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Socio-demographic determinants of the severity of locomotor disability among adults in Bangladesh: A cross-sectional study, December 2010-February 2011
(BioMed Central Ltd., 2017-11-20) Mahmud, Ilias; Clarke, Lynda; Ploubidis, George B.; BRAC James P Grant School of Public Health
Background: Socio-demographic variables are widely known to have an association with the presence of any disability. However, the association between the severity of locomotor disability and socio-demographic variables has never been investigated in Bangladesh. Methods: A cross sectional survey of adults with locomotor disabilities was conducted between December 2010 and February 2011 at the Centre for the Rehabilitation of the Paralysed (CRP), Dhaka, Bangladesh. During the study period 328 adults with locomotor disabilities met our selection criteria, but 316 consented and participated in the study. The 55-item Locomotor Disability Scale was used to measure disability. This study investigated the socio-demographic determinants of the severity of locomotor disability: age, gender, marital status, educational attainment, occupation, income status, type of house, living in own/rented house, household monthly income, household population and area of residence. Results: Participants' age was positively associated with the severity of their locomotor disability (β = 0.01; 95% CI: 0.004 to 0.02), adjusting for diagnosis and other socio-demographic variables studied. Individuals who had an income experienced 0.35 (95% CI: -0.63 to -0.07) points decrease in the severity of disability than those did not have an income, adjusting for diagnosis and rest of the socio-demographic variables studied. In comparison to the unemployed individuals, students, homemakers, and individuals in elementary occupation respectively experienced 0.75 (95% CI: -1.08 to -0.43), 0.51 (95% CI: -0.82 to -0.19) and 0.37 (95% CI: -0.66 to -0.08) points decrease in the severity of locomotor disability, adjusting for diagnosis and rest of the socio-demographic variables studied. Conclusions: The severity of locomotor disability has an association with individuals' age, income status and occupation of the adults with such disability in Bangladesh. No such association was evident with other socioeconomic position and demographic variables. This finding suggests that people with locomotor disabilities in Bangladesh experience similar disabling built and attitudinal environments irrespective of their socioeconomic positions and demographic characteristics. Further community-based studies are needed to confirm such conclusions. © 2017 The Author(s).
Choice of primary healthcare providers among population in urban areas of low- and middle-income countries—a protocol for systematic review of literature
(BioMed Central Ltd, 2024-12-01) Hasan, Md. Zahid; Webb, Edward J D; Quayyum, Zahidul; Ensor, Tim; BRAC James P Grant School of Public Health
Introduction: Strengthening and reforming the urban primary healthcare (PHC) system is essential to efficiently deliver need-based healthcare services to the rapidly increasing urban poor population. Such reforms of PHC system need to emphasize the opinion of patients in co-designing services in order that delivery of services can be accessed effectively by the urban population in a timely and low-cost way. Hence, it is important to identify the preference of urban population while choosing healthcare providers. The aim of this proposed protocol is to summarize a planned systematic review of existing evidence on the attributes considered for choosing PHC providers in urban settings of low- and middle-income countries (LMICs), as classified by the World Bank. Methods and analyses: An inclusive literature search will be conducted in electronic databases including Pubmed/MEDLINE, Embase, Global Health, Cochrane Library, Web of Science, and Scopus. Databases will be searched from the earliest date of entry until March 30, 2024. Database search will be supplemented by manual search of citations, reference lists, and grey literature sources. Following the pre-set inclusion and exclusion criterion, two researchers will independently screen all the retrieved studies in Covidence. Any discrepancies will be resolved through a discussion between two researchers, and if disagreements persist, a third reviewer will be consulted. The methodological quality of included studies will be appraised using checklist for Conjoint Analysis studies and the Mixed Methods Appraisal Tool (MMAT). An Excel-based data extraction table will be developed, piloted, and refined during the review process. Preference attributes will be identified and analyzed according to their types. The systematic review will be reported according to the Preferred Reporting Items for Systematic Reviews and Meta‑Analyses (PRISMA) guidelines. Discussion: The identification of attributes, their influence on preference, and heterogeneity with socioeconomic characteristics of the population will help the policymakers and researchers to design targeted PHC interventions. Such evidence will be also useful to design choice experiment studies to quantify the preferred attributes of PHC providers in urban context of LMICs. Systematic review registration: PROSPERO CRD42023409720. © The Author(s) 2024.
Social determinants of common metabolic risk factors (high blood pressure, high blood sugar, high body mass index and high waist-hip ratio) of major non-communicable diseases in South Asia region: A systematic review protocol
(BioMed Central Ltd., 2017-09-07) Sharma, Sudesh Raj; Mishra, Shiva Raj; Wagle, Kusum; Page, Rachel; Matheson, Anna; Lambrick, Danielle; Faulkner, James; Lounsbury, David; Vaidya, Abhinav; BRAC James P Grant School of Public Health
Background: Prevalence of non-communicable diseases has been increasing at a greater pace in developing countries and, in particular, the South Asia region. Various behavioral, social and environmental factors present in this region perpetuate common metabolic risk factors of non-communicable diseases. This study will identify social determinants of common metabolic risk factors of major non-communicable diseases in the context of the South Asian region and map their causal pathway. Methods: A systematic review of selected articles will be carried out following Cochrane guidelines. Review will be guided by Social Determinants of Health Framework developed by the World Health Organization to extract social determinants of metabolic risk factors of non-communicable diseases from studies. A distinct search strategy will be applied using key words to screen relevant studies from online databases. Primary and grey literature published from the year 2000 to 2016 and studies with discussion on proximal and distal determinants of non-communicable risk factors among adults of the South Asia region will be selected. They will be further checked for quality, and a matrix illustrating contents of selected articles will be developed. Thematic content analysis will be done to trace social determinants and their interaction with metabolic risk factors. Findings will be illustrated in causal loop diagrams with social determinants of risk factors along with their interaction (feedback mechanism). Discussion: The review will describe the interplay of social determinants of common NCD metabolic risk factors in the form of causal loop diagram. Findings will be structured in two parts: the first part will explain the linkage between proximal determinants with the metabolic risk factors and the second part will describe the linkage among the risk factors, proximal determinants and distal determinants. Evidences across different regions will be discussed to compare and validate and/or contrast the findings. Possible bias and limitations of this study will also be discussed. Systematic review registration: PROSPERO CRD42017067212 © 2017 The Author(s).
Optimum energy harvesting model for bidirectional cognitive radio networks
(Springer Science and Business Media Deutschland GmbH, 2021-12-01) Hasan, Mohammad Kamrul; Chowdhury, Md. Monwar J.; Ahmed, Shakil; Sabuj, Saifur R.; Nibhen, Jamel; Bakar, Khairul A. A.; Department of Electrical and Electronic Engineering
Wireless devices’ energy efficiency and spectrum shortage problem has become a key concern worldwide as the number of wireless devices increases at an unparalleled speed. Wireless energy harvesting technique from traditional radio frequency signals is suitable for extending mobile devices’ battery life. This paper investigates a cognitive radio network model where primary users have their specific licensed band, and secondary users equipped with necessary hardware required for energy harvesting can use the licensed band of the primary user by smart sensing capability. Analytical expressions for considered network metrics, namely data rate, outage probability, and energy efficiency, are derived for uplink and downlink scenarios. In addition, optimal transmission power and energy harvesting power are derived for maximum energy efficiency in downlink and uplink scenarios. Numerical results show that outage probability improves high transmission power in the downlink scenario and high harvested power in the uplink scenario. Finally, the result shows that energy efficiency improves using optimum transmission power and energy harvesting power for downlink and uplink scenarios. © 2021, The Author(s).
Technical efficiency of sub-district level hospitals in Bangladesh: a comparative frontier analysis
(BioMed Central Ltd, 2026-12-01) Hasan, Md. Zahid; Webb, Edward JD; Nikolova, Silviya; Tisha, Khadija Islam; Quayyum, Zahidul; Ensor, Tim; BRAC James P Grant School of Public Health
Background: In Bangladesh, sub-district hospitals (SDHs) are the first referral point for inpatient primary healthcare (PHC) services of the public providers in both rural and municipal corporation areas. These facilities also provide both outpatient and emergency healthcare services to the population at a minimum user fee. The efficient use of resources in primary-level healthcare facilities is essential for delivering quality healthcare services. Therefore, our aim was to estimate the technical efficiency (TE) of the SDHs in Bangladesh. Methods: We used an output-oriented data envelopment analysis (DEA) method to estimate the variable returns to scale (VRS) and constant returns to scale (CRS) TE of a total of 423 SDHs using data from the Local Health Bulletin -2017. To measure TE, we used workforce and inpatient beds as inputs and the number of inpatients and outpatients served by the hospitals in a month as output. We applied the Simar and Wilson model to find how the other internal and external characteristics of these hospitals influenced estimated TE score. We compared our DEA results with stochastic frontier analysis (SFA) and performed sensitivity analysis. Results: The average VRS and CRS TE of the SDHs were estimated to be 58.9% and 53.4%, respectively. Of the 423 SDHs, 15 were fully efficient in CRS, 30 were in VRS and 60 were scale efficient, while the rest operated below the efficiency frontier. The population density per bed, ratios of bed occupancy, ratios of beds to physicians, ratios of physicians to nurses, and administrative division had a significant positive influence, while lengths of stay and ratios of beds to nurses had a significant negative influence on the SDHs efficiency scores. The mean TE demonstrated that the SDHs, on an average, could improve their output by 42% using the existing level of input mix. The results were consistent in the sensitivity analysis. Conclusions: The average TE of the SDHs was half of the best score, suggesting there is scope for overall improvement among the inefficient SDHs by learning from the efficient SDHs. The Ministry of Health and Family Welfare (MOHFW) of Bangladesh allocates resources to SDHs based on the number of beds rather than based on an assessment of needs. The MOHFW could improve its monitoring system to investigate why some facilities are performing well using similar resources while others do not and adjust the allocation system to take into account the quantity and quality of care. © The Author(s) 2026.