abstract: 'Bangladesh, the eighth most populous country in the world with about 153

  million people, has recently been applauded as an exceptional health

  performer. In the first paper in this Series, we present evidence to

  show that Bangladesh has achieved substantial health advances, but the

  country''s success cannot be captured simplistically because health in

  Bangladesh has the paradox of steep and sustained reductions in birth

  rate and mortality alongside continued burdens of morbidity. Exceptional

  performance might be attributed to a pluralistic health system that has

  many stakeholders pursuing women-centred, gender-equity-oriented, highly

  focused health programmes in family planning, immunisation, oral

  rehydration therapy, maternal and child health, tuberculosis, vitamin A

  supplementation, and other activities, through the work of widely

  deployed community health workers reaching all households. Government

  and non-governmental organisations have pioneered many innovations that

  have been scaled up nationally. However, these remarkable achievements

  in equity and coverage are counterbalanced by the persistence of child

  and maternal malnutrition and the low use of maternity-related services.

  The Bangladesh paradox shows the net outcome of successful direct health

  action in both positive and negative social determinants of health-ie,

  positives such as women''s empowerment, widespread education, and

  mitigation of the effect of natural disasters; and negatives such as low

  gross domestic product, pervasive poverty, and the persistence of income

  inequality. Bangladesh offers lessons such as how gender equity can

  improve health outcomes, how health innovations can be scaled up, and

  how direct health interventions can partly overcome socioeconomic

  constraints.'
affiliation: 'Chowdhury, AMR (Corresponding Author), BRAC, Dhaka 1212, Bangladesh.

  Chowdhury, A. Mushtaque R., BRAC, Dhaka 1212, Bangladesh.

  Chowdhury, A. Mushtaque R., Columbia Univ, New York, NY USA.

  Bhuiya, Abbas; Chowdhury, Mahbub Elahi; Rasheed, Sabrina, Int Ctr Diarrhoeal Dis
  Res, Dhaka 1000, Bangladesh.

  Hussain, Zakir, WHO, Southeast Asia Reg Off, New Delhi, India.

  Chen, Lincoln C., China Med Board, Cambridge, MA USA.'
author: Chowdhury, A. Mushtaque R. and Bhuiya, Abbas and Chowdhury, Mahbub Elahi and
  Rasheed, Sabrina and Hussain, Zakir and Chen, Lincoln C.
author-email: mushtaque.chowdhury@brac.net
author_list:
- family: Chowdhury
  given: A. Mushtaque R.
- family: Bhuiya
  given: Abbas
- family: Chowdhury
  given: Mahbub Elahi
- family: Rasheed
  given: Sabrina
- family: Hussain
  given: Zakir
- family: Chen
  given: Lincoln C.
da: '2023-09-28'
doi: 10.1016/S0140-6736(13)62148-0
eissn: 1474-547X
files: []
issn: 0140-6736
journal: LANCET
keywords-plus: CIVIL-SOCIETY
language: English
month: NOV 23
number: '9906'
number-of-cited-references: '77'
orcid-numbers: rasheed, sabrina/0000-0002-7444-200X
pages: 1734-1745
papis_id: 42ea6d1d7fd202914baa8048e4884d4c
ref: Chowdhury2013bangladeshinnovation
researcherid-numbers: 'rasheed, sabrina/A-4145-2010

  '
times-cited: '213'
title: 'Bangladesh: Innovation for Universal Health Coverage 1 The Bangladesh paradox:
  exceptional health achievement despite economic poverty'
type: Article
unique-id: WOS:000327539900031
usage-count-last-180-days: '1'
usage-count-since-2013: '19'
volume: '382'
web-of-science-categories: Medicine, General \& Internal
year: '2013'