People’s Participation in Health Services: A Study of Bangladesh’s Rural Health Complex

Health is a basic requirement to improve the quality of life. A national economic and social development depends on the state of health. A large number of Bangladesh’s people, particularly in rural areas, remained with no or little access to health care facilities. The lack of participation in health service is a problem that has many dimensions and complexities. Education has a significant effect on participation in health services and administrative factors could play a significant role in increasing the people’s participation in Bangladesh’s health sector. But the present health policy is not people oriented. It mainly emphasizes the construction of Thana Health Complexes (THCs) and Union Health and Family Welfare Centers (UHFWCs) without giving much attention to their utilization and delivery services. The study reveals that financial and technical support is very helpful to ensure health service among village people. However, the Government allocates only 5 percent of the budget to the health sector, while it allocates 13 percent for defense. The paper shows that the Government’s allocation and technical support (medical equipments) are not sufficient in the rural health complex and that the people’s participation is far from being satisfactory. The paper concludes with a variety of recommendations.Bangladesh, health, participation, rural health

The Impact of Transparency on Quality of Health Service Delivery in Bangladesh: Findings of a Field Survey of Rural and Urban Health Service Organisations

Bangladesh has gained a glorious achievement in the quantitative reduction of maternal and child mortality in the recent past. But, the quality health service delivery still needs much improvement. This is considered as a big challenge facing the Government of Bangladesh in general and the agencies providing health care services to the people. This study endeavours to explore how organisational management, electronic devices, socio-economic and political factors impact on transparency in delivering good quality health care. This study selects two health service organisations of rural and urban areas for understanding the issues surrounding transparency and quality health service provision. This study used 68 in-depth interviews and five focus group discussions for gathering the required data. The urban health service organisation provides slightly improved transparent health care delivery because of better physical communication, adequate supervision and participative civil society organisation. However, general community has limited participation to both the rural and the urban health service organisations for lack of their education, poverty and bureaucratic mis-management in the organisations. Electronic devices contribute significantly for promoting transparent health service delivery, although resource constraints have posed a big challenge. Inadequate transparency contributes to corruption and absenteeism of health professionals which has an impact on quality health care provision. Participation of local elected representatives through adequate decentralisation and strengthening information management system in health care organisations can improve transparency and quality health service delivery

COP26 and the Crisis of Climate Change in Bangladesh

Bangladesh, a developing country located in South Asia, is one of the most environmentally vulnerable countries in the world. Global warming and climate change affect the country’s ecological balance, imposing threats to the existence of humans and animals, especially in flood-prone areas. Natural calamities, including floods, upsurges, cyclones, droughts, and so on, frequently hit some parts of the country. Bangladesh has already encountered massive floods in 1974 and 1988; the giant cyclones in 1970 and 1991; Sidr in 2007, and Ayla in 2009. Floods occur almost every year; as a result, many places of the country are submerged, and people suffer colossal losses—often, their houses and crops are washed away. Many families turn homeless and destitute, living in extreme poverty, and die of hunger. Global warming and climate change are also responsible for heavy rain inundating several cities and for drought destroying crops. The government of Bangladesh attempts to draw international attention to the impacts of global warming and climate change in different forums. In COP26, which took place in Glasgow in November 2021, the Prime Minister of Bangladesh seriously addressed the issue and sought the attention of world leaders to take steps to redress the impacts of climate change and global warming. This study attempts to delve into the environmental issues, COP26, and the effects of climate change and global warming in Bangladesh

Two Poems

The poems “Other Fish to Fry” and “Lives of Others” reflect on how South Asian women fall victim to social systems and prejudices about gender. The first poem, “Other Fish to Fry,” metaphorically presents a mother bird and its kids, who represent women suffering from discrimination and torture. “Lives of Others” also depicts women who migrate to Middle Eastern countries in order to earn money and bring solvency to their families. But over time, they are victimized by landlords and brokers who regularly torture them. As a result, both poems address violence against South Asian women, including heinous crimes such as rape, acid attacks, and murder, as well as their silence

The Influence of Politics on Accountability of Health Professionals in Bangladesh: An Analysis of the Quality of Health Service Delivery

This study explored the role and responsibility of elected officials including political actors and addressed the factors of politics, decentralisation, bureaucratic management, and political commitment to understanding accountability in health service delivery. This study used qualitative case studies for which a total of 68 in-depth interviews and five focus group discussions were conducted in two areas of rural and urban Bangladesh. The findings show that political actors have poor commitment to improving accountability and healthcare delivery. The elected officials are not interested in organising regular meetings and they are even reluctant to organise a health service committee to make health officials accountable. The opposition political parties have no participation in health service organisations as the existing political culture does not allow it. Moreover, elected officials have a limited administrative authority because of an inadequate decentralised health system that leads to poor accountability and inadequate healthcare delivery. Further, bureaucrats want to capture power and are unwilling to decentralise the health system. The policy recommendation includes the decentralisation of healthcare provision and increased participation of elected representatives in a decentralised system. Abbreviations: ADP – Annual Development Plan; MP – Member of Parliament; NGO – Non Government Organisation; UHC – Upazilia Health Complex; UP – Upazilia Parishad

Integrated Decision Support System for Prognostic and Diagnostic Analyses of Water Distribution System Failures

This paper presents an innovative decision support system (DSS) for prognostic and diagnostic analyses of water distribution system (WDS) failures. The framework of the DSS is based on four novel models developed and published by the authors of this paper. The four models include reliability assessment model, leakage potential model, leakage detection model, and water quality failure potential model. Information obtained from these models together with external information such as customer complaints, lab test results (if any), and historical information are integrated using Dempster-Shafer (D-S) theory to evaluate prognostic and diagnostic capabilities of the DSS. The prognostic capabilities of the DSS provide hydraulic and water quality states of a WDS whereas the diagnostic capabilities of the DSS help to identify the failure location with minimal time after the occurrence and will help to reduce false positive and false negative predictions. The framework has ‘unique’ capacity to bring the modeling information (hydraulic and Quality), consumer complaints, historical failure data, and laboratory test information under a single platform to perform a prognostic and diagnostic investigation of WDS failures (hydraulic and Quality). The proof of concept of the DSS has been demonstrated using data used in published four articles. The outcomes of this research widely addressed the uncertainties associated with WDS which improves the efficiency and effectiveness of diagnosis and prognosis analyses of WDS. It is expected that the developed integrated framework will help municipalities to make informed decisions to increase the safety, reliability and the security of public health.Natural Sciences and Engineering Research Council of Canada (NSERC-SPG (Strategic Project Grants)

Engaged Reading: Moving from Theory to Implication for L2 Learners

There have been a good number of research studies on ‘engaged reading’ in general but not much literature is known about the ‘engaged reading’ that makes connections between theory and practice with special reference to ESL/EFL teachers. Hence, this paper aims to examine the efficacy of engaged reading and shows how it can be facilitated through mass awareness among the ESL or EFL teachers. Teachers’ adequate knowledge and perception about engaged reading can only ensure the implementation of it as a means of learning by owning the language thus creating a real attachment to it. This article uses a qualitative research method that exclusively uses the relevant secondary references/works available on the topic. The literature revealed that attitudes and strategy instruction of teachers in the classroom play a significant role in terms of increasing the learners’ motivation for reading with interest and their reading engagement for better academic achievement. The paper finally demonstrates how teachers with the best of their potential and concentration can immensely contribute to the growth of a reader to be an engaged reader

Comparison of outcome between suture and suture-less surgery following pterygium excision and conjunctival autograft

Background: A pterygium, known as surfer's eye, is a raised, wedge-shaped growth of the conjunctiva that extends onto the cornea, the outer layer of the eye. Aim was to compare the safety, efficacy and outcome of suture less technique with suture of conjunctival autograft in the management of pterygium. Methods: This study was carried out in the department of ophthalmology, Sir Salimullah medical college and Mitford hospital, Dhaka. Study period was July 2019 to June 2020. Subjects for this study were divided into two groups, forty patients were enrolled in each group of the study population. Group I (control) comprised the subjects in whom suture was used following pterygium excision and conjunctival autograft and group II (experimental) comprised the subjects in whom no suture was used following pterygium excision and conjunctival autograft. Results: In group I, 20% were 20-29 years old, 30% were 30-39, 27.5% were 40-49, and 22.5% were over 50, with 77.5% being male and 22.5% female. In group II, 22.5% were 20-29 years old, 27.5% were 30-39, 30% were 40-49, and 20% were over 50, with 72.5% being male and 27.5% female. The most common symptom was "foreign body sensation" in both groups. In group I, 5% experienced partial graft dehiscence, 2.5% a conjunctival cyst, 10% hyperemia, and 17.5% visual improvement. In group II, 2.5% had partial graft dehiscence, 2.5% hyperemia, and 22.5% visual improvement. Neither group had graft retraction or recurrence. Conclusions: Postoperative presentation like hyperemia was significantly less in experimental group. Incidence of post-operative complications like graft dehiscence and conjunctival cyst were comparatively less frequent in suture less technique. Thus, suture less technique following pterygium excision and conjunctival autograft is a safer and less complicated than sutured technique

A 50-year-old woman presented with severe reduction of vision and recurrent pain in right eye following cataract surgery

This article has no abstract. The first 100 words appear below: A 50-year-old female, hailing from Patuakhali, was admitted at the Department of Ophthalmology for the management of severe reduction of vision and pain at the right eye for the last 7 months following cataract surgery at a government hospital. Her cataract surgery (small incision cataract surgery with PC-IOL implantation) of the right eye was performed on October 28, 2018. On the first post-operative day, she developed pain, redness and severe reduction of vision in the right eye. The following day, she was discharged with the advice of some medications like moxifloxacin, dexamethasone, bromfenac eye drops and oral acetazolamide and potassium

Histomorphological Effect of Centella Asiatica on Swiss Albino Mice Brain upon Ketamine Anesthetic Induced Memory Impairment

Introduction: Ketamine is a medication mainly used for starting and maintaining anesthesia. It induces a trance-like state while providing pain relief, sedation and memory loss. Ketamine causes morphological changes in the neuronal cells of growing rodent. Centella asiatica is used for memory enhancement in the ayurvadic system of medicine. It has been shown to be useful in improving learning and memory. Centella asiatica leaf extract treatment enhances neuronal dendritic  arborization in hippocampus of growing rodent.Materials and Methods: Swiss albino mice were used for our experiment. Ketamine was administered subcutaneously and Centella-asiatica leaf extract was administered orally. Mice brain collected, grossed, processed and finally stained by Hematoxylin and Eosin (H&E) staining process for viewing cellular and tissue structure detail by pathologists. Results: Focal cellular damage was seen in CA2 and CA4 area of cornu ammonis (CA), expanded cytoplasmic eosinophilia saw in the pyramidal cell layers (PY) of CA2, expanded cytoplasmic eosinophilia found with obliteration of neurifibrilary components (NFE), typical pyramidal cell (NPY) in the CA4, ordinary engineering of dentate granule layers (DG) and hardly any cells were found with diminished size in regards to granule layer cells (GC) in the brain hippocampus of the high ketamine prompted mice. In the mouse brain hippocampus for high ketamine-Centella asiatica summed up cell destruction found in the CA1 to CA4 of CA. Expanded cytoplasmic eosinophilia found in the pyramidal cell layers of CA2 than high dose ketamine group. The vast majority of the pyramidal cells were necrotic (PYN) with annihilation of neurofibrilary components (NFE) in the pyramidal cell layers of CA4. Keywords: Centella asiatica, Ketamine and memory impairment. DOI: 10.7176/ALST/82-02 Publication date:October 31st 202