This document discusses the demographic transition model and its stages as applied to Bangladesh. It begins with an overview of the 4 standard stages of demographic transition: 1) pre-industrial with high birth and death rates, 2) transitional with high birth but decreasing death rates, 3) industrialization with decreasing birth and death rates, and 4) post-industrial with low birth and death rates. It then applies these stages to Bangladesh, noting it is in stage 3. The document outlines challenges Bangladesh may face as a result of its demographic transition, such as education, health services, nutrition, housing, and women's status. It stresses the need to prepare for changes brought on by demographic transition.

1. The Demographic Transition and its
Challenges
Dr A H Md Moinul Ahsan
Student, MPH in NCD
Department of Noncommunicable Diseases (NCD)
Bangladesh University of Health Sciences (BUHS)

2. Topics to be discussed:
• the basic concept of Demographic transition
• the stages of demographic transition
• Factors acting behind transition
• Demographic Transition of Bangladesh
• Challenges and solution

3. • Health Transition
Demographic and epidemiologic changes that
have occurred in the last five decades in many
developing countries and that are
characterized by major growth in the number
and proportion of middle-aged and elderly
persons and in the frequency of the diseases
that occur in these age groups. The health
transition is the result of efforts

4. to improve maternal and child health via primary
care and outreach services and such efforts have
been responsible for a decrease in the birth rate;
reduced maternal mortality; improved preventive
services; reduced infant mortality, and the
increased life expectancy that defines the
transition. (From Ann Intern Med 1992 Mar
15;116(6):499-504)

5. Introduction
Demographic Transition Model (DTM)
 Represents a nation’s transition through
industrialization
 Commonly involves 4 stages
 An idealized picture of population change in a
country

6. Stage 1: Pre-Industrial Period
 Crude Birth Rate: High
 Crude Death Rate: High
 Rate of Natural Increase: Fluctuating
 Examples: Britain in the 17th and 18th century;
some remote Amazon tribes

7. Stage 1: Birth Rate
Birth Rate is high due to:
 Lack of family planning
 High Infant Mortality Rate
 Need for workers in agriculture
 Religious beliefs
 Children as economic assets
 Lack of future planning about heath sector

8. Stage 1: Death Rate
Death Rate is high due to:
 Disease
 Famine
 Lack of clean water and sanitation
 Lack of health care
 War
 Limited food supply
 Lack of education

9. Stage 1: Population Change
Population Change
 Due to high birth and death rates,
population is stable
 Population Growth Rate:
≤ 1%
 Doubling Time: ~100 years

10. Stage 1: Age Structure
Population Pyramid Shape: Concave triangular
Age Structure of Population:
 Rapid fall in each age group due to high death rates
 Short life expectancy
10 8 6 4 2 0 2 4 6 8 10
0-4
5-9
10-14
15-19
20-24
25-29
30-34
35-39
40-44
45-49
50-54
55-59
60-64
65-69
70-74
75-79
80-84
85+
Percent (%)
Age Class % Females
% Males

11. Stage 2: Transitional Period
Crude Birth Rate: High
Crude Death Rate: Decreasing
Rate of Natural Increase: Increasing
Examples: Britain late 18th Century to mid-19th
Century, Kenya

12. Stage 2: Birth Rate
Birth Rate remains high due to:
 Total Fertility Rate (TFR): 4.56
 People are used to having many children.
Takes time for culture to change
 Religious beliefs
 Lack of family plaaning.

13. Stage 2: Death Rate
Death Rate decreasing due to:
 Improved hygiene
 Improve health care system
 Improved sanitation
 Improved food production and storage
 Improved transport for food

14. Stage 2: Age Structure
Population Pyramid Shape: Triangular
Age structure of Population:
 Growing young dependant population
 Increasingly youthful age structure
 Accelerating population growth
8 6 4 2 0 2 4 6 8
0-4
5-9
10-14
15-19
20-24
25-29
30-34
35-39
40-44
45-49
50-54
55-59
60-64
65-69
70-74
75-79
80-84
85+
Percent (%)
Age Class % Females
% Males

15. Stage 3: Industrial Period
Crude Birth Rate: Decreasing
Crude Death Rate: Continues to decrease
Rate of Natural Increase: Increasing but at a
slower rate
Examples: Present Bangladesh. Britain
early 20th century; Brazil; Mexico

16. Stage 3: Birth Rate
Birth Rate decreasing due to:
 TFR: 2.05
 Improve maternal and child health
 Improvements in contraceptive technology
 Changes in values about children and sex
 Parents need fewer children
 Rising costs of dependent children to a family
 Valuation of women beyond motherhood
 Working women have less time to devote to child
rearing

17. Stage 3: Death Rate
Death Rate low due to:
 Better Health Care
 Vaccinations
 Better understanding of the spread of
diseases
 Pre-natal care
 Control of communicable diseases.
 Improved sanitation (i.e. indoor plumbing)
 Improved quality and quantity of food

18. Stage 3: Age Structure
Population Pyramid Shape: Columnar
Age structure of Population:
 Decreasing TFR
 Bulge in the reproductive cohorts
 Narrowing pyramid base
5 4 3 2 1 0 1 2 3 4 5
0-4
5-9
10-14
15-19
20-24
25-29
30-34
35-39
40-44
45-49
50-54
55-59
60-64
65-69
70-74
75-79
80-84
85+
Percent (%)
Age Class % Females
% Males

19. Stage 4: Post-Industrial Period
Crude Birth Rate: Low
Crude Death Rate: Low
Rate of Natural Increase: Stable
Examples: Britain late-20th century; Sweden; Japan

20. Stage 4: Birth Rate
Birth Rate low due to:
 TFR: 2.1
 Family planning
 Good health
 Improved status of
women
 Later marriages

21. Stage 4: Death Rate
Death Rate low due to:
 Improved health care
 High quantity and quality of food supply

22. Stage 4: Age Structure
Population Pyramid Shape: Inverted
Age structure of Population:
 Characterized by stability
 Age structure becomes older
5 4 3 2 1 0 1 2 3 4 5
0-4
5-9
10-14
15-19
20-24
25-29
30-34
35-39
40-44
45-49
50-54
55-59
60-64
65-69
70-74
75-79
80-84
85+
Percent (%)
Age Class % Females
% Males

23. A Fifth Stage?
The original Demographic Transition Model has just four stages;
however in some cases the fertility rate falls well below replacement
level and population decline sets in rapidly. It is theorized that a fifth
stage is necessary to account for this demographic stage.
0
2
4
6
8
10
12
14
16
18
20
22
24
CBR CDR Population
 Example: Romania, Italy
 CBR: 10.53
 CDR: 11.88
 TFR: 1.39
 Population Growth : -0.147%

24. What are the stages

26. Demographic Transition of Bangladesh
• Population trends in Bangladesh show that
Bangladesh is well into third phase of demographic
transition, having shifted from a high mortality-high
fertility regime to a low mortality-low fertility one

27. Graphical presentation of demographic
transition of Bangladesh

28. Challenges Bangladesh will to face
1.Proper education for the growing number of
children and young generation
2.Adequate and specialized health service for the
communicable disease and increase number of
NCD
3.Huge nutritional production for active workforce.

29. 3.Improve geriatric health system for ageing people
4.Providing inequality in all sector
5.Suitable cheap, low area consuming housing for
middle class people
6.Control social and political unrest
7.Improve the status of women
8.To reduce the rate of unemployment

30. Our country is facing the crude reality of
demographic transition along with the whole
world. We have no way to avoid these changes.
But still we are not ready locally , nationally ,
logistically and structurally. To get maximum
benefit and avoid negative impact of
demographic transition we must prepare
ourselves.

31. Thank You all