The MCE study Bangladesh took place in the following context: the average annual under-five mortality decline in Bangladesh has been between 10 and 12 % for five consecutive years, a world record; in this period, impressive gains have been made in female literacy rates, and other indicators of socio-economic development; in addition, care seeking from village doctors, was between 40 and 60%.

The MCE in Bangladesh showed that it is possible to successfully implement the three components of IMCI, at a cost which is similar to that of current care: the total annual cost of under-five care was $24.60 per child in IMCI areas compared to $23.71 in comparison areas in 2007, when IMCI was fully implemented. Health workers' performance has been consistently higher in the IMCI intervention areas, resulting in a higher proportion of children correctly managed (65% in intervention vs. 10% in comparison areas), as has been demonstrated in other countries. Evaluation of the impact of modified guidelines demonstrated that it is safe to treat severe pneumonia without danger signs at first level facilities. IMCI was associated with 3 times increase in facility utilization and improved care seeking.

A significantly higher proportion of children under six months of age were exclusively breastfed (75% vs. 65%) and there were significant differences in meal frequency in the 6-11 month age group in the IMCI areas. IMCI was associated with improved nutritional status (stunting prevalence in the 12-59 months age group reduced from 64% to 51% in intervention areas and from 61% to 55% in comparison areas). 

Full results are being prepared and will shortly be published. More detailed information is available on request from WHO department of Child and Adolescent Health and Development.