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Publications

Filtering by Tag: Abbas Bhuiya

The Bangladesh paradox: exceptional health achievement despite economic poverty

Future Health Systems

Bangladesh, the eighth most populous country in the world with about 153 million people, has recently been applauded as an exceptional health performer. In the first paper in this Series, we present evidence to show that Bangladesh has achieved substantial health advances, but the country's success cannot be captured simplistically because health in Bangladesh has the paradox of steep and sustained reductions in birth rate and mortality alongside continued burdens of morbidity. Exceptional performance might be attributed to a pluralistic health system that has many stakeholders pursuing women-centred, gender-equity-oriented, highly focused health programmes in family planning, immunisation, oral rehydration therapy, maternal and child health, tuberculosis, vitamin A supplementation, and other activities, through the work of widely deployed community health workers reaching all households.
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Exploring the Ethics of Long-Term Research Engagement With Communities in Low- and Middle-Income Countries

Future Health Systems

Over the past few decades, there has been increasing attention focused on the ethics of health research, particularly in low- and middle-income countries. Despite the increasing focus on the literature addressing human protection, community engagement, appropriate consent procedures and ways to mitigate concerns around exploitation, there has been little discussion about how the duration of the research engagement may affect the ethical design and implementation of studies. In other words, what are the unique ethical challenges when researchers engage with host communities for longer periods (10 years or more), and what special considerations does this time commitment generate when applying ethical principles to these kinds of studies? This article begins to outline key areas of ethical concern that arise during long-term, sustained research activities with communities in low-resource settings. Through a review of the literature and consultations with experts in health systems, we identified the following key themes: fair benefits and long-term beneficence; community autonomy, consultation and consent; impacts on local health systems; economic impacts of research participation; ethical review processes; and institutional processes and oversight within research organizations. We hope that this preliminary exploration will stimulate further dialogue and help inform ethical guidance around long-term research engagements in the developing world.
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Doctoring the Village Doctors: Giving Attention Where it is Due

Future Health Systems

Previous work from ICDDR,B established village doctors as an important player Bangladesh’s healthcare system, as they are often the first port of call for the rural poor. Considering this importance and the huge shortfall of formally trained health workforce in the country, there is a clear need to improve the quality of the services offered by these semi-trained village doctors. In response, a team of ICDDR,B researchers tested a package of interventions, which included training of the village doctors, establishing a community watch for improved accountability and establishing branded franchise of better trained village doctors.
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Making health markets work better for poor people: the case of informal providers

Future Health Systems

There has been a dramatic spread of market relationships in many low- and middle-income countries. This spread has been much faster than the development of the institutional arrangements to influence the performance of health service providers. This paper applies lessons from this experience to the issue of informal providers, drawing on the findings of studies in Bangladesh and Nigeria.
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WP2 - Rapid methods for monitoring the utilization of healthcare facilities by the poor: Findings from a pilot project in rural Bangladesh

Future Health Systems

There has been growing concern about the inequities in the utilization of health care services by the socially disadvantaged in any setting. Health programme personnel always aim to increase the level of utilization of the services they provide to people from all segments of society.the present exercise applied benefit incidence, LQAS and sequential sampling methods in monitoring the utilization of health services by the poorest section of the population in two upazilas in Bangladesh. The practical challenges in adopting the methods and the consistency in the conclusions made by using the three methods have been examined and their possible use has been discussed.
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FHS Bangladesh Research Brief 1 - Health Seeking Behaviour in Chakaria

Future Health Systems

This research brief focuses on the health-seeking behaviour of the people in Chakaria, a rural area in Bangladesh. Information was collected from 1,000 households during February 2007 on the type of illnesses the villagers suffered from during the two weeks preceding the survey and their associated health seeking behavior
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Health for the rural masses: Insights from Chakaria

Future Health Systems

Health for the rural masses: Insights from Chakaria provides an overview of the situation of health system as it exists in rural Chakaria, Bangladesh. The findings highlight the construct of the existing health systems, people’s health seeking behaviours, the role of formal and informal healthcare providers, the size of health market, and costs of healthcare.
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Potential of Performance Based Payment

Future Health Systems

In Bangladesh the rates of maternal mortality have not reduced appreciably over the past decade. Although many of these deaths could be prevented by providing safe motherhood services through skilled birth attendants, equitable access to these services for the poor remains a problem. This article illustrates how a performance based payment scheme can decrease this inequity and provide lessons for future programs.
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Exploring evidence-policy linkages in health research plans: A case study from six countries

Future Health Systems

Three key activities were undertaken by FHS during the initial phase of this five-year project. First, key considerations in strengthening evidence-policy linkages in health system research were developed by FHS researchers through workshops and electronic communications. Four key considerations in strengthening evidence-policy linkages are postulated: development context; research characteristics; decision-making processes; and stakeholder engagement. Second, these four considerations were applied to research proposals in each of the six countries to highlight features in the research plans that potentially strengthen the research-policy interface and opportunities for improvement. Finally, the utility of the approach for setting research priorities in health policy and systems research was reflected upon.
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Performance of the lot quality assurance sampling method compared to surveillance for identifying inadequately-performing areas in Matlab, Bangladesh

Future Health Systems

This paper compared the performance of the lot quality assurance sampling (LQAS) method in identifying inadequately-performing health work-areas with that of using health and demographic surveillance system (HDSS) data and examined the feasibility of applying the method by field-level programme supervisors.
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Health markets and future health systems: innovation for equity

Future Health Systems

If health services are to benefit the poor, it is essential to gain a detailed understanding of such markets that can both inform attitudes towards them and guide innovations that attempt to engage with them to improve health outcomes.
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Chakaria Health and Demographic Surveillance System

Future Health Systems

This report contains findings from a population census carried out in 8 of the 19 unions of Chakaria, a remote rural upazila in the south-eastern coastal area of Bangladesh. ICDDR,B has been engaged in health activities in 6 of these 8 unions since 1994 through a community-initiated primary healthcare project. Two of the unions where ICDDR,B has no activities were designated as comparison areas to assess the impact of ICDDR,B activities on health and health-related behaviours.
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