in low-income and low-literacy regions—must be treated as national priorities. Free or subsidised ANC, stronger community health services, and safer delivery options are essential steps. Unless the state confronts these inequalities head-on, the poorest mothers and children will continue to bear the heaviest burden.
