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Based in Dhaka, Bangladesh, icddd,b is a distinguished research, training and service institution and is the only international health research centre based in a developing country. Its reputation has largely been established in biomedical and population research, and has recently broadened its mandate to examine health systems and poverty issues. It has recently established a Health and Poverty Programme, which it intends to strengthen through participation in FHS.

ICDDR,B has worked extensively with JHSPH in numerous research endeavours over the past 40 years in child health and demographic surveillance.

Who we work with at icddr,b

Recent FHS publications involving icddr,b


Hanifi, S.M.A., Hossain, A., Chowdhury, A.H. et al. (2020) Do community scorecards improve utilisation of health services in community clinics: experience from a rural area of Bangladesh, Int J Equity Health 19, 149,

The government of Bangladesh initiated community clinics (CC) to extend the reach of public health services and these facilities were planned to be run through community participation. However, utilisation of CC services is still very low. Evidence indicates community score card is an effective tool to increase utilisation of services from health facility through regular interface meeting between service providers and beneficiary. We investigated whether community scorecards (CSC) improve utilisation of health services provided by CCs in rural area of Bangladesh.

Mahmood, S.S., Rasheed, S., Chowdhury, A.H. et al. (2020) Feasibility, acceptability and initial outcome of implementing community scorecard to monitor community level public health facilities: experience from rural Bangladesh, Int J Equity Health 19, 155,

Engaging communities in health facility management and monitoring is an effective strategy to increase health system responsiveness. Many developing countries have used community scorecard (CSC) to encourage community participation in health. However, the use of CSC in health in Bangladesh has been limited. In 2017, icddr,b initiated a CSC process to improve health service delivery at the community clinics (CC) providing primary healthcare in rural Bangladesh. The current study presents learnings around feasibility, acceptability, initial outcome and challenges of implementing CSC at community clinics.

Community clinics (CCs) were established by the Government of Bangladesh with an aim to extend primary health services to the grassroots population in rural areas. Currently there are 13,500 CCs throughout the country and each covers 6,000 population under its jurisdiction and are meant to provide maternal, child health, family planning and other primary health care services. However, challenges still remain in ensuring accountability, quality and equity in healthcare service at the local level. Voice and accountability mechanism are almost non-existent. There are gaps in logistics, quality assurance procedures and the facilities suffer from high staff absenteeism, unskilled staff and inefficient use of supplies. Stakeholders are not fully aware of clinics' purposes and there is weak communication and lack of involvement of local government institutions.

Community clinics, a flagship programme of the Government of Bangladesh, are health facilities set up to deliver primary health care, family planning and nutrition services to rural people at the grassroots level. Currently there are 13,500 community clinics (CC) in Bangladesh, aimed to cover every 6000 rural population. Despite the widespread establishment of the community clinics, challenges such as shortage of supply, provider absenteeism, lack of properly defined roles and responsibilities of human resources, poor behaviour towards patients, weak accountability and governance, and absence of active participation from community in healthcare delivery restrict efficient use of these facilities and available resources.

To complement the monitoring mechanism of community clinics, the Future Health Systems (FHS) Bangladesh team at icddr,b aimed to implement a community scorecard (CSC) to ensure community participation and provider accountability in the local health system. This FHS Research Brief presents the learnings from the three cycles of community scorecard implementation in the intervention community clinics.

Hanifi SM, Ravn H, Aaby P and Bhuiya A (2018) Where girls are less likely to be fully vaccinated than boys: Evidence from a rural area in Bangladesh, Vaccine, 36(23):3323-30, DOI: 10.1016/j.vaccine.2018.04.059

Immunization is one of the most successful and effective health intervention to reduce vaccine preventable diseases for children. Recently, Bangladesh has made huge progress in immunization coverage. In this study, we compared the recent immunization coverage between boys and girls in a rural area of Bangladesh.

Huda TM, Rahman MM, Raihana S, Islam S, Tahsina T, Alam A, Agho K, Rasheed S, Hayes A, Karim MA and Rahman QS (2018) A community-based cluster randomised controlled trial in rural Bangladesh to evaluate the impact of the use of iron-folic acid supplements early in pregnancy on the risk of neonatal mortality: the Shonjibon trial, BMC Public Health, 18(1):816, DOI: 10.1186/s12889-018-5713-1

Iron-deficiency is the most common nutritional deficiency globally. Due to the high iron requirements for pregnancy, it is highly prevalent and severe in pregnant women. There is strong evidence that maternal iron deficiency anaemia increases the risk of adverse perinatal outcomes. However, most of the evidence is from observational epidemiological studies except for a very few randomised controlled trials. IFA supplements have also been found to reduce the preterm delivery rate and neonatal mortality attributable to prematurity and birth asphyxia. These results combined indicate that IFA supplements in populations of iron-deficient pregnant women could lead to a decrease in the number of neonatal deaths mediated by reduced rates of preterm delivery. In this paper, we describe the protocol of a community-based cluster randomised controlled trial that aims to evaluate the impact of maternal antenatal IFA supplements on perinatal outcomes.