To the MDGs and Beyond : Accountability and Institutional Innovation in Bangladesh

In recent years Bangladesh has made impressive gains across a range of social indicators and has enjoyed strong economic growth, which together convincingly refute its reputation as an 'international basket case'. As a result, Bangladesh has achieved one of its Millennium Development Goals (MDGs) already, and will probably reach several more by 2015 a result few expected when the MDGs were originally agreed. But detailed analysis shows that most of the MDGs are unlikely to be met on the basis of continued economic growth alone, even at moderately higher levels. In order to meet the MDGs and achieve the sort of social progress of which it is capable Bangladesh needs to generate structural breaks in the trend lines of its principal social indicators. That is, it needs to shift to fundamentally higher rates of progress in the main social problems that it faces. If economic growth is not enough to achieve this, it is necessary to examine the institutions and delivery models responsible for the services that are meant to combat hunger, disease, mortality, ignorance and discrimination, to name a few. This report analyzes the specific policy and institutional reforms required for Bangladesh to increase its rate of progress towards the MDGs. Rather than examining each MDG in turn, with the attendant risk of producing a grocery list of piecemeal recommendations, we prefer to operationalize our task by focusing on the deep institutional and social determinants of two MDGs: maternal mortality and child mortality. In doing so, we hope to reach an analytically informed and coherent view of why performance varies drastically amongst Bangladesh's regions and models of service provision. The reasons for choosing these particular indicators are both obvious and subtle. Maternal and child mortality are, of course, important goals in and of themselves. They are also amongst the most complex of the MDGs in terms of the policy mix required for their attainment, with implications for hunger, education, nutrition, environmental, water and sanitation policy, and so on. Efforts to improve them must necessarily span multiple sectors in rural and urban areas in order to find the most appropriate package of policies and interventions. Bangladesh has made strong progress towards reducing income poverty, placing it roughly on track to meet the target of halving the share of the population living on less than US $1 per day by 2015. Rising and stable economic growth, underpinned by good economic and social policies, has been a key factor in making this possible. In addition, pioneering social entrepreneurship, often with creative partnerships under innovative institutional arrangements, has also contributed immensely to the successes attained. These successes have compensated somewhat for Bangladesh's critical and persistent weaknesses in governance.