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- Andrews-Chavez, Johanna, et al.
(författare)
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Identifying households with low immunisation completion in Bangladesh
- 2012
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Ingår i: Health. - Irvine, USA : Scientific Research Publishing. - 1949-4998 .- 1949-5005. ; 4:11, s. 1088-1097
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Tidskriftsartikel (refereegranskat)abstract
- The objective of this study was to investigate if the mothers’ demographics and household characteristics—including type of use of cooking fuel, energy and toilet facilities—have any implication for complete immunisation rates among their children. A cross-sectional data analysis of a nationally representative sample of 4925 women with at least one child was performed. Chisquared tests and multivariate logistic regression analyses were used. Immunisation coverage was positively associated with the mother’s education and with household characteristics such as toilet facility, electricity and involvement in a microfinance group. These findings indicate the need for further advocacy for increased knowledge on the importance of vaccination and affordable public immunisation programs focusing on higher risk households such as those with pit facilities, lack of electricity and no participation in a microfinance group. Such households warrant further attention and can be targeted for immunisation coverage.
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- Beckman, Linda, 1980-, et al.
(författare)
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Effects on alcohol use of a Swedish school-based prevention program for early adolescents: a longitudinal study
- 2017
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Ingår i: BMC Public Health. - London, United Kingdom : Springer Science and Business Media LLC. - 1471-2458. ; 17
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Tidskriftsartikel (refereegranskat)abstract
- Background: The aim of the study was to address the lack of evaluations of school-based substance use prevention programs and to conduct a quasi-experimental evaluation of the alcohol use part of the Triad intervention. Methods: Eleven Swedish intervention schools (285 pupils) and three control schools (159 pupils) participated in the evaluation. Baseline measurements were conducted in 2011 before the alcohol part in the prevention program was implemented in the intervention schools (school year 6, ages 12-13). We estimated an Intention-To-Treat (ITT) Difference-in-Difference (DD) model to analyze the effectiveness of the intervention on subsequent alcohol use measured in grades 7, 8 and 9. Results: The main results show no effect on the likelihood of drinking alcohol or drinking to intoxication. Conclusions: The lack of positive effects highlights the need for policy-makers and public health officials need to carefully consider and evaluate prevention programs in order to ensure that they are worthwhile from school, health, and societal perspectives.
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- Biswas, Animesh, 1978-, et al.
(författare)
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Community Notification of Maternal, Neonatal Deaths and Still Births in Maternal and Neonatal Death Review (MNDR) System : Experiences in Bangladesh
- 2014
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Ingår i: Health. - China : Scientific Research Publishing. - 1949-5005 .- 1949-4998. ; 6:16, s. 2218-2226
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: The aim of the study was to examine the process of community maternal, neonatal deaths and still births notification within the Bangladesh government health structure using the Maternal and Neonatal Death Review (MNDR) system. The study also explored the feasibility and acceptance of community death notification in the MNDR system.Methods: The study was under-taken in the Thakurgaon district of Bangladesh during 2010. During the study a mix of both qualitative and quantitative information was collected. A review of the documentation process of community death notification was undertaken and focus group discussions (FGDs) with community members, health care providers and managers in a sub-district were conducted, with in-depth interviews (IDIs) with district heath and family planning managers. Quantitative data were collected from community death notifications in the district during January to December 2010.Results: The death notification process was implemented by the government health care system within the Thakurgaon district. Field level health and family planning staff collected maternal and neonatal death information, recorded the death on the notification form and reported back to the Upazila (sub-district of the district) focal point at the Upazila health complex (primary health care centre). Community people were encouraged to share their death information to field level health staff. The health and family planning managers in the district periodically discussed the maternal and neonatal deaths and prepared remedial action plans in high death notified areas. In 2010, 59 maternal deaths, 739 neonatal deaths and 633 still births were reported in Thakurgaon district. District health and family planning departments performed community death notification as part of their routine daily work and integrated these procedures with other field level activities.
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- Biswas, Animesh, 1978-, et al.
(författare)
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Experiences of community verbal autopsy in maternal and newborn health in Bangladesh
- 2015
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Ingår i: HealthMed. - Sarajevo, Bosnia & Herzegovina : D R U N P P. - 1840-2291 .- 1986-8103. ; 9:8, s. 329-338
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: Verbal autopsy in maternal and neonatal deaths is commonly used in developing countries to understand the medical and social causes of death in the community. Bangladesh first undertook a community verbal autopsy program in 2010. This was implemented under the maternal and neonatal death review (MNDR) system.Objectives: To know the process of implementation of community verbal autopsy, its acceptability and effect in maternal and neonatal health, Bangladesh.Methods: A qualitative study was performed In two districts of Bangladesh in 2011. A review of documents, observations, focus group discussions (FGDs) and in-depth interviews (IDIs) were conducted with health care providers from different systems. Data were analysed using a thematic approachResults: Community verbal autopsy was developed in Bangladesh using existing available tools and guidelines. First line field supervisors from health and family planning departments conducted verbal autopsies at the deceased’s home. It has been adopted within the government health system and is able to identify medical and social causes, including delays within the community that are the major contributing factors of maternal and neonatal deaths. Verbal autopsy findings are shared at the Upazila level (sub-district) and these influence the development and implementation of local action plans. Recall bias and hard to reach areas are still challenges to be overcome in the conduction of verbal autopsies.Conclusions: The use of community verbal autopsy to identify medical and social causes of maternal and neonatal deaths is possible in an encouraging country context. The Government health system can comfortably conduct autopsies within the community. The findings of autopsy can be an effective tool and can be used by the local health and family planning managers to take the initiative at local level to improve health status of the mother and newborn.
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| 8. |
- Biswas, Animesh, 1978-, et al.
(författare)
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Facility death review of maternal and neonatal deaths in Bangladesh
- 2015
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Ingår i: PLOS ONE. - San Francisco, USA : Public Library of Science. - 1932-6203. ; 10:11
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Tidskriftsartikel (refereegranskat)abstract
- Objectives To explore the experiences, acceptance, and effects of conducting facility death review (FDR) of maternal and neonatal deaths and stillbirths at or below the district level in Bangladesh. Methods This was a qualitative study with healthcare providers involved in FDRs. Two districts were studied: Thakurgaon district (a pilot district) and Jamalpur district (randomly selected from three follow-on study districts). Data were collected between January and November 2011. Data were collected from focus group discussions, in-depth interviews, and document review. Hospital administrators, obstetrics and gynecology consultants, and pediatric consultants and nurses employed in the same departments of the respective facilities participated in the study. Content and thematic analyses were performed. Results FDR for maternal and neonatal deaths and stillbirths can be performed in upazila health complexes at sub-district and district hospital levels. Senior staff nurses took responsibility for notifying each death and conducting death reviews with the support of doctors. Doctors reviewed the FDRs to assign causes of death. Review meetings with doctors, nurses, and health managers at the upazila and district levels supported the preparation of remedial action plans based on FDR findings, and interventions were planned accordingly. There were excellent examples of improved quality of care at facilities as a result of FDR. FDR also identified gaps and challenges to overcome in the near future to improve maternal and newborn health. Discussion FDR of maternal and neonatal deaths is feasible in district and upazila health facilities. FDR not only identifies the medical causes of a maternal or neonatal death but also explores remediable gaps and challenges in the facility. FDR creates an enabled environment in the facility to explore medical causes of deaths, including the gaps and challenges that influence mortality. FDRs mobilize health managers at upazila and district levels to forward plan and improve healthcare delivery. © 2015 Biswas et al.This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
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| 9. |
- Biswas, Animesh, 1978-, et al.
(författare)
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Maternal and neonatal death review (MNDR) : A useful approach to identifying appropriate and effective maternal and neonatal health initiatives in Bangladesh
- 2014
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Ingår i: Health. - : Scientific Research Publishing. - 1949-5005 .- 1949-4998. ; 6, s. 1669-1679
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Annan publikation (övrigt vetenskapligt/konstnärligt)abstract
- Objectives: To identify the effects of Maternal and Neonatal Death Review (MNDR) in terms of improving maternal and neonatal health at the community level in Bangladesh.Methods: Both quan- titative and qualitative methods were undertaken for collecting data in Kashipur Union, Bangla- desh. Death notifications from households, subsequent data collections from a focus-group discus- sion (FGD), a group discussion (GD) and in-depth interviews (IDIs) were obtained using structured tools and guidelines.Results: A total of four maternal deaths, 21 neonatal deaths and 15 still births were reported in the MNDR death notification system at Kashipur Union in 2010. Data were presented to local programme managers, who took various initiatives including awareness pro- grammes, pregnancy registration, antenatal care, birth planning, and also the revitalization of a community clinic. The coverage of antenatal care, delivery in clinics, postnatal care and referral of complications increased through the active participation of the community. Community health- care providers, care recipients and members of the community expressed satisfaction with the quality of maternal and neonatal services. In the preceding two years, maternal and neonatal deaths substantially reduced in Kashipur (in 2011 maternal death = 1, neonatal death = 20, still birth = 8; in 2012 maternal death = 1, neonatal death = 8, still birth = 13).Conclusions: The MNDR system successfully delivered notification of all maternal and neonatal deaths in the defined area and collected information for the formulation and implementation of specific interventions, which resulted in visible and tangible changes in care-seeking and client satisfaction.
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| 10. |
- Biswas, Animesh, 1978-
(författare)
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Maternal and Neonatal Death Review System to Improve Maternal and Neonatal Health Care Services in Bangladesh
- 2015
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Bangladesh has made encouraging progress in reducing maternal and neonatal mortality over the past two decades. However, deaths are much higher than in many other countries. The death reporting system to address maternal, neonatal deaths and stillbirths is still poor. Moreover, cause identification for each of the community and facility deaths is not functional. The overall objective of this thesis is to develop, implement and evaluate the Maternal and Neonatal Death Review (MNDR) system in Bangladesh. The study has been conducted in two districts of Bangladesh. A mixed method is used in studies I and II, whereas a qualitative method is used in studies III-V, and cost of MNDR is calculated in study VI. In-depth interviews, focus group discussions, group discussions, participant observations and document reviews are used as data collection techniques. Quantitative data are collected from the MNDR database. In study I, community death notification in the MNDR system was found to be achievable and acceptable at district level in the existing government health system. A simple death notification process is used to capture community-level maternal and neonatal deaths and stillbirths. It was useful for local-level planning by health managers. In study II, death-notification findings explored dense pocket areas in the district. The health system took local initiatives based on the findings. This resulted in visible and tangible changes in care-seeking and client satisfaction. Death numbers in 2012 were reduced in comparison with 2010 in the specific area. In study III, verbal autopsies at community level enabled the identification of medical and social causes of death, including community delays. Deceased family members cordially provided information on deaths to field-level government health workers. The health managers used the findings for a remedial action plan, which was implemented as per causal findings. In study IV, social autopsy highlights social errors in the community, and promotes discussion based on a maternal or neonatal death, or stillbirth. This was aneffective means to deliver some important messages and to sensitize the community. Importantly, the community itself plans and decides on what should be done in future to avert such deaths. In study V, facility death review of maternal and neonatal deaths was found to be possible and useful in upazila and district facilities. It not only identified medical causes of death, but also explored gaps and challenges in facilities that can be resolved. The findings of facility death reviews were helpful to local health mangers and planners in order to develop appropriate action plans and improve quality of care at facility level. Finally, in study VI, the initial piloting costs required for MNDR implementation were estimated, including large capacity development and other developmental costs. However, in the following year, costs were reduced. Unit cost per activity was 3070 BDT in 2010, but, in the following years, 1887 BDT and 2207 BDT, in 2011 and 2012 respectively.
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