| 1. |
- Hossain, Jahangir, et al.
(author)
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Snakebite Epidemiology in Bangladesh : A national community based health and injury survey
- 2016
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In: Health. - Irvine, USA : Scientific Research Publishing. - 1949-4998 .- 1949-5005. ; 8, s. 479-486
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Journal article (peer-reviewed)abstract
- Insert Snakebite is a global public health issue, and in majority of cases it is undermined. Tropical and subtropical countries are most effected, Bangladesh being one of them. There is scarcity of countries’ epidemiological situation in relation to snakebite poisoning. This study has looked at the epidemiological status of snakebite poisoning from national representative survey findings.Methods: A nationwide cross-sectional survey was conducted in 12 randomly selected districts of Bangladesh in 2003. A total of 171,366 households were surveyed and information was collected from 819,429 populations by face to face interview. Multi-stage cluster sampling methods were used in this survey and covered urban, rural and slum populations. Results: Annually an estimated 15,372 (10.98/100,000) individuals were bitten by snakes and of them 1709 (1.22/100,000) died every year. Males were found to be most vulnerable with a risk of 1.51 times higher than female. Rural populations were also 10.54 times higher at risk than the populations living in the urban areas. Among the victims 94% were from the poor socio economic conditions. Around 43.9% of the incidences occurred during evening to midnight. Home was found the most common area for snake bite (33.6%), and the Leg was found to be the most common site for biting (63.1%). A total of 96.6% victims sought treatment, of them 61% sought immediate treatment from traditional healing methods.Conclusions: Present incidence of snakebite in Bangladesh has clearly shown that there is emerging public health needs for intervention that can reduce the mortality and burden of the disease in the country.
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| 2. |
- Alam, Md Badrul, et al.
(author)
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Health-seeking behaviour of stroke patients in a rural area of Bangladesh
- 2023
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In: Bangabandhu Sheikh Mujib Medical University Journal. - : Bangladesh Academy of Sciences. - 2224-7750. ; 16:2, s. 75-80
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Journal article (peer-reviewed)abstract
- Background: Improper health-seeking behaviours (HSB) have been correlated with detrimental health outcomes, elevated rates of illness and mortality. The study aimed to investigate how stroke patients in a rural community of Bangladesh seek health care.Methods: A cross-sectional survey was conducted in the Raiganj sub-district of Sirajganj district from January to June 2016, using a validated screening tool to identify stroke patients at the household level. Neurologists confirmed the diagnosis after examining all suspected cases. Out of the 419 suspected cases identified during the screening process, 186 cases were officially reported after undergoing a confirmed diagnosis. Information on health-seeking behaviour was collected through face-to-face interviews with patients or their attendants.Results: After experiencing a stroke, approximately 35% of patients received treatment from unregistered care providers and over 40% received treatment outside of a hospital setting. Males were significantly more likely than females to receive treatment from registered physicians or hospitals (P<.05 and P<.01). A significantly higher proportion of educated individuals sought healthcare from registered physicians or hospitals (P<.05). Although better health-seeking behaviour was observed among higher-income groups, the findings were not statistically significant. Around 67% of patients were found to be hypertensive, with about one-third of them not taking any medication for their elevated blood pressure. Approximately 37% of patients had elevated blood glucose levels but only 22% were taking medication.Conclusion: A notable proportion of stroke patients in rural Bangladesh sought treatment from unqualified service providers. Health-seeking behaviour was associated with factors such as gender, education, and economic condition.
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| 3. |
- Begum, Afroza, et al.
(author)
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Prevalence of suicide ideation among adolescents and young adults in Bangladesh
- 2017
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In: International Journal of Mental Health. - : Informa UK Limited. - 0020-7411 .- 1557-9328. ; 46:3, s. 177-187
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Journal article (peer-reviewed)abstract
- Suicide is a leading cause of death world-wide. However, adolescent suicidal behavior is a neglected public health issue, especially in low-income countries such as Bangladesh. The study was conducted to estimate the prevalence of suicidal ideation among adolescents in a rural community and to examine factors associated with suicidal ideation. A cross-sectional survey was carried out in 2013 among 2,476 adolescents aged 14–19 years, selected randomly from a rural community of Bangladesh. An adapted version of the WHO/SUPRE-MISS questionnaire was used to collect data in the Raiganj sub-district. A two stage screening was performed to identify the suicidal ideation cases. It was found that the life-time prevalence for suicidal ideation was 5 percent among adolescents. The majority of the adolescents with suicidal ideation were females 66 (52.8%), unmarried 103 (82.4%), and students 92 (73%). Suicidal ideation was statistically significantly associated with age, education, occupation, living with parents or others, and house ownership. Respondents who were aged 18–19 years, had secondary school certificate (SSC) and secondary school certificate (HSC) or higher education, were day laborers, had own house, and do not lived with parents had odds ratios of 2.31 (CI 1.46–3.65), 2.38 (CI 1.51–3.77), 4.15 (CI 2.41–7.14), 0.28 (CI 0.13–0.60), 0.14(CI 0.05–0.35), and 1.80 (CI 1.07–3.03), respectively. Among adolescents, the prevalence of life-time suicidal ideation was moderately high. Age, education, occupation, house ownership, and living with parents were statistically significantly associated with suicidal ideation. It is important to design and implement effective community based suicide prevention programs for adolescents in Bangladesh.
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| 4. |
- Biswas, Animesh, et al.
(author)
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Exploring perceptions of common practices immediately following burn injuries in rural communities of Bangladesh
- 2018
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In: BMC Health Services Research. - : BioMed Central. - 1472-6963. ; 18
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Journal article (peer-reviewed)abstract
- Background: Burns can be the most devastating injuries in the world, they constitute a global public health problem and cause widespread public health concern. Every year in Bangladesh more than 365,000 people are injured by electrical, thermal and other causes of burn injuries. Among them 27,000 need hospital admission and over 5600 people die. Immediate treatment and medication has been found to be significant in the success of recovering from a burn. However, common practices used in the treatment of burn injuries in the community is not well documented in Bangladesh. This study was designed to explore the perception of local communities in Bangladesh the common practices used and health-seeking behaviors sought immediately after a burn injury has occurred.Methods: A qualitative study was conducted using Focus Group Discussions (FGD) as the data collection method. Six unions of three districts in rural Bangladesh were randomly selected and FGDs were conducted in these districts with six burn survivors and their relatives and neighbours. Data were analyzed manually, codes were identified and the grouped into themes.Results: The participants stated that burn injuries are common during the winter in Bangladesh. Inhabitants in the rural areas said that it was common practice, and correct, to apply the following to the injured area immediately after a burn: egg albumin, salty water, toothpaste, kerosene, coconut oil, cow dung or soil. Some also believed that applying water is harmful to a burn injury. Most participants did not know about any referral system for burn patients. They expressed their dissatisfaction about the lack of available health service facilities at the recommended health care centers at both the district level and above.Conclusions: In rural Bangladesh, the current first-aid practices for burn injuries are incorrect; there is a widely held belief that using water on burns is harmful.
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| 5. |
- Biswas, Animesh, et al.
(author)
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Lightning Injury is a disaster in Bangladesh? : Exploring its magnitude and public health needs
- 2016
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In: F1000 Research. - London, United Kingdom : Faculty of 1000 Ltd.. - 2046-1402. ; 5
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Journal article (peer-reviewed)abstract
- Background: Lightning injury is a global public health issue. Low and middle-income countries in the tropical and subtropical regions of the world are most affected by lightning. Bangladesh is one of the countries at particular risk, with a high number of devastating lightning injuries in the past years, causing high mortality and morbidity. The exact magnitude of the problem is still unknown and therefore this study investigates the epidemiology of lightning injuries in Bangladesh, using a national representative sample.Methods: A mixed method was used. The study is based on results from a nationwide cross-sectional survey performed in 2003 in twelve randomly selected districts. In the survey, a total of 819,429 respondents from 171,336 households were interviewed using face-to-face interviews. In addition, qualitative information was obtained by reviewing national and international newspaper reports of lightning injuries sustained in Bangladesh between 13 and 15 May 2016.Results: The annual mortality rate was 3.661 (95% CI 0.9313–9.964) per 1,000,000 people. The overall incidence of lightning injury was 19.89/100,000 people. Among the victims, 60.12% (n=98) were males and 39.87% (n=65) were females. Males were particularly vulnerable, with a 1.46 times increased risk compared with females (RR 1.46, 95% CI 1.06–1.99). Rural populations were more vulnerable, with a 8.73 times higher risk, than urban populations (RR 8.73, 95% CI 5.13–14.86). About 43% of injuries occurred between 12 noon and 6 pm. The newspapers reported 81 deaths during 2 days of electric storms in 2016. Lightning has been declared a natural disaster in Bangladesh.Conclusions: The current study indicates that lightning injuries are a public health problem in Bangladesh. The study recommends further investigations to develop interventions to reduce lightning injuries, mortality and related burden in Bangladesh.
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| 6. |
- Biswas, Animesh, 1978-, et al.
(author)
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Unintentional injuries and parental violence against children during flood : a study in rural Bangladesh.
- 2010
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In: Rural and remote health. - Deakin West, Australia : Australian Rural Health Education Network. - 1445-6354. ; 10:1
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Journal article (peer-reviewed)abstract
- Introduction: Violence and injuries are under-reported in developing countries, especially during natural disasters such as floods. Compounding this, affected areas are isolated from the rest of the country. During 2007 Bangladesh experienced two consecutive floods which affected almost one-third of the country. The objective of this study was to examine unintentional injuries to children in rural Bangladesh and parental violence against them during floods, and also to explore the association of socioeconomic characteristics.Methods: A cross-sectional rural household survey was conducted in the worst flood-affected areas. A group of 638 randomly selected married women of reproductive age with at least one child at home were interviewed face-to-face using pre-tested structured questionnaires. The chi2 test and logistic regression were used for data analysis.Results: The majority of families (90%) were affected by the flood and were struggling to find food and shelter, resulting in the parents becoming violent towards their children and other family members in the home. Cuts (38%), falls (22%) and near drowning (21%) comprised the majority of unintentional injuries affecting children during the floods. A large number of children were abused by their parents during the floods (70% by mothers and 40% by fathers). The incidence of child injuries and parental violence against children was higher among families living in poor socio-economic conditions, whose parents were of low occupational status and had micro-credit loans during the floods.Conclusions: Floods can have significant effects on childhood injury and parental violence against children. The improvement of socio-economic conditions would assist in preventing child injuries and parental violence.
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| 7. |
- Dalal, Koustuv, 1969-, et al.
(author)
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The magnitude of injury problems among child labourers in a rural community of Bangladesh : findings from an injury surveillance system
- 2016
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In: International Health. - Oxford, United Kingdom : Oxford University Press. - 1876-3405 .- 1876-3413. ; 8:1, s. 73-76
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Journal article (peer-reviewed)abstract
- Background: Child labour is an important topic in contemporary society. In this study we have tried to explore the magnitude of injury problems among child labourers in Bangladesh using an injury surveillance system.Methods: An injury surveillance system (ISS) was performed under the Prevention of Child Injuries through Social intervention and Education (PRECISE) project in Bangladesh during 2006–2010 in three sub-districts covering a population of more than 700 000. We used the ISS for assessing child labour. Appropriate epidemiological methods were considered in the study.Results: Considering the reported main occupation of the children, 30% of children from the surveillance households were identified as child labourers. More than two thirds of child labourers were educated to primary or secondary level. The majority of boys worked as unskilled labourers and girls were employed in domestic work. The incidence of injury and deaths among child labourers was estimated as 24 per 100 000 children years. More than 19 injury related illnesses of moderate to severe intensity were found among 1000 child labourers in a year. Fractures, sprains, dislocations, cuts/wounds, animal bites, abrasions or lacerations, burns, head injuries and internal organ injuries are most common among child labourers.Conclusions:Working children are at risk of injury, death and illness in Bangladesh. Child labourers are now even more clearly tied to quantified morbidity and mortality.
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| 8. |
- Haque, M. Atiqul, 1970-, et al.
(author)
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Child Maltreatment Portrayed in Bangladeshi Newspapers
- 2020
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In: Child Abuse Review. - : WILEY. - 0952-9136 .- 1099-0852. ; 29:5, s. 448-462
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Journal article (peer-reviewed)abstract
- As in most low-income countries, there is a lack of scientific information on the incidence and pattern of child maltreatment (CM) in Bangladesh. However, the role of the media to disclose CM and to develop public awareness in society is noteworthy. The present study assessed newspaper reports about CM by type and socio-demographics of victims and perpetrators in Bangladesh. In total, 790 news articles were collected retrospectively from four Bengali- and two English-language newspapers from October to December 2014. Among all reported incidents, almost half of the CM cases concerned alleged physical abuse (26%) and sexual abuse (22%). Neglect and emotional or psychological abuse received less coverage. Female children were to a high degree (90%) victims of sexual abuse. The main perpetrators were males, and they were often known to the victims. Approximately 32 per cent of the reported abuse cases resulted in death and were related to rape, family violence, administrative negligence, abduction and ransom demand. Some of these deaths were suicides. News stories concerning CM were often reported in an unethical way by identifying the victim and not respecting child rights. Further, the stories seldom discussed the individual or social consequences of CM, or how maltreatment could be prevented. 'The present study assessed newspaper reports about CM by type and socio-demographics of victims and perpetrators in Bangladesh' Key Practitioner Messages The main types of reported cases of CM in Bangladeshi print media are physical abuse and sexual abuse, and there is a high proportion of fatal consequences. The perpetrators are often known to the victims. The identity of the victim is frequently reported, potentially putting the child at risk and violating child rights. Bangladeshi print media seldom discusses individual or societal consequences of CM, or how it could be prevented.
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| 9. |
- Haque, M. Atiqul, et al.
(author)
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Children's exposure to physical abuse from a child perspective : A population-based study in rural Bangladesh
- 2019
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In: PLOS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 14:2
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Journal article (peer-reviewed)abstract
- Background Although child physical abuse (CPA) is considered as a major global public health problem, it has not yet been recognized as such in Bangladesh. Very few studies have assessed the prevalence and victims' characteristics of multiple forms of CPA. Objective This population-based study assessed the prevalence of CPA committed by adults in a rural area of Bangladesh and examined its association with demographic and socio-contextual factors. Methods Data were obtained using ISPCAN Child Abuse Screening Tool for Children (ICAST-C) in a random sample of 1416 children (49% girls, 51% boys) aged 11 to 17 years by face-to-face interviews during March-April 2017. The response rate was 91.5%. To estimate predictors of CPA, physical abuse was categorized into frequent and less frequent groups. Results The prevalence of at least one form (>= 1), two forms (>= 2) and three or more forms (>= 3) of CPA were estimated approximately to 99%, 95% and 83% in their lifetime and 93%, 79%, and 57% in the past year respectively. Hitting (except on buttocks), standing/kneeling and slapping were the most common physical abuse whereas given drugs or alcohol, pinched, burned or scalded, beaten-up and locked up were less reported. Female children were faced severe forms of CPA more than that of males. Male children, younger age groups, witnessing adults using weapons at home, bullied by siblings and low level of maternal education were found to be significant risk factors for both >= 1 form and >= 2 forms of frequent CPA whereas adding also adult shouting in a frightening way was found as a significant risk factor for >= 2 forms of frequent CPA. Conclusion Self-reported prevalence of CPA is extremely common in the Bangladeshi rural society. The prevalence was associated with demographic and socio-contextual characteristics of the children such as being younger, witnessing domestic violence and maternal low education. The findings provide evidence to support parents and policy-makers to take effective measures to implement policy and programme on alternative up-bringing methods and creating awareness of negative effects of CM which in turn help Bangladesh to line up with UN Convention on the Rights of the Child, which the country signed in 1990.
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| 10. |
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| 11. |
- Haque, Md Atiqul, et al.
(author)
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Children's exposure to psychological abuse and neglect : A population-based study in rural Bangladesh
- 2021
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In: Acta Paediatrica. - : John Wiley & Sons. - 0803-5253 .- 1651-2227. ; 110:1, s. 257-264
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Journal article (peer-reviewed)abstract
- Aim: We aimed to estimate the prevalence and risk factors of child psychological abuse and neglect in a rural area of Bangladesh.Methods: Data were obtained from interviewing 1416 children aged 11-17 years administering the International Society for the Prevention of Child Abuse and Neglect Child Abuse Screening Tool for Children between March and April 2017. Linear regression analysis was used to estimate the risks of child psychological abuse and neglect.Results: The prevalence rates of at least one form of psychological abuse both in the past year and lifetime were more than 97 per cent. Moreover, the rates of at least one form of neglect were about 58 per cent during the past year and 78 per cent over lifetime. Living separately from parents posed children to significant risks of neglect and psychological abuse. Working children and greater number of siblings in a family were risk factors for neglect, whereas witnessing family violence and being bullied were risk factors for psychological abuse. Children with more years of schooling experienced less neglect and psychological abuse.Conclusion: The high prevalence of child psychological abuse and neglect in this study shows child maltreatment as an ignored issue in Bangladesh.
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| 12. |
- Haque, M. Atiqul, 1970-, et al.
(author)
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Children's exposure to psychological abuse and neglect from a child perspective : A population-based study in rural Bangladesh
- 2021
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In: Acta Paediatrica. - : Wiley-Blackwell. - 0803-5253 .- 1651-2227. ; 110:1, s. 257-264
-
Journal article (peer-reviewed)abstract
- Aim We aimed to estimate the prevalence and risk factors of child psychological abuse and neglect in a rural area of Bangladesh. Methods Data were obtained from interviewing 1416 children aged 11-17 years administering the International Society for the Prevention of Child Abuse and Neglect Child Abuse Screening Tool for Children between March and April 2017. Linear regression analysis was used to estimate the risks of child psychological abuse and neglect. Results The prevalence rates of at least one form of psychological abuse both in the past year and lifetime were more than 97 per cent. Moreover, the rates of at least one form of neglect were about 58 per cent during the past year and 78 per cent over lifetime. Living separately from parents posed children to significant risks of neglect and psychological abuse. Working children and greater number of siblings in a family were risk factors for neglect, whereas witnessing family violence and being bullied were risk factors for psychological abuse. Children with more years of schooling experienced less neglect and psychological abuse. Conclusion The high prevalence of child psychological abuse and neglect in this study shows child maltreatment as an ignored issue in Bangladesh.
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| 13. |
- Hussain, A. H. M. Enayet, 1963-, et al.
(author)
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Barriers to the uptake of eye health services of the children in rural Bangladesh : A community-based cross-sectional survey
- 2023
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In: PLOS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 18:12
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Journal article (peer-reviewed)abstract
- Globally, ocular morbidity and disability among children are major public health concerns.This study was designed to explore the health-seeking behaviours of parents in Bangladesh whose children have ocular problems. A cross-sectional mixed method was followed for this study. The method was designed to measure the eye health care-seeking practices of caregivers/parents with children with ocular morbidity in three unions (the lowest administrative geographical area comprising 30,000–50,000 population) of the Raiganj Upazila under the Sirajganj District of Bangladesh. The study period was from January to April 2017. Face-to face interviews using a semi-structured quantitative questionnaire with the caregivers and KI were conducted among the health service providers during the study period. This was the first community-based study conducted in Bangladesh to find out caregivers’ health-seeking behaviour with identified ocular morbidity. Among 198 confirmed cases of childhood ocular problems, only 87 (43.9%) parents sought health care for their children’s ocular morbidities. Better health-seeking behavior was found among the wealthier families. Proportions were 55.3% and 36% among wealthy and low-income families, respectively. Affluent families sought care from qualified service providers. Educated household heads chose qualified service providers for their children at a higher rate than illiterate household heads. Lack of knowledge, lack of awareness and financial constraints are significant barriers to seeking proper health care. More than half of the caregivers did not seek any eye care services for their children. Socio-demographic factors, and financial constraints play an essential role in the health-seeking behaviour of the parents.
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| 14. |
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| 15. |
- Islam, Farzana, 1969-, et al.
(author)
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Assessment of quality of infrastructure and clinical care performance of HCPs during MNH services at district and sub-district level government hospitals, Bangladesh
- 2015
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In: HealthMed. - Sarajevo, Bosnia & Herzegovina : D R U N P P. - 1840-2291 .- 1986-8103. ; 9:12, s. 500-510
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Journal article (peer-reviewed)abstract
- Background: Despite the progress towards the MDG4 and 5, compared to the developed world maternal and newborn deaths are still high in Bangladesh. Poor quality of maternal and newborn health care is often blamed for this high mortality. However, only few studies assessed the quality of health care of the facilities in Bangladesh. This study assessed the two important components of quality of maternal and newborn health care namely, infrastructure and performance of health care providers (HCPs) of three different levels of health facilities in Bangladesh.Methodology: A cross sectional survey including observation and document reviews conducted to measure the quality of infrastructures and to assess the clinical care performance of the health care providers related to maternal and newborn services. Two district hospitals, two maternal and child welfare centres, and 10 upazila (sub-district) health complexes were purposively selected from Thakurgaon and Jamalpur districts of Bangladesh to conduct the study. Six components including human resource, physical infrastructure, infection prevention, equipments/logistics/supplies, essential drugs and recordkeeping were assessed under infrastructure. Maternal and newborn care services provided by the health care providers were evaluated during antenatal care, postnatal care, conduction of delivery care and newborn care. Sixteen doctors using pre-tested infrastructure survey and observation checklists collected data between November and December 2011. The average of the sub-items of each item was calculated and then the mean average of the items were calculated and expressed in percentage. Ethical clearance was obtained from a competent authority and informed consent was obtained from the hospital authorities and the persons who participated in the study.Results: The percentage of mean average scores of all items of infrastructure for district hospitals, maternal and child welfare centres and upazila health complexes were 57.1%, 52.7% and 45.9% respectively, which were below the cut-off point (60.0%). None of the health care providers of three types of government hospitals obtained 100% score in any areas namely antenatal care, post-natal care, delivery care and newborn care.Conclusion: Quality of infrastructure of health facilities, and clinical care performance of the health care providers during discharging maternal and newborn health services were found poor in the selected three types of public hospitals.
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| 16. |
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| 17. |
- Islam, Farzana, 1969-, et al.
(author)
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Perceptions of health care providers and patients on quality of care in maternal and neonatal health in fourteen Bangladesh government healthcare facilities : a mixed-method study
- 2015
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In: BMC Health Services Research. - London, United Kingdom : BioMed Central. - 1472-6963. ; 15
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Journal article (peer-reviewed)abstract
- Background: Bangladesh has achieved remarkable progress in healthcare with a steady decline in maternal and under-5 child mortality rates in efforts to achieve Millennium Development Goals 4 and 5. However, the mortality rates are still very high compared with high-income countries. The quality of healthcare needs improve to reduce mortality rates further. It is essential to investigate the current quality of healthcare before implementing any interventions. The study was conducted to explore the perception of healthcare providers about the quality of maternal and neonatal health (MNH) care. The study also investigated patient satisfaction with the MNH care received from district and sub-district hospitals.Methodology: Both qualitative and quantitative methods were used in the study. Two district and 12 sub-district hospitals in Thakurgaon and Jamalpur in Bangladesh were the study settings. Fourteen group discussions and 56 in-depth interviews were conducted among the healthcare providers. Client exit interviews were conducted with 112 patients and their attendants from maternity, labor, and neonatal wards before being discharged from the hospitals. Eight physicians and four anthropologists collected data between November and December 2011 using pretested guidelines.Results: The hospital staff identified several key factors that affected the quality of patient care: shortage of staff and logistics; lack of laboratory support; under use of patient-management protocols; a lack of training; and insufficient supervision. Doctors were unable to provide optimal care because of the high volume of patients. The exit interviews revealed that 85 % of respondents were satisfied with the hospital services received. Seven out of 14 respondents were satisfied with the cleanliness of the hospital facilities. More than half of the respondents were satisfied with the drugs they received. In half of the facilities, patients did not get an opportunity to ask the healthcare providers questions about their health conditions and treatments.Conclusion: The quality of healthcare is poor in district and sub-district hospitals in Bangladesh because of the lack of healthcare personnel and logistic support. An integrated quality improvement approach is needed to improve MNH care service in district and sub-district hospitals in Bangladesh.
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| 18. |
- Islam, Farzana, 1969-
(author)
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Quality Improvement System for Maternal and Newborn Health Care Services at District and Sub-district Hospitals in Bangladesh
- 2016
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Doctoral thesis (other academic/artistic)abstract
- In Bangladesh, research focusing on the quality of maternal and newborn health (MNH) services in hospitals remains neglected. There have only been a few studies conducted on quality issues and found the quality of MNH care provided at district and sub-district hospitals to be poor. The overall objective of this thesis was to develop, implement and evaluate a framework for quality improvement (QI) system for MNH care at the district and sub-district level government hospitals in Bangladesh. The thesis is comprised of four papers. Mixed methods were used in paper I and paper IV. In paper II quantitative methods were utilized, and to develop the “Model QI System”, exploratory methodological approaches were used and illustrated in paper III. Group discussions, focus group discussions, in-depth interviews, documents review and photography were utilised as qualitative data collection techniques. Through structured observation and exit interviews quantitative data were obtained. Findings of baseline survey identified several keyfactors that affected the quality of patient care: shortage of staff and logistics; lack of laboratory support; under useof patient-management protocols; lack of training; and insufficient supervision. The clinical performance of health care providers was found unsatisfactory. Utilizing the baseline survey findings and existing information on QI models, theories and QI intervention programmes implemented in defferent settings an adapted “Model QI System” and its implementation framework, guidelines and tools were developed. The key areas of this “Model QI System” included health system support, clinical service delivery, inter-departmental coordination; and utilization of services and client satisfaction. The adopted “Model QI System” was incorporated within the existing hospital management system and it was found that the quality of care improved. The evaluation of the study showed that the “Model QI System” was acceptable to the top health managers, health care providers and hospital support staff and feasible to implement in district and sub-district hospitals in Bangladesh.
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| 19. |
- Patwary, Muhammad Mainuddin, et al.
(author)
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Impact of extreme weather events on mental health in South and Southeast Asia : A two decades of systematic review of observational studies
- 2024
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In: Environmental Research. - : Elsevier. - 0013-9351 .- 1096-0953. ; 250
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Research review (peer-reviewed)abstract
- Extreme weather events in South and Southeast Asia exert profound psychosocial impacts, amplifying the prevalence of mental illness. Despite their substantial consequences, there is a dearth of research and representation in the current literature. We conducted a systematic review of observational studies published between January 1, 2000, and January 20, 2024, to examine the impact of extreme weather events on the mental health of the South and Southeast Asian population. Quality assessment of the included studies was conducted using the Newcastle-Ottawa Scale (NOS) quality appraisal checklist. The search retrieved 70 studies that met the inclusion criteria and were included in our review. Most were from India (n = 22), and most used a cross-sectional study design (n = 55). Poor mental health outcomes were associated with six types of extreme weather events: floods, storm surges, typhoons, cyclones, extreme heat, and riverbank erosion. Most studies (n = 41) reported short-term outcome measurements. Findings included outcomes with predictable symptomatology, including post-traumatic stress disorder, depression, anxiety, general psychological distress, emotional distress and suicide. Limited studies on long-term effects showed higher mental disorders after floods and typhoons, while cyclone-exposed individuals had more short-term distress. Notably, the review identified over 50 risk factors influencing mental health outcomes, categorized into six classes: demographic, economic, health, disaster exposure, psychological, and community factors. However, the quantitative evidence linking extreme weather events to mental health was limited due to a lack of longitudinal data, lack of control groups, and the absence of objective exposure measurements. The review found some compelling evidence linking extreme weather events to adverse mental health in the South and Southeast Asia region. Future research should focus on longitudinal study design to identify the specific stressors and climatic factors influencing the relationship between climate extremes and mental health in this region.
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| 20. |
- Abdullah, Abu Sayeed Md., et al.
(author)
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Effects of climate change and maternal morality : Perspective from case studies in the rural area of Bangladesh
- 2019
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In: International Journal of Environmental Research and Public Health. - : MDPI AG. - 1661-7827 .- 1660-4601. ; 16:23
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Journal article (peer-reviewed)abstract
- This study explored the community perception of maternal deaths influenced by natural disaster (flood), and the practice of maternal complications during natural disaster among the rural population in Bangladesh. It also explored the challenges faced by the community for providing healthcare and referring the pregnant women experiencing complications during flood disaster. Three focus group discussions (FGDs) and eight in-depth interviews (IDIs) were conducted in the marginalized rural communities in the flood-prone Khaliajhuri sub-district, Netrakona district, Bangladesh. Flood is one of the major risk factors for influencing maternal death. Pregnant women seriously suffer from maternal complications, lack of antenatal checkup, and lack of doctors during flooding. During the time of delivery, it is difficult to find a skilled attendant, and referring the patient with delivery complications to the healthcare facility. Boats are the only mode of transport. The majority of maternal deaths occur on the boats during transfer from the community to the hospital. Rural people feel that the maternal deaths influenced by natural disaster are natural phenomena. Pre-preparation is needed to support pregnant women during disasters. There is unawareness of maternal health, related care, and complications during disasters among local health service providers and volunteers.
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| 21. |
- Begum, Afroza, et al.
(author)
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Parental socio-economic position and suicidal ideation among adolescents in Rural Bangladesh
- 2018
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In: Journal of Psychiatry and Behavioral Sciences. - : MedDocs Publishers LLC. - 2637-8027. ; :4
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Journal article (peer-reviewed)abstract
- Background: Suicide is a leading cause of death worldwide and becoming a public health concern among adolescents. However, adolescent suicidal behaviour is a neglected public health issue, especially in low-income countries such as Bangladesh. Of great importance is the understanding of which factors might be related to this growing public problem. Objective: To examine the relationship between parental socio-economic position and suicide ideation among adolescents in rural Bangladesh Methods: A cross-sectional survey was conducted in 2013 among 2,476 adolescents, aged 14-19 years, selected randomly from a rural community of Bangladesh. An adapted version of the WHO/SUPRE-MISS questionnaire was used to collect data in the Raiganj sub-district, which is a surveillance area of the Centre for Injury Prevention and Research, Bangladesh (CIPRB).Descriptive statistics and binary logistic regression analyses were used to analyze the data. Comparisons of proportions between groups were carried out using the χ2 test. Multivariate logistic regression analysis was used to examine the relationship between parental co-variants and suicidal thoughts among adolescents. The significance level was set atp <0.05. All analyses were performed using SPSS 20. Results: The majority of parents had education only up to primary school (mothers 58.7% and fathers 49.5%). Most of them were farmers (53.3% of fathers) and housewives (96.5% of mothers). Monthly income and expenditure of the adolescent’s parents were mainly upto 10,000 taka only. Suicidal ideation is more common among adolescents of low income group parents 104 (5.5%) and who were not living with their parents 18 (8.2%). Adolescent’s suicidal ideation was found to be significantly associated with education, marital status and house ownership of their parents. Not being able to live with their parents was also a significant factor. Parents who received education up to SSC had odds ratio of 2.10 (1.21,3.64) and 1.92 (1.15, 3.23) for mothers and fathers respectively. Parent’s income or expenditure was not associated with adolescent’s suicidal ideation. Adolescent’s suicidal ideation of single parents had higher odds (OR 3.00, CI 1.75-5.19) in comparison to adolescents who had both parents. Adolescents whose parents owned a house and who weren’t living withtheir parents had odds ratios of 0.14 (0.05,0.35), and 1.80 (1.07,3.03) respectively. After adjusting for other covariates parents’ marital status and house ownership significantly associated with the adolescent suicide ideation. Conclusion: Parental socio-economic position was associated with suicidal ideation. Adolescent with single parents were more likely to report suicidal ideation. Low parental education and socio-economic status, marital status, house ownership, not living with parents at home as well as adolescent loneliness were the important factors for suicidal ideation.
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| 22. |
- Begum, Afroza
(author)
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Social Determinants of Suicidal Ideation among Adolescents in Rural Bangladesh
- 2021
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Licentiate thesis (other academic/artistic)abstract
- Background and Objective: Suicide is a leading cause of death and a critical public health problem among adolescents worldwide. However, adolescent suicidal behaviour is a neglected public health issue, especially in low- and middle-income countries, such as Bangladesh. There is evidence from developed countries showing that suicidal ideation (SI) among adolescents is related to social indicators as well as individual risk factors. Scarce evidence from studies inlow- and middle-income countries suggests that social factors may influence adolescent SI. In Bangladesh, only a few studies have focused on the social determinants of suicide, and the present study is the first to examine the prevalence and social determinants of suicidal ideation among adolescents in rural Bangladesh. Therefore, the present thesis assessed the effects of socioeconomic status (SES) on adolescent SI.Methods: The present thesis is based on two studies, which used data from a cross-sectional survey conducted in 2013 among 2,476 adolescents aged 14-19 years selected randomly in arural community in Bangladesh. An adapted version of the WHO/SUPRE-MISS questionnaire was used to collect data in the Raiganj sub-district, an area surveyed within the Injury Prevention Program of the Centre for Injury Prevention and Research, Bangladesh (CIPRB). Study I estimated the prevalence of suicidal ideation among adolescents and investigated what factors were associated with suicidal ideation. Study II examined the relationship between parental socio-economic factors and suicidal thoughts among adolescents.Results: Study I showed that life time prevalence of suicidal ideation was 5% among adolescents. The majority of adolescents with suicidal ideation were female (67, 5.3%), unmarried (106, 5.5%) and students (86, 6.2%). Suicidal ideation was significantly associated with age, education, occupation and living with parents or others. Respondents aged 18-19 years, had a Secondary school certificate (SSC) and Higher Secondary school certificate (HSC) or higher, were day labourers, living without parent had odds ratios of 2.31 (CI 1.46-3.65), 2.38(CI 1.51-3.77), 4.15 (CI 2.41-7.14), .28 (CI 0.13-0.60) and 1.80 (CI 1.07-3.03), respectively.In study 2, results demonstrated that suicidal ideation was more common among adolescents with parents from the low-income group (5.5%). In addition, adolescent SI was found to be significantly associated with parental education, marital status and house ownership. Adolescents whose parents received an SSC or higher had an SI odds ratio of 2.10 (CI 1.21-3.64) and 1.92 (CI 1.15-3.23) for mothers and fathers respectively. Suicidal ideation among adolescents with single parents was higher with an odds ratio of 3.00 (CI 1.75-5.19) in comparison to adolescents who had both parents. Adolescents whose parents owned a house had an odds ratio of 0.14 (0.05, 0.35).Conclusion: The thesis found that the prevalence of lifetime suicidal ideation among adolescents is moderately high in a rural community of Bangladesh. Furthermore, it was observed that personal characteristics such as parental marital status, education and homeownership were statistically significantly associated with suicidal ideation among adolescentseven after adjusting for potential confounders.
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| 23. |
- Biswas, Animesh, 1978-, et al.
(author)
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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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In: Health. - China : Scientific Research Publishing. - 1949-5005 .- 1949-4998. ; 6:16, s. 2218-2226
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Journal article (peer-reviewed)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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| 24. |
- Biswas, Animesh, 1978-, et al.
(author)
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Experiences of community verbal autopsy in maternal and newborn health in Bangladesh
- 2015
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In: HealthMed. - Sarajevo, Bosnia & Herzegovina : D R U N P P. - 1840-2291 .- 1986-8103. ; 9:8, s. 329-338
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Journal article (peer-reviewed)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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| 25. |
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| 26. |
- Biswas, Animesh, 1978-, et al.
(author)
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Exploration of social factors associated to maternal deaths due to haemorrhage and convulsions : Analysis of 28 social autopsies in rural Bangladesh
- 2016
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In: BMC Health Services Research. - London, United Kingdom : BioMed Central. - 1472-6963. ; 16:1
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Journal article (peer-reviewed)abstract
- Background: Social autopsy is an innovative approach to explore social barriers and factors associated to a death in the community. The process also sensitize the community people to avert future deaths. Social autopsy has been introduced in maternal deaths in Bangladesh first time in 2010. This study is to identify the social factors in the rural community associated to maternal deaths. It also looks at how the community responses in social autopsy intervention to prevent future maternal deaths.Methods: The study was conducted in the Thakurgaon district of Bangladesh in 2010. We have purposively selected 28 social autopsy cases of which maternal deaths occurred due to either haemorrhage or due to convulsions. The autopsy was conducted by the Government health and family planning first line field supervisors in rural community. Family members and neighbours of the deceased participated in each autopsy and provided their comments and responses.Results: A number of social factors including delivery conducted by the untrained birth attendant or family members, delays in understanding about maternal complications, delays in decision making to transfer the mother, lack of proper knowledge, education and traditional myth influences the maternal deaths. The community identified their own problems, shared within them and decide upon rectify themselves for future death prevention.Conclusions: Social autopsy is a useful tools to identify social community within the community by discussing the factors that took place during a maternal death. The process supports villagers to think and change their behavioural patterns and commit towards preventing such deaths in the future.
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| 27. |
- Biswas, Animesh, 1978-, et al.
(author)
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Intimate Partner Violence during pregnancy and victim’s perception on miscarriage
- 2015
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In: International Journal of Public Health Research. - New York, USA : Open Science. - 2381-4837. ; 3:2, s. 58-63
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Journal article (peer-reviewed)abstract
- Introduction: Women who suffer intimate partner violence (IPV) encounter reproductive health problems including miscarriages. IPV in Bangladeshi women is known to be acute socio- medical problem. The aim of the current study was to determine the prevalence of intimate partner violence from the husband during pregnancy and to explore the victims’ perceptions of IPV and miscarriage.Methods: Women who were admitted to a sub-district level hospital in Bangladesh due to miscarriage between July and December 2007 were invited to participate. A cross-sectional study was performed using mixed methods. Descriptive statistics were applied to the quantitative data and the qualitative data were analysed using thematic analysis.Results: Majority of women aged between 18 – 30 years (68.4%), more than 38% had no education and most of them had low socio-economic conditions. 43 (56.6%) women reported that they had experienced sexual violence in the last four months. 20 (26.3%) women suffered this once a week and 30% (n=23) faced sexual violence twice or more in a week. 29 (38.2%) women believed that current miscarriage was due to their husband’s sexual violence. The women reported that their husband forced sexual intercourse on them and that they were highly controlling over their day-to-day lives.Conclusion: Sexual violence during pregnancy is a hidden health problem for women in rural Bangladesh. Education and information need to be made more widely available to improve maternal health and child survival.
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| 28. |
- Biswas, Animesh, 1978-, et al.
(author)
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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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In: Health. - : Scientific Research Publishing. - 1949-5005 .- 1949-4998. ; 6, s. 1669-1679
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Other publication (other academic/artistic)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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| 29. |
- Biswas, Animesh, 1978-
(author)
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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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Doctoral thesis (other academic/artistic)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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| 30. |
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| 31. |
- Biswas, Animesh, 1978-, et al.
(author)
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The Economic Cost of Implementing Maternal and Neonatal Death Review in a District of Bangladesh
- 2016
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In: Journal of Public Health Research. - Pavia, Italy : PagePress. - 2279-9028 .- 2279-9036. ; 5:3, s. 99-103
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Research review (peer-reviewed)abstract
- Introduction: Maternal and neonatal death review (MNDR) introduced in Bangladesh and initially piloted in a district during 2010. MNDR is able to capture each of the maternal, neonatal deaths and stillbirths from the community and government facilities (hospitals). This study aimed to estimate the cost required to implement MNDR in a district of Bangladesh during 2010-2012.Materials and Methods: MNDR was implemented in Thakurgaon district in 2010 and later gradually extended until 2015. MNDR implementation framework, guidelines, tools and manual were developed at the national level with national level stakeholders including government health and family planning staff at different cadre for piloting at Thakurgaon. Programme implementation costs were calculated by year of costing and costing as per component of MNDR in 2013. The purchasing power parity conversion rate was 1 $INT = 24.46 BDT, as of 31st Dec 2012.Results: Overall programme implementation costs required to run MNDR were 109,02,754 BDT (445,738 $INT $INT) in the first year (2010). In the following years cost reduced to 8,208,995 BDT (335,609 $INT, during 2011) and 6,622,166 BDT (270,735 $INT, during 2012). The average cost per activity required was 3070 BDT in 2010, 1887 BDT and 2207 BDT required in 2011 and 2012 respectively. Each death notification cost 4.09 $INT, verbal autopsy cost 8.18 $INT, and social autopsy cost 16.35 $INT. Facility death notification cost 2.04 $INT and facility death review meetings cost 20.44 $INT. One death saved by MNDR costs 53,654 BDT (2193 $INT).Conclusions: Programmatic implementation cost of conducting MPDR give an idea on how much cost will be required to run a death review system for a low income country settings using government health system.
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| 32. |
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| 33. |
- Halim, Abdul, et al.
(author)
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When, Where, and Why Are Babies Dying? : Neonatal Death Surveillance and Review in Bangladesh
- 2016
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In: PLOS ONE. - : Public Library of Science. - 1932-6203. ; 11:8
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Journal article (peer-reviewed)abstract
- Background: Better data on cause of, and factors contributing to, neonatal deaths are needed to improve interventions aimed at reducing neonatal mortality in low-and middle-income countries.Methods: Community surveillance to identify all neonatal deaths across four districts in Bangladesh. Verbal autopsy for every fifth case and InterVA-4 used to assign likely cause of death.Findings: 6748 neonatal deaths identified, giving a neonatal mortality rate of 24.4 per 1000 live births. Of these, 51.3% occurred in the community and 48.7% at or on the way to a health facility. Almost half (46.1%) occurred within 24 hours of birth with 83.6% of all deaths occurring in the first seven days of life. Birth asphyxia was the leading cause of death (43%), followed by infections (29.3%), and prematurity (22.2%). In 68.3% of cases, care had been provided at a health facility before death occurred. Care-seeking was significantly higher among mothers who were educated (RR 1.18, 95% CI: 1.04-1.35) or who delivered at a health facility (RR 1.48, 95% CI 1.37-1.60) and lower among mothers who had 2-4 previous births (RR 0.89, 95% CI 0.82-0.96), for baby girls (RR 0.87, 95% CI 0.80-0.93), and for low birth weight babies (RR 0.89, 95% CI 0.82-0.96).Interpretation: Most parents of neonates who died had accessed and received care from a qualified health-care provider. To further reduce neonatal mortality, it is important that the quality of care provided, particularly skilled birth attendance, emergency obstetric care, and neonatal care during the first month of life is improved, such that it is timely, safe, and effective.
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| 34. |
- Rahman, Fazlur
(author)
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A model for injury surveillance at the local level in Bangladesh : implications for low-income countries
- 2000
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Doctoral thesis (other academic/artistic)abstract
- Injury is a major public health problem in Bangladesh as in other low income countries throughout the world, but one that has gained very little attention from policy makers or even health professionals, mainly due to the lack of valid injury information in these countries. The establishment of surveillance systems for injuries at the national and local levels for the purpose of measuring trends, detecting clusters, identifying injury related risk factors, and developing intervention strategies are now essential steps to be taken in low-income countries. Despite several advances in public health surveillance practice such as sophisticated public health methods, computers, and the development of software for statistical analysis, the development of any kind of disease surveillance is a challenging task in low-income countries. This is mainly due to the scarcity of resources, low priority given to the problem, lack of interest by the people involved in these processes, and non-initiatives for the development of such systems. A model for injury surveillance is developed to be applied as part of injury prevention programmes at the local level in Bangladesh as well as in other low-income countries. The model contains the utilization of four sources of injury information to depict the injury panorama for the area, the sources being hospital injury registry, post-mortem reports, police reports, and household surveys on injury. The development of the model is based on a series of scientific approaches. First, the medical-care seeking behaviour of injury patients in a local community in Bangladesh was studied, at the same time that injury morbidity and mortality in the same community were assessed. Then the different potential sources of injury information were evaluated in terms of validity, cost effectiveness and practical feasibility. Using this information, a model of injury surveillance was designed incorporating the establishment of a practical, effective, and affordable injury registry system. Finally, the epidemiology of injury was described by means of the new injury surveillance system. The injury surveillance model has been developed and applied in the Sherpur sadar thana of Bangladesh, a district which is situated in the northern part of the country, about 200 km from the capital city Dhaka, and as a total population of 381,419. Overall research project was conducted during the period 1996 until 1999. In the thesis, five studies are presented which build upon data collected for the development as well as the application of the model. The development of injury surveillance as part of a local injury prevention programme in Bangladesh is the first attempt of its kind. This experience may be useful for designing and implementing similar systems in other low-income countries.
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| 35. |
- Vet, Jasper M., et al.
(author)
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The first integrated speed management program benefitting vulnerable road users in Bangladesh : results and implications for LMICS
- 2016
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Conference paper (peer-reviewed)abstract
- Over 20,000 people are killed due to road traffic crashes in Bangladesh annually. The country has over 100 road traffic deaths per 10,000 motor vehicles, one of the highest rates in the world. 70% of crash fatalities occur in rural areas. In 2014, Safe Crossings (Netherlands) and CIPRB (Bangladesh) received permission from the government of Bangladesh to design and implement an integrated speed management program to prevent road traffic injuries at three locations on a national highway that passes through villages. The study goal was to understand and quantify the improvement in road safety as a result of small-scale infrastructural adaptations combined with active community involvement and road user education. We had a specific interest in the effects on VRUs. Prior to installing the interventions, the three intervention locations combined had, on average, per year: 110 serious accidents, 12 deaths, and 240 injured people. Pedestrians accounted for 63% of all fatalities in the Before Period. In an ideal world one would like to use accident statistics as the ultimate measure of road safety. In reality, this was not possible as the accident statistics were neither sufficiently accurate nor complete. Hence we had to design an alternative monitoring & evaluation approach. The basic research design is a Before and After study using three methods: i) speed measurement (also in control locations), ii) an accident recording system using local record keepers that we set up ourselves, and iii) conflict observation using the DOCTOR method with video recording. Implementation of all infrastructural interventions was completed in April 2015. The integrated speed management for three locations in Bangladesh has resulted a reduction in road traffic injuries and fatalities of around 60%. The net speed effect is a reduction on average of 13,3 km/h (or 20% in relative terms), suggesting a reduction in the number of people killed of 59% using Nilsson’s power law. Our accident recording system shows a 66% reduction in the number of serious accidents (significant at p < 0.01), a 73% reduction in the number of injured people (significant at p < 0.01), and a 67% reduction in the number of road traffic deaths (significant at p < 0.10).Analysis of the conflict data revealed a 54% reduction in relative terms (52% reduction when taking the traffic volumes into account) in the number of serious conflicts. In addition, no conflicts of the highest severity category occurred in the after period. An additional advantage of the integrated speed management program is that it can be implemented relatively quickly (in 6 to 12 months) and the cost-effectiveness is very high. Our calculation suggests a ‘cost per DALY saved’ of below USD 100. We would like to suggest three specific areas of future research based on this study: i) traffic calming in city environments in LMICs, ii) interventions to further reduce the speed of fast-moving traffic in general and buses in particular and iii) investigating the potential of an integrated speed management program in a large number of locations in LMICs with the joint aim of significantly improving road safety and generating valuable road safety data on (cost-) effectiveness and implementation challenges and solutions.
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