Training Traditional Birth Attendants on the Use of Misoprostol and a Blood Measurement Tool to Prevent Postpartum Haemorrhage: Lessons Learnt from Bangladesh

A consensus emerged in the late 1990s among leaders in global maternal health that traditional birth attendants (TBAs) should no longer be trained in delivery skills and should instead be trained as promoters of facility-based care. Many TBAs continue to be trained in places where home deliveries are the norm and the potential impacts of this training are important to understand. The primary objective of this study was to gain a more nuanced understanding of the full impact of training TBAs to use misoprostol and a blood measurement tool (mat) for the prevention of postpartum haemorrhage (PPH) at home deliveries through the perspective of those involved in the project. This qualitative study, conducted between July 2009 and July 2010 in Bangladesh, was nested within larger operations research, testing the feasibility and acceptability of scaling up community-based provision of misoprostol and a blood measurement tool for prevention of PPH. A total of 87 in-depth interviews (IDIs) were conducted with TBAs, community health workers (CHWs), managers, and government-employed family welfare visitors (FWVs) at three time points during the study. Computer-assisted thematic data analysis was conducted using ATLAS.ti (version 5.2). Four primary themes emerged during the data analysis, which all highlight changes that occurred following the training. The first theme describes the perceived direct changes linked to the two new interventions. The following three themes describe the indirect changes that interviewees perceived: strengthened linkages between TBAs and the formal healthcare system; strengthened linkages between TBAs and the communities they serve; and improved quality of services/service utilization. The data indicate that training TBAs and CHW supervisors resulted in perceived broader and more nuanced changes than simply improvements in TBAs\u2019 knowledge, attitudes, and practices. Acknowledgeing TBAs\u2019 important role in the community and in home deliveries and integrating them into the formal healthcare system has the potential to result in changes similar to those seen in this study

Design and development of maize peeler for farmers in Bangladesh

Hand peeling of maize is common practice before shelling in Bangladesh. The main problems of hand peeling are that these require more time and increase labour cost. A maize peeling machine has been designed and fabricated in Farm Machinery and Postharvest Process Engineering Divisional workshop, BARI, Gazipur during 2016-2017 which reduce the human power in peeling operation of maize. This maize peeler can be very helpful for medium and small scale farmer. Two rubber and two spiral rollers were used for peeling of cobs. The functional parts of the machine are hopper, spiral roller and rubber roller. For the peeling operation moisture content of maize cobs were taken 20%- 24% (w b). The peeling capacities of the manual and power peelings were 87 kg/h and 1008 kg/h respectively when moisture content of maize cobs was 22% (wb). The highest peeling capacity was 1107 kg/h when the moisture content of the maize cob was 20 % (wb). The average machine speeds were found to be 1.41m/s. During peeling operation, it was observed that 1% of grains were injured and 3.2 % of maize cobs were found to be unhusked which is very negligible. The efficiency of the machine was found to be 96 %.

Training traditional birth attendants on the use of misoprostol and a blood measurement tool to prevent postpartum haemorrhage: lessons learnt from Bangladesh.

A consensus emerged in the late 1990s among leaders in global maternal health that traditional birth attendants (TBAs) should no longer be trained in delivery skills and should instead be trained as promoters of facility-based care. Many TBAs continue to be trained in places where home deliveries are the norm and the potential impacts of this training are important to understand. The primary objective of this study was to gain a more nuanced understanding of the full impact of training TBAs to use misoprostol and a blood measurement tool (mat) for the prevention of postpartum haemorrhage (PPH) at home deliveries through the perspective of those involved in the project. This qualitative study, conducted between July 2009 and July 2010 in Bangladesh, was nested within larger operations research, testing the feasibility and acceptability of scaling up community-based provision of misoprostol and a blood measurement tool for prevention of PPH. A total of 87 in-depth interviews (IDIs) were conducted with TBAs, community health workers (CHWs), managers, and government-employed family welfare visitors (FWVs) at three time points during the study. Computer-assisted thematic data analysis was conducted using ATLAS.ti (version 5.2). Four primary themes emerged during the data analysis, which all highlight changes that occurred following the training. The first theme describes the perceived direct changes linked to the two new interventions. The following three themes describe the indirect changes that interviewees perceived: strengthened linkages between TBAs and the formal healthcare system; strengthened linkages between TBAs and the communities they serve; and improved quality of services/service utilization. The data indicate that training TBAs and CHW supervisors resulted in perceived broader and more nuanced changes than simply improvements in TBAs knowledge, attitudes, and practices. Acknowledgeing TBAs important role in the community and in home deliveries and integrating them into the formal healthcare system has the potential to result in changes similar to those seen in this study

Conservation tillage (CT) for climate-smart sustainable intensification : Assessing the impact of CT on soil organic carbon accumulation, greenhouse gas emission and water footprint of wheat cultivation in Bangladesh

Soil organic carbon (SOC), greenhouse gas (GHG) emissions and water footprint (WF) are the key indicators of environmental sustainability in agricultural systems. Increasing SOC while reducing GHG emissions and WF are effective measures to achieve high crop productivity with minimum environmental impact (i.e. a multi-pronged approach of sustainable intensification (SI) and climate-smart agriculture (CSA) to achieve food security). In conventional agricultural systems, intensive soil tillage and removal of crop residues can lead to increase negative environmental impact due to reduce SOC, GHG emission and high water consumption. Conservation agriculture (CA) based conservation tillage systems (CTS) with crop residue retention is often suggested as a resource conserving alternative to increase crop productivity without compromising soil health and environmental sustainability of cereal cropping systems. The environmental impact of CTS in terms of SOC, WF and GHG emissions nonetheless remains understudied in Bangladesh. A two-year field experiment was carried out to evaluate the impacts of CTS with retention of crop residue on SOC accumulation, GHG emission and WF in wheat cultivation of Bangladesh. In the experiment, CTS such as zero tillage (ZT) and minimum tillage (MT) were compared with the conventional tillage (CT) practice. Result observed that the SOC accumulation in the soil was 0.11 t ha−1, 0.97 t ha−1, and 1.3 t ha−1 for CT, MT and ZT practices, respectively. A life cycle GHG emission estimation by farm efficiency analysis tool (FEAT) calculated 1987, 1992 and 2028 kg CO2eq ha−1 for ZT, MT and CT practices, respectively. Among the studied tillage options, lowest WF was achieved by MT (570.05 m3 t−1) followed by ZT (578.56 m3 t−1) and CT (608.85 m3 t−1). Since the results are in favor of CTS, this study recommends MT and ZT practice to reduce negative environmental externalities in wheat cultivation in Bangladesh. In comparison between the methods, the MT, which retains crop residue (20 cm), and involves principles of CA, is suitable for both CSA and SI of wheat cultivation in Bangladesh due to its ability to increase SOC accumulation, prevent both water loss, and GHG emission without compromising yield.</p

Design, Development, and Performance Evaluation of a Power-Operated Jute Fiber Extraction Machine

Jute is the golden fiber of Bangladesh, but its production is declining due to the involvement of higher production and processing costs, where a major portion of the cost is needed for fiber extraction. Labor unavailability and increasing labor cost have led to higher jute fiber production cost. To address these issues, this study looks at the development of a power-operated and cost-effective fiber extraction machine aiming at reducing the production cost. The study was conducted at the Rangpur regional office premises of Practical Action in Bangladesh, and the developed machine was branded as “Aashkol”, which had the following major parts: a feeding tray, a primary extraction roller, a secondary extraction roller, grabbing rollers, fiber collection stand, base frame, protection cover, and a spring-loaded tray under the primary extraction roller. The Aashkol can extract green ribbon from the jute stem, but jute sticks were broken down into smaller pieces (3–6 cm). The performance evaluation of the machine was conducted using different types of jute (Deshi, Kenaf, and Tossa) and compared with another jute extraction machine (KP model, introduced by Karupannya Rangpur Ltd.). The Aashkol-based extraction and improved retting systems were also evaluated and compared with traditional jute extraction systems. The jute stem input capacity (4.99 t h−1) of the Aashkol was 47.6% higher than the KP model (3.38 t h−1). Compared with the traditional system, across jute types, the Aashkol produced a 9% higher fiber yield and saved 46% retting time. Overall, the Aashkol reduced 90% of the labor requirement and saved 11.6 USD t−1 in jute fiber extraction and retting than the traditional method