Bangladesh Rural Advancement Committee (BRAC): organizational innovation in population, health and development in Bangladesh in the context of the millennium development goals

Bangladesh has marked strides to make in reaching the Millennium Development Goals (MDGs)for child mortality and maternal health by 2015. Progress and achievements that have been made to date are recognized. However, challenges remain that may impede steady progress towards the realization of the goals, including social inequality, largely defined by the low status of women, and the rich-poor divide. BRAC’s innovative organizational approach in Bangladesh serves to fill in the gaps left by the public sector, and brings a comprehensive approach to addressing these challenges and encouraging advances in health and development

Variables that May Affect the Transmission of Dengue – A Case Study for Health Management in Asia

Funding for Open Access provided by the UMD Libraries Open Access Publishing Fund.Dengue, an emergent viral infection, has increased exponentially since the 1960s [1]. In spite of the alarming escalation of cases reported, the WHO still believes the disease is significantly underreported [2]. The effects of climate change are expected to dramatically increase the global incidence and geographic locations of dengue. According to the WHO, the number of countries reporting dengue cases has increased from nine countries before 1960 to more than 64 countries in 2007 [2]. Dengue cases continue to climb despite numerous interventions globally to halt the progression. Climate change allows the primary dengue vectors to thrive in more geographical locations; increased population, urbanization and deforestation have also provided favorable conditions for vectors. In areas with poor or nonexistent infrastructure, sanitation, and unreliable water supplies, water storage systems provide ideal breeding grounds for mosquitos. These issues are compounded by intercontinental commerce, specifically the transport of tires, which harbor rainwater and mosquito larvae, allowing introduction of non-native mosquitos to other countries. No cure currently exists for dengue and vaccine development has been fraught with difficulties. Dengue should be categorized as one of the most imperative global health issues in need of effective solutions. Drastic changes need to occur in public health approaches and health management policies for dengue. Without serious and immediate attention to the escalation of dengue the global burden of disease will significantly intensify

Firearms: Ownership, Laws & and The Case for Community Mobilization

The United States (U.S.) currently ranks number one in the world in both the quantity of privately owned guns and the rate of private gun ownership. These privately owned firearms, which include rifles, shotguns and handguns, are predominantly owned by middle-aged, 35-54, white men, but the gaps have been steadily closing over the years, especially depending on the type of firearm, in all areas including gender, age, race, education level, political affiliation and geographic location. Gun violence is a leading cause of injury death in the U.S. In examining gun violence and potentially reducing its incidence, this article reviews gun ownership, access and utilization in the U.S., outcomes of gun violence, and the impact of community involvement in reducing gun violence. Specific areas of focus include the current state of background checks, with a focus on mental illness, and the role of medical professionals in guiding gun policy development. Gun violence continues to negatively impact the safety of individuals, families and communities. This article will emphasize the importance of social mobilization in enacting meaningful changes in gun policy and the development of relationships among healthcare professionals, social workers, and community members so as to further reduce and/or prevent gun violence

Universal Health Coverage and Environmental Health: An Investigation in Decreasing Communicable and Chronic Disease by Including Environmental Health in UHC

Over 83% of major diseases are environmentally mediated. These environmental factors include access to clean air and water, nutritional food, adequate shelter and access to health care. As health care systems across the globe struggle to include not only preventive health, but also health literacy in their approaches, it has become apparent that the most feasible system to combine all of these necessities is the universal health care/coverage (UHC) approach. This system also ensures that everyone has access to health services without financial hardship. It is imperative that environmental health (EH) is included in this approach, however, considering the global burden of disease due to environmental health factors. Epidemiological evidence-based approaches such as Water, Sanitation and Hygiene (WASH), have proven the advantage of utilizing these environmental health practices. In order to integrate EH into UHC, a dual multipronged (preventive and clinical) approach can be implemented; however, many are using a multisectoral approach due to the array of public-private partnerships which aid in its success. In alignment with the Millennium and Sustainable Development Goals, nations must make strides to address health disparities, chronic disease and poverty. Low and middle income countries (LMIC) are disproportionately burdened by economic insecurity, global pollution and preexisting issues within their government infrastructure, creating the worst health outcomes in these nations. Bangladesh has some of the worst chronic disease morbidities in the world due to indoor air pollution, rural and urban health disparities and food insecurity. Although the nation has begun to integrate EH into UHC, better coordination among ministries implementing health care is necessary, along with increased monetary allocation from the government. There is also a dire need for more health care providers who possess appropriate skills to work in the public sector. Lastly, more equitable access to services in both rural and urban areas and an improved financing mechanism must be instilled to successfully implement this EH/UHC approach

The Case for Microcredit: Does It Improve Maternal and Child Health and Wellbeing?

It is possible to achieve the above development goals, if disposable income, especially of the poor, is increased. A joint research project in Bangladesh was initiated by BRAC and ICDDR,B to evaluate the extent to which socioeconomic development engineered through microcredit might enhance maternal and child health programs and to determine the impact of rural community development programs on community well-being. We conducted a systematic review on BRAC-ICDDR,B Joint Research Project Working Paper Series. The series contained 32 working papers out of which we only selected papers that examined or had references to maternal and child health (n=13). We developed a checklist based on the Transparent Report of Evaluations with Nonrandomized Designs (TREND) criteria. The BRAC papers show promising positive linkages between implementation of microcredit programs in rural areas and (1) increase in income, (2) increase in health status and (3) improvement in women’s health. The assumption that increasing women’s empowerment through income and education leads to improvements health and survival is referred a number of times in the BRAC studies, however, this assumption has not been tested in well controlled intervention studies and further independent research needs to be conducted in order to test the hypotheses set out by the BRAC papers. The data from BRAC is a unique opportunity to examine pre and post intervention of the impact of microcredit and such data sets can provides researchers with the prospect of conducting continuous rigorous research in the country

Health facilities roles in measuring progress of universal health coverage

Outlined in Sustainable Development Goal 3.8, universal health coverage (UHC) ensures all people can access affordable and equitable essential health services without facing economic challenges. Advised by the World Health Organization (WHO), countries can strengthen their health systems and subsequently UHC by establishing a robust health system on a framework of service delivery; health workforce; information; medical products, vaccines and technologies; financing; and leadership and governance. By achieving UHC, countries progress in other health-related goals and provide for healthier children, a stronger workforce and long-term economic development. As announced by Prime Minister Sheikh Hasina in 2011, Bangladesh has remained committed towards UHC through the implementation of programs that increase availability and financial accessibility of essential health services. To produce information regarding their contribution to UHC and specifically the work of its health facilities, Bangladesh produced the 2017 Bangladesh health facilities survey (BHFS). Based on a qualitative analysis, the 2017 BHFS provides substantial information regarding the presence of essential services within different facilities and locations. However, the survey inadequately addresses other components that contribute to availability and accessibility of services, including utilization, patient load, quality of care and financial burden. Subsequently, the 2017 BHFS does not provide a comprehensive evaluation of their health facilities and their contribution to UHC. Arguably, a future survey must address these topics and incorporate a multidisciplinary approach to successfully implement UHC. This approach would incorporate multidisciplinary stakeholders including economists, public health figures and politicians to address challenges such as financial burden, public distrust, and qualified training of providers

The Impacts of Biotechnology on Biodiversity in Global Health: A Case Study on Avian Influenza in Bangladesh

Biodiversity is the variability of between genetics, species, or ecosystems of living organisms within a specific region. Biodiversity is essential for sustaining healthy living networks and systems because it allows for a variety of food sources, medicine, and biological control, while also playing a significant role in atmospheric regulation, nutrient cycling, and pollination. Loss of biodiversity and ecosystem change increases the risk of the emergence or spreading of infectious diseases and global pandemics such as the Avian Influenza (AI H5N1). Biotechnology is one solution for reducing, and ultimately eliminating, the transmission of avian influenza. Traditional methods of treating infected animals, such as common vaccines, are temporary solutions that have no effect on the biodiversity of an ecosystem. Methods in animal biotechnology such as artificial insemination, embryo transfer, and in vitro fertilization have led to developments of cheaper, safer, and more effective vaccines. Livestock that have been treated for H5N1, as well as those that are healthy and have never been infected have proven to increase the diversity, leading to the elimination of specific issues. Similar effects are attainable if these animal biotechnology methods were to be used on poultry infected with the avian influenza virus