How Did Research Partnerships Contribute to Bangladesh’s Progress in Improving Lives?

The last few decades have seen tremendous progress in improving the lives and livelihoods of people around the world. In almost all sectors of development, Bangladesh has done enviously well. One of the important change agents in this impressive development has been non-governmental organisations (NGOs). This article looks at BRAC as an important actor in Bangladesh’s development and how it contributed to the changes by working in partnership with likeminded entities. Such partnership has spanned across governments, NGOs, research and academic institutions, and development partners. It presented an example of how an independent research outfit contributed to improving BRAC’s programme quality and its delivery, leading to spectacular results.Department for International Development (DFID)Economic and Social Research Council (ESRC

Celebrating Bangladesh at 50: a positive deviance

LSE alumnus and Member of our Senior Advisory Board Ahmed Mushtaque Raza Chowdhury’s personal account of his journey in independent Bangladesh explains the triumphs of the nation against the odds, the challenges that lie ahead, and his own participation in it

Nous sommes une ONG qui a de nombreuses entreprises à son service

A. Mushtaque R. Chowdhury est professeur en santé populationnelle et familiale, vice-président et directeur exécutif par interim de BRAC (Bangladesh Rural Advancement Committee). Basée à Dacca, cette véritable institution – presque aussi puissante et ancienne que l’État bangladais lui-même – est un modèle original d’entreprise sociale combinant forme commerciale et statut d’ONG. Implantée dans les 64 districts du pays où elle déploie un large éventail d’activités, de la microfinance à la santé en passant par l’éducation, elle est également présente dans une dizaine de pays étrangers. Avec 120 000 salariés déclarés et 126 millions de bénéficiaires, on dit d’elle qu’elle est la plus grande ONG au monde

Nous sommes une ONG qui a de nombreuses entreprises à son service

A. Mushtaque R. Chowdhury est professeur en santé populationnelle et familiale, vice-président et directeur exécutif par interim de BRAC (Bangladesh Rural Advancement Committee). Basée à Dacca, cette véritable institution – presque aussi puissante et ancienne que l’État bangladais lui-même – est un modèle original d’entreprise sociale combinant forme commerciale et statut d’ONG. Implantée dans les 64 districts du pays où elle déploie un large éventail d’activités, de la microfinance à la santé en passant par l’éducation, elle est également présente dans une dizaine de pays étrangers. Avec 120 000 salariés déclarés et 126 millions de bénéficiaires, on dit d’elle qu’elle est la plus grande ONG au monde

Anaemia and iron deficiency during pregnancy in rural Bangladesh.

OBJECTIVE: To study the prevalence of anaemia and its association with measures of iron deficiency (ID) among a group of pregnant women. DESIGN: Cross-sectional survey. SETTING: Pregnant women identified through house-to-house visits and participating in community-based antenatal care activities in a rural location of Mymensingh, Bangladesh. SUBJECTS: The estimates are based on 214 reportedly healthy pregnant women in their second trimester. Information on socio-economic status and reproductive history were obtained through home visits and venous blood samples were collected at antenatal care centres. Haemoglobin concentration (Hb) was measured by HemoCue, serum ferritin (sFt) by radioimmunoassay and serum transferrin receptor (sTfR) by enzyme-linked immunosorbent assay methods. ID was defined as presence of either low sFt (8.5 mg l(-1)). RESULTS: The prevalence of anaemia (Hb /=110 g l(-1)) also had ID, but the prevalence was significantly lower than that observed in anaemic women (P=0.001). CONCLUSIONS: Despite the high prevalence of anaemia, severe cases were absent. The prevalence of ID increased at lower Hb. However, an increased prevalence was also found among women in the highest category of Hb

Sustainability of Scientific Journals in the Developing World With Special Reference to Bangladesh

The study explores sustainability of scientific journal publication in Bangladesh. Forty-three journal editors were interviewed, and 66 current journals were physically examined for production quality, regularity of publication, and availability at concerned libraries. Findings revealed that 68% of the journals were published late, 30% had inconsistencies in typesetting, and 14% were indexed. Most journals were found either excellent or of good quality in terms of printing (85%), binding (77%), paper (92%), and graphic reproduction (76%). Most journals were not available in major libraries under study. Of the 43 editors, 28 (35%) reported a cost recovery of 1-45% from subscriptions, advertisements, and sales. About 74.4% of the editors did not consider their journals at risk. Although 86% of the editors were confident that their journals would be sustained in the long run, 37.3% could not give any convincing logic in support of their statement. Major problems include lack of skilled staff, finance, quality articles and institutional support, and lengthy peer review process. Only one journal editor was found to be a full-time editor having training in editing and publication. One-half (51%) of the editors reported have training in editing, while four had publication training. Most editors (79%) were interested in acquiring training in editing and publication. Institutional support and backup, enthusiasm and zeal of editors, unmet need for standard local journals, constant flow of funds and articles, and skilled manpower are instrumental for sustainability of science journals in Bangladesh

Marital Disruption: Determinants and Consequences on the Lives of Women in a Rural Area of Bangladesh

This study, carried out during the second half of 1995, investigated the predisposing factors leading to marital disruption and its consequences on the lives of women in Matlab, a rural area of Bangladesh. Both qualitative and quantitative methods were used. Data were generated from detailed case studies and quantitative surveys of a small number of martially-disrupted women. Additional data were used from the ongoing demographic surveillance system of ICDDR,B: Centre for Health and Population Research. The findings revealed that divorced and abandoned women and their children were extremely vulnerable, both socially and economically. Various factors that influence marital disruption were identified, the most important ones being: aspects determining the process of marriage, various family problems due to non-fulfillment of demand for dowry, mutual distrust, extramarital relationships, quality of sexual life, education of women, and other behavioural characteristics of individuals. Level of education of the wife showed an inverse relationship with the risk of divorce. Women who did not have livebirths from their first pregnancy had a higher risk of divorce. The effect of pregnancy outcome was dependent on the level of education of women. Illiterate women with unsuccessful pregnancy outcomes were at the highest risk of being divorced, with the lowest risk for women with some education and a livebirth. The findings clearly indicate the need for broad-based social development programmes for women, especially to enhance their education to reduce their vulnerability to marital instability and its consequences

A Multidimensional Approach to Measure Poverty in Rural Bangladesh

Poverty is increasingly being understood as a multidimensional phenomenon. Other than income-consumption, which has been extensively studied in the past, health, education, shelter, and social involvement are among the most important dimensions of poverty. The present study attempts to develop a simple tool to measure poverty in its multidimensionality where it views poverty as an inadequate fulfillment of basic needs, such as food, clothing, shelter, health, education, and social involvement. The scale score ranges between 72 and 24 and is constructed in such a way that the score increases with increasing level of poverty. Using various techniques, the study evaluates the poverty-measurement tool and provides evidence for its reliability and validity by administering it in various areas of rural Bangladesh. The reliability coefficients, such as test-retest coefficient (0.85) and Cronbach's alpha (0.80) of the tool, were satisfactorily high. Based on the socioeconomic status defined by the participatory rural appraisal (PRA) exercise, the level of poverty identified by the scale was 33% in Chakaria, 26% in Matlab, and 32% in other rural areas of the country. The validity of these results was tested against some traditional methods of identifying the poor, and the association of the scores with that of the traditional indicators, such as ownership of land and occupation, asset index (r=0.72), and the wealth ranking obtained from the PRA exercise, was consistent. A statistically significant inverse relationship of the poverty scores with the socioeconomic status was observed in all cases. The scale also allowed the absolute level of poverty to be measured, and in the present study, the highest percentage of absolute poor was found in terms of health (44.2% in Chakaria, 36.4% in Matlab, and 39.1% in other rural areas), followed by social exclusion (35.7% in Chakaria, 28.5% in Matlab, and 22.3% in other rural areas), clothing (6.2% in Chakaria, 8.3% in Matlab, and 20% in other rural areas), education (14.7% in Chakaria, 8% in Matlab, and 16.8% in other rural areas), food (7.8% in Chakaria, 2.9% in Matlab and 3% in other rural areas), and shelter (0.8% in Chakaria, 1.4% in Matlab, and 3.7% in other rural areas). This instrument will also prove itself invaluable in assessing the individual effects of poverty-alleviation programmes or policies on all these different dimensions

The Next WHO Director-General’s Highest Priority: a Global Treaty on the Human Right to Health

Amidst the many challenges facing the next WHO Director-General, the new WHO head should find WHO’s foremost priority in its most important constitutional pillar: the right to health. The centerpiece of this endeavor should be leadership on the Framework Convention on Global Health (FCGH), the proposed global treaty based in the right to health and aimed at national and global health equity. The treaty would reform global governance for health to enhance accountability, transparency, and civil society participation and protect the right to health in trade, investment, climate change, and other international regimes, while catalyzing governments to institutionalize the right to health at community through to national levels. It would usher in a new era of global health with justice – vast improvements in health outcomes, equitably distributed. With the Framework Convention on Tobacco Control having served as a proof of concept, the FCGH would be an innovative treaty finding solutions to overcome global health failings in accountability, equality, financing, and inter-sectoral coherence. It would include a global health accountability framework, encompassing, civil society engagement, independent monitoring, and plans for redress, while catalyzing national health accountability strategies, accountability mechanisms, disaggregated data, and community participation. National health equity strategies, pro-poor pathways to universal health coverage, and robust non-discrimination provisions could elevate the voices, priorities, and ultimately power of marginalized populations. The FCGH would include a national and global health financing framework, while reaching beyond the health sector with right to health assessments, public health participation in developing international agreements, and responsibility for all sectors for improving health outcomes. The FCGH would reinvigorate WHO’s global health leadership, breathing new life into its founding principles. It could become the platform for reforming WHO as a rights-based 21st century institution, with badly-needed reforms, such as community participation, new priorities favouring social determinants of health, and a culture of transparency and accountability. The next Director-General should launch a historic effort to align national and global governance for with human rights through the FCGH, bringing the world closer to global health with justice

Comprehensive review of the evidence regarding the effectiveness of community-based primary health care in improving maternal, neonatal and child health: 8. summary and recommendations of the expert panel

Background: The contributions that community-based primary health care (CBPHC) and engaging with communities as valued partners can make to the improvement of maternal, neonatal and child health (MNCH) is not widely appreciated. This unfortunate reality is one of the reasons why so few priority countries failed to achieve the health-related Millennium Development Goals by 2015. This article provides a summary of a series of articles about the effectiveness of CBPHC in improving MNCH and offers recommendations from an Expert Panel for strengthening CBPHC that were formulated in 2008 and have been updated on the basis of more recent evidence.Methods: An Expert Panel convened to guide the review of the effectiveness of community-based primary health care (CBPHC). The Expert Panel met in 2008 in New York City with senior UNICEF staff. In 2016, following the completion of the review, the Panel considered the review\u27s findings and made recommendations. The review consisted of an analysis of 661 unique reports, including 583 peer-reviewed journal articles, 12 books/monographs, 4 book chapters, and 72 reports from the gray literature. The analysis consisted of 700 assessments since 39 were analyzed twice (once for an assessment of improvements in neonatal and/or child health and once for an assessment in maternal health).Results: The Expert Panel recommends that CBPHC should be a priority for strengthening health systems, accelerating progress in achieving universal health coverage, and ending preventable child and maternal deaths. The Panel also recommends that expenditures for CBPHC be monitored against expenditures for primary health care facilities and hospitals and reflect the importance of CBPHC for averting mortality. Governments, government health programs, and NGOs should develop health systems that respect and value communities as full partners and work collaboratively with them in building and strengthening CBPHC programs - through engagement with planning, implementation (including the full use of community-level workers), and evaluation. CBPHC programs need to reach every community and household in order to achieve universal coverage of key evidence-based interventions that can be implemented in the community outside of health facilities and assure that those most in need are reached.Conclusions: Stronger CBPHC programs that foster community engagement/empowerment with the implementation of evidence-based interventions will be essential for achieving universal coverage of health services by 2030 (as called for by the Sustainable Development Goals recently adopted by the United Nations), ending preventable child and maternal deaths by 2030 (as called for by the World Health Organization, UNICEF, and many countries around the world), and eventually achieving Health for All as envisioned at the International Conference on Primary Health Care in 1978. Stronger CBPHC programs can also create entry points and synergies for expanding the coverage of family planning services as well as for accelerating progress in the detection and treatment of HIV/AIDS, tuberculosis, malaria, hypertension, and other chronic diseases. Continued strengthening of CBPHC programs based on rigorous ongoing operations research and evaluation will be required, and this evidence will be needed to guide national and international policies and programs