International Centre for Diarrhoeal Disease Research, Bangladesh

About: International Centre for Diarrhoeal Disease Research, Bangladesh is a facility organization based out in Dhaka, Bangladesh. It is known for research contribution in the topics: Population & Vibrio cholerae. The organization has 3103 authors who have published 5238 publications receiving 226880 citations. The organization is also known as: SEATO Cholera Research Laboratory & Bangladesh International Centre for Diarrhoeal Disease Research.

Strengthening capacity to apply health research evidence in policy making: experience from four countries

Abstract: Increasing the use of evidence in policy making means strengthening capacity on both the supply and demand sides of evidence production. However, little experience of strengthening the capacity of policy makers in low- and middle- income countries has been published to date. We describe the experiences of five projects (in Bangladesh, Gambia, India and Nigeria), where collaborative teams of researchers and policy makers/policy influencers worked to strengthen policy maker capacity to increase the use of evidence in policy. Activities were focused on three (interlinked) levels of capacity building: individual, organizational and, occasionally, institutional. Interventions included increasing access to research/data, promoting frequent interactions between researchers and members of the policy communities, and increasing the receptivity towards research/data in policy making or policy-implementing organizations. Teams were successful in building the capacity of individuals to access, understand and use evidence/data. Strengthening organizational capacity generally involved support to infrastructure (e.g. through information technology resources) and was also deemed to be successful. There was less appetite to address the need to strengthen institutional capacity—although this was acknowledged to be fundamental to promoting sustainable use of evidence, it was also recognized as requiring resources, legitimacy and regulatory support from policy makers. Evaluation across the three spheres of capacity building was made more challenging by the lack of agreed upon evaluation frameworks. In this article, we propose a new framework for assessing the impact of capacity strengthening activities to promote the use of evidence/data in policy making. Our evaluation concluded that strengthening the capacity of individuals and organizations is an important but likely insufficient step in ensuring the use of evidence/data in policy-cycles. Sustainability of evidence-informed policy making requires strengthening institutional capacity, as well as understanding and addressing the political environment, and particularly the incentives facing policy makers that supports the use of evidence in policy cycles.

In-depth assessment of an outbreak of Nipah encephalitis with person-to-person transmission in Bangladesh: implications for prevention and control strategies.

Abstract: Continued Nipah encephalitis outbreaks in Bangladesh highlight the need for preventative and control measures to reduce transmission from bats to humans and human-to-human spread. Qualitative research was conducted at the end of an encephalitis outbreak in Faridpur, Bangladesh in May 2004 and continued through December 2004. Methods included in-depth interviews with caretakers of cases, case survivors, neighbors of cases, and health providers. Results show contrasts between local and biomedical views on causal explanations and appropriate care. Social norms demanded that family members maintain physical contact with sick patients, potentially increasing the risk of human-to-human transmission. Initial treatment strategies by community members involved home remedies, and public health officials encouraged patient hospitalization. Over time, communities linked the outbreak to supernatural powers and sought care with spiritual healers. Differing popular and medical views of illness caused conflict and rejection of biomedical recommendations. Future investigators should consider local perceptions of disease and treatment when developing outbreak strategies.

Newborn care practices among slum dwellers in Dhaka, Bangladesh: a quantitative and qualitative exploratory study

Abstract: Background Urbanization is occurring at a rapid pace, especially in low-income countries. Dhaka, Bangladesh, is estimated to grow to 50 million by 2015, with 21 million living in urban slums. Although health services are available, neonatal mortality is higher in slum areas than in urban non-slum areas. The Manoshi program works to improve maternal, newborn, and child health in urban slums in Bangladesh. This paper describes newborn care practices in urban slums in Dhaka and provides program recommendations.

Impact on mortality of a community-based programme to control acute lower respiratory tract infections.

Abstract: Acute lower respiratory tract infections (ALRIs) are a major cause of death among young children in developing countries. A targeted programme designed to treat children with ALRI was implemented in 1988 in a primary health care project in rural Bangladesh. In the 2 years preceding the introduction of the programme (1986-87), non-ALRI-specific health services were provided, including promotion of oral rehydration therapy, family planning, immunization of children and mothers, distribution of vitamin A, referral of severely sick children to field clinics, and nutritional rehabilitation of malnourished children. The targeted ALRI programme, which was in place in 1988-89, was based on systematic ALRI case detection and management by community health workers, who were linked to a referral system for medical support. These two levels of intervention have been evaluated by comparing the ALRI-specific mortality in the programme area and a neighbouring control area during the two periods. During the first phase (1986-87), the ALRI mortality among under-5-year-olds was 28% lower in the intervention than in the comparison area (P less than 0.01). During the second phase (1988-89), the ALRI mortality was 32% lower in the intervention area than during the preceding phase, while there was no significant difference for the comparison area. These findings suggest that in the study region the combination of specific and nonspecific interventions can reduce ALRI mortality by as much as 50% and the overall mortality among under-5-year-olds by as much as 30%.

Retention of female volunteer community health workers in Dhaka urban slums: a case-control study

Abstract: Introduction Volunteer community health workers (CHWs) are one approach to addressing the health workforce shortage in developing countries BRAC, a large NGO in Bangladesh, is a pioneer in using female volunteer CHWs as core workers in its successful health programmes After 25 years of implementing the CHW model in rural areas, BRAC is now using CHWs in urban slums of Dhaka through Manoshi, a community-based maternal and child health project However, high dropout rates among CHWs in the slums suggested a need to better understand factors associated with their retention, and consequently recommend strategies for increasing their retention Methods This mixed-method study included a case-control design to assess factors relating to the retention of volunteer CHWs, and focus group discussions (FGDs) to explore solutions to problems In total, 542 current and 146 dropout CHWs participated in the survey Six FGDs were held with groups of current and groups of dropout CHWs Results Financial incentives were the main factor linked to CHW retention CHWs who joined with the expectation of income were almost twice as likely to remain as CHWs This finding was reinforced by the inverse association between wealth quintile of the CHWs and retention; the poorest CHWs were significantly more likely to stay in the programme than the richest However, social prestige, community approval and household responsibilities were important non-financial factors associated with CHW retention Restructuring and expansion of existing financial incentives to better compensate CHWs were recommended by CHWs to improve their retention Conclusions Factors found to be important in this study are similar to those from earlier studies in rural areas While the data indicate that financial incentives are the most commonly discussed factor regarding CHW retention in urban slums, the results also suggest other avenues that could be strengthened to improve their retention