Research Reports (2010): Economic Studies, Vol - XXVII

Permanent URI for this collectionhttps://hdl.handle.net/10361/13183

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Women-focused development intervention reduces delays in accessing emergency obstetric care in urban slums in Bangladesh: a cross-sectional study
(BRAC, 2010) Nahar, Shamsun; Banu, Morsheda; Nasreen, Hashima-E-
Background: Recognizing the burden of maternal mortality in urban slums, in 2007 BRAC (formally known as Bangladesh Rural Advancement Committee) has established a woman-focused development intervention, Manoshi (the Bangla abbreviation of mother, neonate and child), in urban slums of Bangladesh. The intervention emphasizes strengthening the continuum of maternal, newborn and child care through community, delivery centre (DC) and timely referral of the obstetric complications to the emergency obstetric care (EmOC) facilities. This study aimed to assess whether Manoshi DCs reduces delays in accessing EmOC. Methods: This cross-sectional study was conducted during October 2008 to January 2009 in the slums of Dhaka city among 450 obstetric complicated cases referred either from DCs of Manoshi or from their home to the EmOC facilities. Trained female interviewers interviewed at their homestead with structured questionnaire. Pearson's chi-square test, r-test and Mann-Whitney test were performed. Results: The median time for making the decision to seek care was significantly longer among women who were referred from home than referred from DCs (9.7 hours vs. 5.0 hours, p < 0.001). The median time to reach a facility and to receive treatment was found to be similar in both groups. Time taken to decide to seek care was significantly shorter in the case of life-threatening complications among those who were referred from DC than home (0 9 hours vs.2.3 hours, p = 0.002). Financial assistance from Manoshi significantly reduced the first delay in accessing EmOC services for life-threatening complications referred from DC (p = 0.006). Reasons for first delay include fear of medical intervention, inability to judge maternal condition, traditional beliefs and financial constraints. Role of gender was found to be an important issue in decision making. First delay was significantly higher among elderly women, multiparity, non life-threatening complications and who were not involved in income-generating activities. Conclusions: Manoshi program reduces the first delay for life-threatening conditions but not non-life-threatening complications even though providing financial assistance. Programme should give more emphasis on raising awareness through couple/family-based education about maternal complications and dispel fear of clinical care to accelerate seeking EmOC.
Revisiting Jamuna bridge resettlement areas: exploring livelihood status of the affected people
(BRAC, 2010-09) Ghosh, Shyamal C; Rahman, Hasanur; Rana, AKM Masud
Jamuna Multipurpose Bridge (JMB) project was the first of its kind which incorporated resettlement activities facilitating livelihood restoration of the project affected people (PAP). This study was an endeavor to reveal the livelihood status of the PAP after the implementation of the project in 1998, using both quantitative and qualitative methods. Findings revealed that though the livelihood of the PAP were affected due of loss of land or other assets and/or change of occupation, failure to utilize the compensation money, unavailability of skill development training they could manage to restore their livelihood during the post-project time. Regardless of the category of PAP, the rates of literacy (59%) as well as the use of tube well water (99%), sanitary latrine (40%), and electricity (50%) increased in both districts during the post-project time from that of pre-project time. Additionally, the status of child immunization (86% in Tangail and 91% in Sirajganj) and the use of contraceptive (61% in Tangail and 67% in Sirajganj) was also higher than the national status after the bridge construction. Self-rated food security status showed the reduced proportion of deficit households i.e. from 64% during the pre-project time to 55% during post-project time. All these factors indicated the improvement of quality of life during the postproject time. However, the PAP faced difficulty since agriculture was severely affected due to land acquisition and people shifted to non-farm activities. The logistic regression indicated that the probability of reporting good quality of life was less likely among the poor, who owned less than 50 decimals of land as well as the PAP who were in Sirajganj compared to their counterparts. The JMB resettlement policy and activities were not always appreciated by the PAP and thus, a future resettlement activity for any similar project needs revision to make it more effective for livelihood restoration with minimum difficulties.
Perceptions of production related stakeholders towards Aarong and the Ayesha Abed foundation
(BRAC, 2010-04) Rahman, Rehnuma; Alim, Md. Abdul
Aarong and Ayesha Abed Foundation were established to support the artisans and rural women in Bangladesh. Thus, these production-related stakeholders are very · important for Aarong and AAF. This study was initiated to investigate the perception of the stakeholders about Aarong and AAF. Data were collected from production workers (PW), independent producers (IP) and employees of Aarong and AAF using a combination of qualitative and quantitative methods. Findings show that female staff of Aarong were relatively more dissatisfied compared to male, and half of the IPs working with Aarong were also dissatisfied. IPs and PWs expressed many grievances about Aarong and AAF but their willingness to stay connected with the organization was evident under these circumstances, it would be better for the organization to address these alarming issues immediately to run the business smoothly in future.

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