Costing and economic analysis of strengthening union level facility for providing normal delivery and newborn care services in Bangladesh

For a long time, the reduction of the maternal mortality ratio has constituted a major challenge for the health, nutrition, and population sector of Bangladesh. The objectives of this Population Council study is to estimate the costs of the additional inputs required for strengthening Health and Family Welfare Centers (HFWC) for providing normal delivery and newborn care services, the cost-effectiveness, and the financial implications of the addition of capacity. Results clearly show that the benefit-cost ratio for the intervention will be quite high. Some additional measures on the demand side should thus adopted. Intensive behavior change communication activities including interpersonal communication in the households, community mobilization, and mass media are possible measures to complement the strengthening of HFWC

Review of the policy process in Bangladesh following ICPD

The International Conference on Population and Development (ICPD) in Cairo in 1994 was the culmination of months of national and international discussions. The issues had been crafted into a Program of Action, which represented a potential shift in thinking. Delegates left the conference espousing a new paradigm and a broad definition of what people, especially women, should expect from their national health services. Governments were encouraged to recognize that the improved health status of women could only be achieved by a life-cycle approach and that health depended not only on good family planning information and services but on women’s empowerment in all spheres—legal, employment, and education. The course had been set to greatly improve the approach of the family planning and maternal and child health programs. ICPD focused on a holistic approach to health that boosted the dynamic process already underway. This report is mainly based on secondary data collected through extensive review of all policy- and program-related documents published prior to and after ICPD

Cost of illness for severe and non-severe diarrhea borne by households in a low-income urban community of Bangladesh: A cross-sectional study

The illness cost borne by households, known as out-of-pocket expenditure, was 74% of the total health expenditure in Bangladesh in 2017. Calculating economic burden of diarrhea of low-income urban community is important to identify potential cost savings strategies and prioritize policy decision to improve the quality of life of this population. This study aimed to estimate cost of illness and monthly percent expenditure borne by households due diarrhea in a low-income urban settlement of Dhaka, Bangladesh. We conducted this study in East Arichpur area of Tongi township in Dhaka, Bangladesh from September 17, 2015 to July 26, 2016. We used the World Health Organization (WHO) definition of three or more loose stool in 24 hours to enroll patients and enrolled 106 severe patients and 158 non-severe patients from Tongi General Hospital, local pharmacy and study community. The team enrolled patients between the first to third day of the illness (≤ 72 hours) and continued daily follow-up by phone until recovery. We considered direct and indirect costs to calculate cost-per-episode. We applied the published incidence rate to estimate the annual cost of diarrhea. The estimated average cost of illness for patient with severe diarrhea was US$27.39 [95$ 6.36 [95% CI: 5.19, 7.55] (499 BDT), 4% of the average monthly income of households. A single diarrheal episode substantially affects financial condition of low-income urban community residents: a severe episode can cost almost equivalent to 4.35 days (17%) and a non-severe episode can cost almost equivalent to 1 day (4%) of household’s income. Preventing diarrhea preserves health and supports financial livelihoods

Measuring Water Quantity Used for Personal and Domestic Hygiene and Determinants of Water Use in a Low-Income Urban Community

There is a paucity of recent research on direct water quantity measurement for personal and domestic hygiene. We aimed to measure the water quantity used for personal and domestic hygiene and to explore the reasons and determinants for variation of water usage. We conducted this study from September 2014 to June 2016 in a low-income urban community in Dhaka. In 12 households, the team conducted a day-long bimonthly ethnographic observation for one year to measure the volume of water used per activity per person. They conducted 28 in-depth interviews to explore the reasons for changes of water usage. Participants used a median of 75 L (61–100) of water per capita per day (LCPD) and of this 75 LCPD they used a median of 39 LCPD (26–58) for personal hygiene. Women used less water than men. Individual and social norms, beliefs, and weather determinants determined personal hygiene. Water availability determined domestic hygiene (e.g., washing dishes, toilets and bathrooms). This study helps to elucidate a range of determinants of water usage of the participants from the participants’ perspective. The quantity of water used for domestic and personal hygiene and its relationship to fecal-oral transmitted disease can be explored in future research