Human Development Nexus: Bangladesh

Executive Summary

Bangladesh has achieved strong gains in child survival and school enrollment, but these are undercut by low learning quality and high stunting. The Human Capital Index composite score of 0.774 is approaching regional benchmarks, reflecting strong child survival (0.9695) and reasonable schooling access (0.821) but constrained by low learning quality (0.589) and the nutritional burden of 23.6% stunting. Social protection adequacy at 47.9/100 is severely insufficient, with the old age allowance of BDT 600/month covering just 22.2% of the poverty line. The intergenerational poverty risk score of 49.2/100 is high, driven by the intersection of stunting, child marriage at 51.0%, and education gaps affecting an estimated 7.1 million children.

Human Capital Index: Where Bangladesh Stands

The World Bank's Human Capital Index measures the productivity a child born today can expect to achieve by age 18, given the health and education risks in their country. Bangladesh's composite score of 0.774 means that a child born today will be only 77.4% as productive as they could be with complete health and education.

• Child survival (0.9695): With under-5 mortality at 30.5 per 1,000, Bangladesh has achieved strong child survival outcomes, comparable to many upper-middle-income countries. This reflects decades of investment in immunization, oral rehydration therapy, and community health worker networks.
• Schooling (0.821): Expected years of schooling at 11.5 is reasonable, reflecting near-universal primary enrollment and improving secondary access. However, this measures quantity, not quality.
• Learning quality (0.589): The harmonized test score of 368 out of 625 reveals the critical weakness. Children attend school but learn far less than their potential. Learning poverty, defined as the inability to read and understand a simple text by age 10, affects an estimated 56% of Bangladeshi children. The schooling years are partially wasted.
• Health and nutrition (0.764): Stunting at 23.6% imposes a permanent cognitive and physical penalty. Stunted children score lower on cognitive tests, complete fewer years of schooling, earn 5-10% less as adults, and are more likely to have stunted children themselves. This is the biological mechanism of intergenerational poverty transmission.

The overall HCI of 0.774 compares with Vietnam (0.69), Sri Lanka (0.59), and India (0.49). Bangladesh's position between India and Sri Lanka reflects its paradoxical development trajectory: strong on basic survival, weak on human capital quality.

Social Protection Adequacy Crisis

Bangladesh's social protection system covers 34.0% of the elderly through the old age allowance, but the benefit of BDT 600 per month is severely insufficient. At just 22.2% of the poverty line (BDT 2700/month), the allowance cannot prevent poverty, let alone provide dignified old age. The monthly out-of-pocket health expenditure of approximately BDT 334 can consume the entire benefit in a single illness episode, with the benefit covering only 179.4% of typical OOP costs.

• The protection gap of BDT 2100 per month represents the difference between the allowance and the poverty line. Closing this gap for all elderly beneficiaries would require roughly a five-fold increase in benefit levels, a fiscally significant but not impossible commitment given Bangladesh's 2.53% of GDP social protection budget.
• The adequacy score of 47.9/100 captures the combined failure of benefit level, health cost exposure, and coverage gaps. Social protection that cannot protect against a single health shock is social protection in name only.

Maternal-Child Continuum of Care

The maternal-child continuum score of 48.9/100 captures the chain of care from pregnancy through early childhood.

• Maternal survival (score 77.0): With MMR at 115 per 100,000 live births, maternal mortality has declined substantially but remains high relative to regional peers (Sri Lanka: 36/100K, Vietnam: 46/100K). The last-mile challenge in chars, haors, and the Chittagong Hill Tracts drives the residual burden.
• Child nutrition (score 52.8): Stunting at 23.6% means that more than one in four children suffers permanent growth faltering, with associated cognitive and economic consequences that compound across the lifecycle.
• Immunization (score 98.0): DPT3 coverage at 98.0% represents a genuine public health triumph, demonstrating what the system can achieve when political will, community infrastructure, and donor support converge.
• Breastfeeding (score 14.3): Exclusive breastfeeding at 14.3% is above the global average but the transition to complementary feeding is where infant nutrition breaks down, with only 28% of children aged 6-23 months achieving minimum dietary diversity.

The continuum breaks between immunization (strong) and nutrition (weak). Bangladesh delivers preventive services efficiently but fails to ensure adequate nutrition, the daily, household-level challenge that immunization campaigns cannot address.

Gender-Health Gap

The gender-health gap score of 57.0/100 captures the intersection of gender inequality and health outcomes that disproportionately affect women.

• Maternal mortality (score 77.0): Declining but still 115/100K, reflecting quality of care deficits and geographic access barriers.
• Female nutrition (score 70.0): Maternal undernutrition at 15.0% (BMI below 18.5) and anemia at 37.6% directly impair pregnancy outcomes and drive the intergenerational cycle. Undernourished mothers produce low-birth-weight babies who are more likely to be stunted.
• Gender-based violence (score 30.0): Domestic violence prevalence at 70.0% (lifetime) creates both direct health consequences (injury, mental health) and indirect effects (restricted mobility, reduced health-seeking, nutritional deprivation within households).
• Child marriage (score 49.0): At 51.0%, child marriage is both a driver and consequence of the gender-health gap. Girls married before 18 face higher maternal mortality risk, are more likely to be undernourished during pregnancy, and have less autonomy over health decisions for themselves and their children.

Lifecycle Coverage Gaps

The average lifecycle coverage of 38.9% reveals critical gaps in Bangladesh's social protection architecture.

• Early childhood (0% coverage): Bangladesh has no universal child benefit, the most conspicuous gap in the lifecycle framework. The first 1,000 days from conception to age 2 represent the highest-return investment window for human capital, yet social protection coverage for this period is effectively zero. A universal child benefit of BDT 800/month for children under 5 would cost approximately 0.4% of GDP with transformative potential for stunting reduction and intergenerational poverty prevention.
• School age (stipends 72.2%, school feeding 15%): Education stipends achieve broad coverage but school feeding, which directly addresses child nutrition and learning outcomes, reaches only 15% of primary schools.
• Old age (34.0% covered, 66.0% gap): Two-thirds of the elderly receive no pension or allowance. With Bangladesh's population aging rapidly (60+ cohort projected at 22% by 2050), this gap will become a crisis within two decades.
• Disability (73.2%): Coverage is reasonable relative to identified beneficiaries but likely understates the true disability population given incomplete registration systems.

Intergenerational Poverty Risk

The intergenerational poverty risk score of 49.2/100 is high, quantifying the probability that today's deprivations will be transmitted to the next generation.

• Stunting (risk 47.2/100): At 23.6%, stunting affects an estimated 7.1 million children. Each stunted child faces a 5-10% lifetime earnings penalty, reduced cognitive capacity, and higher probability of having stunted children. This is the biological channel of poverty transmission.
• Child marriage (risk 51.0/100): At 51.0%, child marriage truncates girls' education, increases adolescent pregnancy risk, and reduces women's lifetime earnings and agency. It is both a cause and consequence of the intergenerational trap.
• Education gap (risk 38.0/100): Female secondary completion at 62.0% means that 38.0% of girls do not complete secondary school, limiting their earnings potential and their capacity to invest in the next generation's health and education.
• Adolescent nutrition (risk 56.0/100): Undernutrition among adolescent girls at 28.0% feeds directly into the maternal undernutrition and low birth weight (23.0%) pathway.

The interaction effects multiply: a stunted girl who marries early, drops out of school, and enters pregnancy undernourished faces compounding risks that no single-sector intervention can address. An estimated 7.1 million children are caught in this nexus.

Integrated Policy Framework

Breaking the intergenerational cycle requires cross-sector interventions that address root causes simultaneously:

• Introduce a universal child benefit of BDT 800/month for children under 5: This is the single highest-return investment Bangladesh can make in human capital. At 0.4% of GDP, it would reduce stunting through improved household nutrition expenditure, complement existing health and immunization services, and begin closing the lifecycle coverage gap. Link receipt to growth monitoring and immunization compliance.
• Launch an integrated adolescent girls program: Combine iron-folic acid supplementation, nutrition counseling, conditional cash transfers tied to school enrollment and delayed marriage, life skills training, and reproductive health education. Deliver through secondary schools and community platforms. Target the 15-19 age group where the intergenerational cycle can be interrupted before first pregnancy.
• Triple the old age allowance to BDT 1,500/month and index to inflation: The current BDT 600 benefit is severely insufficient at 22.2% of the poverty line. A tripled, indexed benefit would reduce old age poverty, decrease catastrophic health expenditure, and reduce the burden on working-age household members, freeing resources for child investment.
• Expand school feeding to universal primary coverage with nutrition-sensitive menus: School feeding at only 15% coverage misses 85% of primary students. Universal coverage with iron, zinc, and vitamin A fortified meals would address the learning-nutrition nexus directly, improving both nutritional status and cognitive performance.
• Establish a cross-sector Human Development Coordination Unit under the Prime Minister's Office: The fragmentation of health (MoHFW), nutrition (multiple ministries), social protection (23+ ministries), and gender (MoWCA) programs creates duplicated targeting systems, inconsistent beneficiary registries, and an estimated 15-20% administrative overhead from parallel delivery mechanisms. A coordination unit with budget authority, shared indicators, and joint monitoring across ministries would reduce duplication and enable the lifecycle approach that the NSSS envisions but current institutional silos cannot deliver.

Data sources: World Bank Human Capital Index 2023, WHO GHO, UNICEF MICS, BDHS 2022, MoF Budget Documents FY2023-24, HIES 2022, BBS Gender Statistics, ILO ILOSTAT.