Poverty alleviation and human resource development under MDG

The government of Bangladesh is strongly committed to reducing poverty, improving human development and reducing inequality. One can find reflection of the commitment in the Perspective Plan of Bangladesh (2010-2021): Making Vision 2021 Reality. The Perspective Plan envisions, "Bangladesh will be a middle-income country through simultaneous fulfillment of economic and social rights of the people alongside civil and political rights." The Perspective Plan itself is reflected in the 6th Five-Year Plan (2011-15) and also the recently developed 7th Five-Year Plan (2016-20). The government of Bangladesh has been continuously investing for the last couple of decades a big amount of public resources for uplifting socio-economic status of the people in the way to developing human resources that fits the need of an emerging middle-income country. The result is evident in the fact that life expectancy at birth has crossed 70 years (70.4 in 2013). The success has been attributed to a number of factors such as growing incomes and increasing education as well as government's efforts to improve the health status of its citizens.   
STATUS OF POVERTY ALLEVIATION
Poverty scenario: Since independence in 1971, the policy makers of the country have identified poverty as one of the major problems, economically and socially. At that time, more than 80 per cent of the population was poor, which decreased to 56.7 per cent (extreme poverty 41 per cent) in 1991. Bangladesh has been successful in achieving significant reduction in poverty since 1990. The Household Income and Expenditure Survey 2010 (HIES-2010) shows that there has been a rapid decline in the poverty rate from 48.9 per cent in 2000 to 31.5  per cent in 2010. Commensurately, the percentage of chronic poor residents, defined as the population below the lower poverty line, fell from 34.3 in 2000 to 17.6 in 2010. Progress has also been made in reducing the depth of poverty. In 2000, the poor on average consumed 26 per cent less than the basic needs consumption basket defined by the poverty line. This gap narrowed to 21 per cent in 2010. The commendable progress in respect of eradication of poverty was possible due to the relatively inclusive growth pattern and robust sustained growth in GDP (gross domestic product) that was accompanied by gradual transformation of the sectoral composition of the GDP culminating in greater share of manufacturing and services sectors and declining share of agriculture. Moreover, the sustained growth (over 6.0  per cent in recent years) has been accompanied by corresponding improvements in several social indicators despite having the world's highest population density.
Recent progress in poverty reduction: The World Bank poverty assessment  reveals that incidence of poverty has been declining, on an average, at 1.74 percentage points in Bangladesh. It was estimated that the MDG (Millennium Development Goal) target of halving the population living under the poverty line has already been achieved in 2012. Since official updated HIES data is not available, latest poverty figures have been estimated by the General Economics Division (GED) using the observed relationship between per capita GDP growth and poverty reduction (Growth Elasticity of Poverty Reduction) from the two most recent HIES surveys of 2005 and 2010. The estimate suggests that the poverty has declined to 24.8 per cent and the extreme poverty has reduced to 12.9  per cent in 2015.
Main drivers of poverty reduction: In recognition of the long-term development challenges, the ninth Parliament (2009-2013) envisioned Bangladesh to become a middle-income country by the end of 2021 and adopted the perspective plan to materialise 'Vision 2021'. Being concerned about the inequality and existing level of high poverty incidence, Bangladesh recognised it as a major obstacle for reaching the goal. The Sixth Five-Year Plan (FY2011-FY2015) developed strategies, policies and institutions that allow Bangladesh to accelerate growth and reduce poverty and inequality. As a result of successful implementation of the plan Bangladesh has been declared as a Lower Middle-Income Country (LMIC) by the World Bank on July 01, 2015. Rapid reduction of poverty has been pursued through attaining high economic growth and ensuring productive employment and incomes for a large number of people.
The growth-employment-poverty reduction linkage focusing on labour-intensive urban and rural manufacturing production played pivotal role in reducing poverty. Sixth plan put on efforts to raise land productivity to support income-earning opportunities of workers remaining in agriculture. Research and development (R&D) has been given priority for improving Total Factor Productivity (TFP). The Government has adopted new Education Policy and Health Policy with a view to transforming the existing population into human resources. Overseas migration of predominantly less-skilled labour and remittance of as much as US$ 15.3 billion, comprising almost 7.9  per cent of GDP (FY 2015), has had major beneficial development impacts on the economy. Moreover, remittances from expatriate Bangladeshis contribute directly to improvements in the financial and social status of migrants' families and communities. Expansion of microcredit played important role in boosting the rural economy. The human capital development programmes in Bangladesh are helping the anti-poverty drive along with creating spill-over effects on other social issues.
Another anti-poverty strategy of the Government through the expanded Social Safety Net Programmes (SSNP) to address risk and vulnerability helped reduce poverty and inequality. In order to fight against poverty, more than 50 per cent of the budgetary allocation is, for the last six years, directly and indirectly targeted to reduction of poverty by instituting social protection and empowerment programmes. Safety net coverage was 13 per cent of population until 2008. However, approximately 25 per cent of households are now receiving monetary benefits (cash or in kind) from anyone of the government's social safety net schemes. Distressed people, particularly women, children and disabled persons, have been given priority under SSNP. The allocation has been hovering around 2.0 per cent of GDP since FY11. The allocation for Annual Development Programme (ADP), which is the main public investment window to reduce poverty, was 3.6 per cent of GDP in FY11 and has been increased to 4.96 per cent of GDP in FY15.  
Risks and challenges of poverty: A major concern in the country is the high underemployment which has prevented the country from fully meeting the goal of eradicating extreme poverty and hunger. The challenge is to ensure pro-poor economic growth that can lead to creation of more jobs, better employment and higher household income. Poverty has declined over the years all over the country, although poverty rate at a few areas remains much higher than other regions. Notwithstanding past progress, some 24.8 per cent of the population is still living below the poverty line. The absolute number of people living below the poverty line (39.2 million), which is larger than the total population of many countries, presents major economic as well as social challenges. Furthermore, structural realities and constraints such as limited land for cultivation, high population density and a growing population represent significant challenges. To meet the future demand of a growing population, agricultural productivity growth, especially for rice and other crops, need to be sustained and a diversified crop sector must emerge.
STATUS OF HUMAN RESOURCES DEVELOPMENT
Education:    Significant progress has been made in increasing equitable access to education, reduction of dropout and implementation of a number of quality enhancement measures in primary education. Initiatives have been taken to introduce pre-school education to prepare the children for formal schooling. The primary school grade-5 survival rate in 2013 was 81.8  per cent (Boys: 77.65, Girls: 84.45) which indicates a modest increase from 43  per cent recorded in 1991.
The Government is in the process of implementing a comprehensive National Education Policy (2010) to achieve its objectives. The Constitution of Bangladesh has provision for free and compulsory primary education. The faster and relatively consistent growth in girls' enrolment vis-à-vis boys has been an important driver of the observed improvement in Net Enrolment Ratio. Focused and substantive initiatives undertaken by the government such as distribution of free textbooks among students up to the secondary level, providing scholarship to female students up to the higher secondary level, holding public examinations and releasing results within the stipulated time and creation of the Education Assistance Trust Fund for the poor and meritorious students, food for education, stipends for primary school children, media outreach, and, spreading of community or satellite schools have all helped in boosting the NER. It is observed that significant contribution of important factors, such as sustained economic growth, decreased unemployment, decreased mortality rate, decreased hunger have made it possible for doing better in attaining the primary and secondary education targets of MDGs in Bangladesh.  
Despite a dearth of comprehensive information on education quality, experts widely agree that the quality of education needs to be appreciably improved for the vast majority of the primary school children. While it is true that Bangladesh has managed to achieve high enrolment rate at a low cost, there is a link between the quality of education and investment in the education sector. The Government of Bangladesh has so far not been able to invest more than 2.5  per cent of its GDP in education. Limited staff development opportunities and low compensation package provide little incentives for sustained quality teaching.
Health, population and nutrition: Bangladesh has already met the MDG target of reducing under-five mortality rate: against the target of achieving 48 per 1,000 live births in 2015, it has already achieved 46 per 1,000 live births in 2014. The infant mortality rate was 32 against the target of 31 per 1,000 live births in 2013. The maternal mortality ratio in 1990 was 574 per 100,000 live births, which has come down to 170 in 2013, implying 70  per cent reduction in the last 23 years. Bangladesh has performed well in halting communicable diseases under this goal. Available data show that prevalence of HIV/AIDS in Bangladesh is currently less than 0.1  per cent and thus is still below an epidemic level. There is a significant improvement in the reduction of malarial deaths in the country over the years.   
A fundamental factor in better health outcome in Bangladesh has been the continuity of political commitment. Another factor has been the government's ability to collaborate with non-governmental actors. The Government views NGOs as a way of extending their reach, particularly in the implementation of national strategies and policies. NGOs have developed strong capacity and innovative delivery models that have prompted a two-way learning exchange between government and non-governmental entities. The Sector Wide Approach (SWAP) has reduced duplication and also financial waste in the health sector and has simplified the process of programme development and implementation. The government has framed the National Health Policy, 2011 and the National Population Policy 2012 has also been finalised. The National Drug Policy 2014 is at the formulation stage to modernise public health system. Moreover, in order to strengthen primary healthcare facilities, the government has launched 12,979 community clinics to expand health services to the grassroots level in rural areas. The innovative idea to use the Information and Communication Technology (ICT) for progress of the health of women and children has already been acclaimed by the world. However, challenges remains in the area of access to reproductive health services.   
Bangladesh is a global leader in developing low-cost interventions such as the use of zinc in the treatment of childhood diarrhoea, oral rehydration solution, delivery kits, tetanus vaccinations for pregnant women, and iodised salt. These interventions have been rolled out locally, scaled up and even used in other developing countries. Strong emphasis on childhood immunisation has resulted in almost universal access.
Non-health initiatives, particularly poverty reduction, have played an important factor in Bangladesh's progress in the health sector. Participation in microcredit programmes has been connected to better child survival and the expansion of electricity coverage in rural areas.
Bangladesh's disaster preparedness has shown the world that it has the ability to plan, coordinate and implement crisis action. This demonstrates the improving governance structures across public sectors.
With regard to HIV/AIDS, Bangladesh followed a systematic process to face the challenge. National AIDS Committee was formed in 1985, National HIV/AIDS Programme was started in 1998, National HIV/AIDS policy was adopted in 2000, National HIV/AIDS-related BCC strategy was developed in 2001, National AIDS and STD Control and Prevention Programme was initiated in 2002, National Strategic Planning 2004 to 2010 was adopted in 2005, Control of AIDS was included as a strategy in Poverty Reduction Strategy Paper (PRSP) document in 2005 and a training manual was developed for all categories of staff related with AIDS services.
With respect to nutritional status, Household Income and Expenditure Survey 2010 (BBS, 2011) shows that overall calorie intake per capita per day has significantly increased to 2,318.3 kcal in 2010 from 2,238.5 kcal in 2005 reversing the general decreasing trend found in previous surveys. Significant increase of per capita per day calorie intake might be due to changing food habit of people as well as to increase in overall quantity of food consumption and increasing food diversity. Nearly two-thirds (66 per cent) of Bangladesh's children under-five years of age were underweight in 1990. The Bangladesh Demographic and Health Survey (BDHS) of 2014 found underweight of under-five year children as 32.6  per cent. Hence Bangladesh has also achieved the MDG target related to hunger. According to the State of Food Insecurity (SOFI) 2014, jointly prepared by the FAO, IFAD and WFP, Bangladesh has reduced the number of undernourished people to 27.3  per cent within 1990-92 to 2012-14.
The recent global food price inflation illustrates the critical importance of ensuring food security for a large poor country like Bangladesh. Past progress in rice production suggests that Bangladesh has the capacity to achieve food availability efficiently through domestic production. Hence the Government has given emphasis on productivity improvements by providing incentives, particularly to the farmers. In FY 08, total production of rice was 28.93 million tonnes while it has increased to 34.4 million tonnes in FY15. The country has thus attained food autarky. Priority has also been given on research and development for crop sector diversification to consider future consumer demand like increased pulse production, water management, effective support and credit for farmers and effective trade policies on food import. As regards food access, government's first priority is to create enabling environment for the private sector to generate more employment and enhance household incomes. For the marginalised groups proper targeting under Social Safety Net Programme is another way to address the accessibility criteria of food security by the government. With regard to food utilisation & nutrition, behavioural change and communication to promote good nutritional practices is one of the important agenda of the government. The Government has mainstreamed the nutrition service delivery at all service delivery point of Health and Family Planning Directorates with the Community Clinics being the first rural contact point for receiving primary healthcare. To help assist the exclusive breast-feeding up to six-month, maternity leave for the working mothers have been enhanced to six-month by the government, which augmented the nutritional status of the populace.
Quality service is frequently inadequate in health facilities because of insufficient number of skilled or trained personnel. Moreover, a lack of routine supportive supervision and monitoring is a major cause of poor quality of services. Reducing the neonatal mortality (up to 28 days after birth) remains a challenge and which may also impact on infant and under-5 mortality. Thus high evidence-based intervention for newborn services need to be scaled up rapidly across the country. Adequate availability of essential drugs is a major impediment in providing relevant services. The achievements of universal health coverage, the removal of rural-urban, rich-poor and other form of equities and the provision of essential services for the vast majority of the population are the key concerns for which effective strategies are to be adopted. Human resource capacities remain a major obstacle to quality health service delivery. Key challenges include acute shortage of manpower of all categories, insufficient skills-mix and insufficient numbers of health workers especially in the rural areas. Despite expansion of physical facilities, use of public health facilities by the poor remains low due to supply-side barriers such as lack of skill manpower, inadequate drug supplies and logistics, and management inadequacies. Underlying socio-cultural factors contribute to the lack of knowledge about maternal health complications among women and families. Social marginalisation, low socio-economic status of women and lack of control over their personal lives make it difficult for many women to seek reproductive healthcare.
Professor Shamsul Alam is Member (Senior Secretary), General Economics Division (GED), Bangladesh Planning Commission. Dr. Alam led the preparation of the Perspective Plan of Bangladesh 2010-2021, Sixth Five-Year Plan of Bangladesh 2011-2015, National Sustainable Development Strategy 2010-2021, National Social Security Strategy of Bangladesh (2015) and now is leading the preparation of the Seventh Five Year Plan of Bangladesh, 2016-2020 which is at the final stage.
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