Research Reports (1994): Health Studies, Vol- XIV

Permanent URI for this collectionhttps://hdl.handle.net/10361/12852

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Vitamin A supplementation program in rural Bangladesh
(BRAC Research and Evaluation Division (RED), 1994-12) Kamal, F M
Tetanus Toxoid coverage during pregnancy: evidence from rural Bangladesh
(BRAC Research and Evaluation Division (RED), 1994-10) Hadi, Abdullahel
TB case management at community level: situation of the treatment completed patients in women's health and development programme
(BRAC Research and Evaluation Division (RED), 1994-12) Islam, Md. Nazrul; Mahmud, Shah Noor; Ali, Ahmed; Fazlul Karim
The Women's Health and Development Programme (WHOP) of BRAC initiated a community based tuberculosis {TB) control programme in 10 thanas in June, 1992 to complement and supplement the government TB control programme. The Research and Evaluation Division conducted a study on 181 TB patients who completed the anti-TB treatment on or before June, 1993 to investigate their a) socioeconomic and physical condition and b) measures taken for the patients who had cough for more than four weeks after completion of treatment. The study was conducted in all 10 thanas of WHOP in July 1994 and data· was collected from 181 patients administering a pretested questionnaire. About 72.0% of ~he patients were male indicative that the males are suffering from TB more than female or their morbidity is more reported than the female. Similar results were also found in national prevalence survey in 1987. Almost 67.0% of the patients came ·from target · group {TG), possibly the programme was more focused to the TG families. Moreover, 65.0% of the patients were treated with 12 months, 16.6% with six months, 17.7% with eight months and 1.1% with nine months treatment regimens. Sputum of 5 patients (2.8%) were found to be bacteriologically positive after one month completion of treatment. Moreover, a total of 9 patients died within one year after completion of treatment, but the causes of three deaths were found to be confirm~d (cancer, madness and suicide). Forty (24.4%) of ~he surveyed patients complained of history of cough for more than 4 weeks but 52.5% of them did not take any treatment, while sputum was examined for 32.5% of the cases.
Socio-demographic and community differentials in Vitamin A coverage: evidence from March 1994 data
(BRAC Research and Evaluation Division (RED), 1994-05) Hadi, Abdullahel
Report on Vitamin A coverage
(BRAC Research and Evaluation Division (RED), 1994-03) Hadi, Abdullahel
Report on EPI surveillance
(BRAC Research and Evaluation Division (RED), 1994-03) Hadi, Abdullahel
Introducing Watch : an initiative in monitoring health and development
(BRAC Research and Evaluation Division (RED), 1994-03) Hadi, Abdullahel
Illnesses and treatment among children in rural Bangladesh
(BRAC Research and Evaluation Division (RED), 1994-07) Hadi, Abdullahel
EPI coverage in September 1994: does parents' religious belief make any difference?
(BRAC Research and Evaluation Division (RED), 1994-12) Kamal, F M
Changes in Diarrhoeal death in rural Bangladesh
(BRAC Research and Evaluation Division (RED), 1994-10) Kamal, FM
Change in health status in RDP area: should current PHC program be continued?
(BRAC Research and Evaluation Division (RED), 1994-03) Hadi, Abdullahel
An investigation into the nature and determinants of maternal morbidity related to delivery and the puerperium in rural Bangladesh
(BRAC Research and Evaluation Division (RED), 1994-06) Goodbum, E. A.; Chowdhury, Mushtaque; Gazi, R.; Marshall, T.; Graham, W.; Karim, F.
It has been estimated that 99% of the world's maternal deaths (currently estimated to be about . 500,000 per annum) occur in developing countries. In Bangladesh, as in many other resource ·poor countries, the maternal mortality ratio has been estimated at between 5 .and 6 deaths per .1 000 live births. The main medical causes of these deaths are haemorrhage, infection, eclampsia, obstructed labour and septic abortion. Far less is known about the nature, determinants, levels and ~ends of maternal morbidity than · is known about maternal mortality. Until recently it was thought that there might be about 16.5 morbidities for every maternal death. More recent estimates· suggest that this figure is far too low and that there may be as many as 100 morbidities for every death meaning that more than 61.8 million women suffer significant ill health annually as a result of childbearing. Studies of maternal deaths which have investigated the timing of maternal deaths show that the majority occur in the post-partum period. It seems likely that most maternal morbidities arise at this time also and are linked to events at delivery. These conditions which include pelvic sepsis, anaemia, prolapse, vesico-vaginal fist~la and prolapse, may not result in death but may have serious social and physical consequences for women. · There have been very few community based studies of maternal morbidity in the post-partum period. One study from Honduras has reported that 28% of women developed complications during the puerperium, but in most countries facility based data is all that is available. Studies which have measured the prevalence of conditions which are long-term consequences of childbirth have often found that the prevalence can be very high. For instance, a recent crosssectional community based study conducted in Egypt discovered that 56% of .508 women examined had demonstrable prolapse. A study in Birmingham UK found that the number of women suffering significant ill health as a result of childbirth was as high as 6~.9%. A recent cross-sectional retrospective study of maternal morbidity in Bangladesh found that around 80% of women reported ill health associated with childbearing. One of the major issues in the estimation of levels of maternal morbidity in the community centres around the measurement techniques needed to provide accurate information. Compared to child health, very little work has been done in this field. Since 1989 a group based at the London School of Hygiene and Tropical Medicine (LSHTM) has co-ordinated a programme of methodological research on maternal health with the objective of evaluating existing methods of measuring maternal health, particularly in the community, and of developing, piloting and promoting the use of new approaches. Most interventions to improve maternal morbidity and mortality have focused on ante-natal care with referral of high risk cases to appropriate medical facilities. However, there has been considerable debate as to the value of ante-natal care in a situation where referral facilities are 11 20 absent or inadequate. In addition, in many countries, such as Bangladesh, where most deliveries occur at home, there have been programmes for training traditional birth attendants. However, it is uncertain how far delivery practices play a part in the aetiology of maternal morbidities, and the effectiveness of the interventions in prevention have never been adequately evaluated. Postpartum care is rarely given prominence in programmes for maternal care and no protocol for optimum surveillance has been developed despite recent interest in the potential of this period for integrated maternal, child and family planning interventions. In order to describe the pattern of maternal morbidity during the puerperium in Bangladesh, define the most important determinants of this morbidity and suggest approaches for future postnatal programmes a collaborative research study was undertaken by BRAC, ar1d the London School of Hygiene and Tropical Medicine (LSHTM).

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