Research Reports (2008): Health Studies, Vol - XL

Permanent URI for this collectionhttps://hdl.handle.net/10361/13129

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Newborn care practices in Nilphamari District of Bangladesh after a year of maternal, neonatal and child health intervention
(BRAC Research and Evaluation Division (RED), 2008-12) Choudhury, Nuzhat; Hashima-E-Nasreen
This study aimed to describe newborn care practices in an area where maternal, neonatal and child health (MNCH) intervention is being implemented, and to assess the effect of such intervention on newborn care. A cross sectional survey was carried out on 600 mothers to describe newborn care practices in Nilphamari district of Bangladesh. Logistic regression was used to identify socio-demographic, ante-natal and delivery care factors that were associated with newborn care practices. Mothers who had at least three ante-natal care visits had significantly better newborn care practice. Likewise, the presence of an individual trained in newborn care management was significantly associated with better newborn care. The association between 'newborn care practices' with 'ante-natal care visits' and 'presence of trained person in delivery' suggests that evidence-based newborn care practices can be promoted through community-based health worker with existing health services.
Maternal and newborn care practices among ultra poor households: a qualitative exploratory study
(BRAC Research and Evaluation Division (RED), 2008-06) Choudhury, Nuzhat
Rational use of essential drugs in the public and private sector PHC facilities in Bangladesh current situation and future directions
(BRAC Research and Evaluation Division (RED), 2008-04) Ahmed, Syed Masud; Islam, Shafayetul
In Bangladesh, the National Drug Policy (NDP) of 1982 was instrumental in improving the supply of quality essential drugs at an affordable price, especially in the early years However, over time, evidences exist about the deterioration of situation both in terms of availability of essential drugs as well as rational Lise of drugs. This study examined the current status of the outcome objectives of the NDP in terms of availability, affordability and rational use of drugs in the primary healthcare (PHC) facilities in Bangladesh. To address this, the study covered a random sample of Upazila Health Complexes (UHC) in the rural areas (n=30) and a convenient sample of Urban Clinics (UC) in the Dhaka Metropolitan area (n=20) for observation, exit-interview and minimarket survey to collect data on WHO core drug use indicators in health facilities. Findings reveal the availability of essential drugs for common illnesses to be poor, varying from 6% in the UHCs to 15% in the UCs. Drugs dispensed out of total prescribed was higher in UHCs (76%) compared to lJCs (44%). Dispensed drugs were not labeled properly, though 73% of the patients/care-givers reported to have understood the dosage schedule. Copy of an Essential Drugs List was available in 55% UCs and 47% UHCs with around 2/3rd drugs being prescribed from it. Polypharmacy was higher in the UCs (46%) than in the UHCs (33%). An antibiotic was prescribed in 44% of the encounters, more frequently for fever (36-40%) and common cold (26-34%) than for lower respiratory tract infection including pneumonia (10-20%). Prices of key essential drugs differed widely by brands (500% or more), seriously compromising the affordability for common people. 'This, the availability, affordability and the rational use of drugs have remained an illusory target to achieve in Bangladesh even 27 years after passing the much acclaimed NDP of 1982.
Knowledge and attitude of rural population towards TB and perception of barriers in accessing to TB services in two provinces of Afghanistan
(BRAC Research and Evaluation Division (RED), 2008-04) Islam, Qazi Shafayetul; Ahmed, Syed Masud; Rahman, Taufiqur; Amin, Sher Shah; Rahman, Mashuqur
The study aimed to explore i) the awareness and knowledge on tuberculosis (TB), ii) knowledge on TB diagnosis and treatment, iii) attitudes towards TB, and iv) perception of barriers in accessing to TB services. The approach adopted for this study was cross-sectional, multi-stage 30-cluster sampling method, face to face interview with adult male and female (aged + 15 year) in Badghis and Balkh provinces of Afghanistan. The total sample size was 900. The general awareness about ·rs was high in both the provinces (around 96%). TB was perceived widely as dangerous (81 %), and incurable (85%) by the population in both the provinces. A misperception that 'TB is a disease of female' was also observed in these provinces (78%) . Though the knowledge on symptom suggestive of TB (chronic cough) was high (9 I%), they lacked knowledge on other associated symptoms of TB. Knowledge on microbiological cause of TB was totally absent. However, they had different cultural explanations for the causation of TB. The knowledge on transmission and prevention was not comprehensive and varied by province and gender. Knowledge on diagnostic test was high (S5%), but when to test sputum was poor (26%). Knowledge on place of diagnosis was lacking. Respondents had also poor knowledge on management of TB (e.g., treatment duration, place of treatment). Tendency to seek care from government facilities lnr TB treatment was low ( 18%) in Afghanistan despite TB services offered free at government health facilities. Population had less access to community health workers (CHW) and public facilities for obtaining TB information. TB patients in both the provinces prioritized work over taking TB treatment. Besides, financial problem, shame and fear of isolation were found to be important deterrents in accessing to TB care. Health education content and materials should be reviewed and redesigned appropriately tnr disseminating comprehensive information on TB causation, transmission, prevention, diagnostic place and misperception associated with TB as well. A social support network (SSN) should be established within the community to support the TB patients to overcome the barriers.
Health status of mothers and children in rural Badghis province, Afghanistan 2007
(BRAC Research and Evaluation Division (RED), 2008-07) Islam, Qazi Shafayetul; Ahmed, Syed Masud; Rahman, Taufiqur; Amin, Sher Shah; Rahman, Mashuqur
To assess the impact of BRAC health programme on sanitation. antenatal care. delivery practices, contraception, breast-feeding. immunization. and childhood illnesses in Badghis province during 2004-2007. This cross-sectional survey used a random sample of households (n=450). The respondents were all married women of reproductive age ( 15-49 years) and under-five children of the sampled households. Since no baseline information was available, the findings were compared with the provincial estimates for Badghis province ti·om the Multiple Indicator Cluster Survey 2003 (MICS) and in some cases with estimates from a similar study carried out by BRAC in Balkh province in 2006. Nearly 75% of the adult population had never been to school. The mean age at marriage for girls was i 6 years in 2007. Safe sanitary practices increased marginally (20% to 27%). Awareness of the danger signs of pregnancy complications (32'Xl). provisions of immunization against tetanus (48%) and antenatal check-up during pregnancy (44%) have not improved among women compared to what was found in Balkh province (45'Yo, 59% and 49% respectively) in 2006. The delivery under the supervision of traditional birth attendant increased I 0% (MICS 2003) to 83%, while the use of post-natal care (PNC) remained poor (35%). The knowledge and practice of family planning increased from baseline (MICS 2003) ( 16% to 56 .0%, and I% to 19% respectively) in the last three years. There is marginal decrease in the proportion of breastfeeding within 6-hr of delivery, from 79% at 2003 (MICS) to 72%. Bacillus Calmette-Guerin (BCG) coverage of under-five children increased from baseline (MICS 2003) (21% to 84%) but the coverage of measles remained somewhat unchanged at around 55%. However, vitamin A coverage declined significantly during the study period. The prevalence of diarrhoea has been remained high compared to baseline (MICS 2003) (around 50%) and the use ofORS has increased. The awareness of mothers about the danger signs during a diarrhoeal episode of children was higher (65%) compared to the Balkh study (50%). BRAC has achieved development on some indicators. Attention needs to be given in areas like ANC, PNC, management of diarrhoea and other childhood illnesses.
Maternal nutritional knowledge and child nutritional status
(BRAC Research and Evaluation Division (RED), 2008) Choudhury, Nuzhat; Jalal, Chowdhury SB
Food consumption pattern and dietary diversity
(BRAC Research and Evaluation Division (RED), 2008) Jalal, Chowdhury SB; Choudhury, Nuzhat; Sulaiman, Munshi
The incentives and constraints of government doctors in primary healthcare facilities in Bangladesh
(BRAC Research and Evaluation Division (RED), 2008-11) Hossain, Naomi; Rashid-uz-Zaman; Banksand, Nicola; Geirbo, Hanne Cecilie

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