ICDDR,B maintains one of the richest, most comprehensive and longest running, longitudinal data resources in the developing world, producing regular accurate demographic and health data for rural Bangladesh. With over 40 years of continuous demographic information on a population of over 200,000 people, Matlab is our major rural field site, and a major public health resource for the world. The site is a model for public health strategies around the world. Public health decision makers often refer to Matlab to understand underlying factors that are important for making decisions regarding intervention design.

The Health and Demographic Surveillance System at Matlab covers a population of about 225,000, providing data necessary to plan, conduct, and evaluate various types of public-health intervention research. The surveillance system’s key role is to monitor population exposure accurately over time to derive health and demographic rates and ratios, and assess impacts of health and social interventions. Structured interviews are conducted to register birth, death, marriage, divorce, migration, internal movement and household split every two months in all households in the 142 villages. Periodic socioeconomic surveys also collect information on occupation and household assets.

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This data set comprises health, demographic, and social characteristics, at the individual and household level, and furthermore can be linked to numerous additional research and clinical information. This extraordinary array of interrelated information is invaluable in a country where there are no accurate vital registrations and scant resources to develop health information systems and monitor trends in the nation’s health. Already these data have enabled a diverse range of investigations which have resulted in significant contributions to our understanding of health, demographic and environmental issues and changes over time, at a national level and within the context of global health. The outcomes have also led to considerable improvement in the health of the field site populations and the whole of Bangladesh.

40 years of population surveillance: sharing knowledge, improving health

Forty years of our research and interventions have achieved:

  • A population of approximately 45 million less people in Bangladesh due to interventions that lowered the fertility rate. These strategies are now being used around the world.
  • Knowledge that 63% of child deaths are due to vaccine-preventable disease and can be lowered close to nil through effective immunization campaigns.
  • A 75% reduction in the annual number of childhood deaths in the last 25 years at Matlab, due to the combined programmes in child health and family planning.
  • Increased life expectancy from 50 years to around 65 years in the past four decades due to child survival and fertility reduction interventions.
  • Bangladesh is now in a pioneering position in reducing child mortality rate among the South Asian countries.

Our surveillance data on 225,000 lives is recognized globally as best practice for calculating life tables, allowing us to predict:

  • Burden of disease in Bangladesh.
  • The numbers of elderly people (over 60 years) will grow from 7 million now to 65 million by the end of this century.
  • The possibility that children born in a food-deprived phase of the year experience dramatically increased mortality after puberty compared to children born during a food-sufficient period of the year (e.g. harvest), irrespective of the overall levels of food availability.
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