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Key performance indicator (KPI) has become a fundamental part of evaluation that focuses on either an individual or a system. Setting KPIs and their revisions is a continuous process that is often determined through either an agreeable or a heated discussion. This paper is the first to investigate the achievement of KPIs of different players in education using Bangladesh as a case study. Because of the nature of policy discourse research, secondary data are used from the designated agencies. Increasing enrolment with the assurance of high-quality education was determined as the prime KPI for primary/secondary provisions. Quantitative KPIs are achieved, which is unsustainable. Both public and private sectors are players in tertiary education; none of them accomplish the prime KPI setup, which consists of research. The need to supply 'job-ready graduates' is ignored. This study suggests that new policy must be formed to attain a sustainable achievement of KPIs.

Age gap between spouses has important implications for a range of outcomes—from fertility and longevity, to gender relationships, marital quality, and stability. This paper examines the age gap between spouses in 12 countries in South and Southeast Asia. The average age difference (husband's minus wife's age) is positive in all countries and ranges from 2.7 in Myanmar to 8.4 in Bangladesh. Age homogamous marriages accounted for 5% of all marriages in Bangladesh to close to half of all marriages in Thailand. The proportion of age hypogamous marriages was uniformly low in all the countries except for Myanmar where it reaches close to 10%. Men's marriage age has a stronger effect in determining the age gap. In general, the age gap for women with lower education was larger than for those with higher education. However, much of this effect was explained by the difference in marriage timing across educational groups. [ABSTRACT FROM AUTHOR]

The purpose of this paper is to analyse and critically reflect on access to Assistive Technology (AT) for persons with disabilities (PWD) in Nepal, India and Bangladesh. This analysis aims to guide the development of a contextualised generic AT service delivery model suitable for these countries, based on the best practices identified. This paper is based on a comprehensive study conducted in Nepal, India and Bangladesh, observing mobility and hearing-related AT service delivery centres run by the government, as well as private and nongovernmental organisations, and interviews with key informants: policymakers (5), AT service providers (20) and AT service users (20) between December 2019 to February 2020. A descriptive, qualitative exploratory study design was followed. A quality assessment framework was used to structure the analysis and interpret the findings. AT service provisions are poorly developed in all three countries. On all quality indicators assessed, the systems show major weaknesses. AT users have very limited awareness about their rights to these services and the availability of AT services, the range of services available is very limited, and eligibility is dependent on medical criteria related to visible and severe disabilities. Lack of accessibility, eligibility, reachability and affordability are the main barriers to access AT services for PWD in Nepal, India and Bangladesh. Increased community level awareness, increased Government funding and a community based, medically informed flexible social model of AT services is a way forward to ensure access to AT services for PWD in these countries. Increased community awareness is necessary to increase access to Assistive Technology Services for Persons with Disabilities. Increased and flexible funding from the Government and philanthropists will improve rehabilitation. Establishment of community based Assistive Technology Services centres will increase access and improve rehabilitation. [ABSTRACT FROM AUTHOR]

Very simply, research is the systematic investigation to explore new knowledge for scientific achievement. Research comprises "creative and systematic work undertaken to increase the stock of knowledge, including knowledge of humans, culture and society, and the use of this stock of knowledge to devise new applications" (OECD, 2015). Research carried out by scientists and researchers has made an enormous impact on the world over the centuries specially for developing countries like Bangladesh. Research can make a significant contribution to the growth and development of any nation. Research and the library are closely interconnected with one another. Libraries especially academic and special libraries responsible for research support that is treated as central pillar in their mission. A "researcher life cycle" approach was applied to identify researcher information needs. Librarians continue to play a central role in conducting successful research and are expanding beyond their traditional duties for delivering high quality information services to engage themselves more as educators, technological guides, and communicators. Librarians should pace more and more into a leadership role develop major initiatives and conduct training to increase research reproducibility. The present paper focuses on the basic technical issues of efficient research skills and highlights the librarians' competencies for research support of Bangladesh for guiding researchers for conducting successful research and ensuring a better work environment to do research. This paper mainly explores the proper referencing and citations, submission of manuscript in impact journals, find out predatory journals and selection for publishing articles in open access journals. This study also highlights the use and impact of various online databases such as Web of Science (WoS) and Scopus in order to explore citation status, h index and research performance of an individual author, country and institution. The study also investigates the role of the library in addressing present and future challenges to bridge technical issues of conducting research in Bangladesh. An attempt has been made to identify the major problems for submission manuscripts in high impact journals and to indicate some possible solutions for developing research information management systems, and efforts to improve training and support for researchers to enhance the research productivity of researchers in Bangladesh. Finally, the study illustrates a real picture of scientific outputs of renowned organizations in Bangladesh using Scopus database. [ABSTRACT FROM AUTHOR]

This paper critically reviews and reflects on the processes for providing Assistive Technology (AT) services to Persons with Disabilities (PWD) in Bangladesh, India and Nepal. The aim is to investigate the AT service delivery systems in these countries and suggest improvements where weaknesses are identified. We carried out a descriptive qualitative exploratory study in Bangladesh, India and Nepal by conducting key informant interviews with policymakers (5), AT service providers (22) and mobility and hearing related AT service users (21). We used a directed content analysis approach guided by a seven-point AT service delivery process model to thematically analyse the existing processes for AT service delivery, from first contact through to follow-up and maintenance. AT service delivery processes are sub-optimal in all three countries, and improvements are needed. No common AT service delivery process was found, although there are common features. In general, it is easier for PWDs in India and Nepal to access AT than for those in Bangladesh, but all three countries are failing to live up to their commitments to uphold the human rights of PWDs. Although good elements of AT service delivery processes can be identified, the systems in all three countries are fragmented and generally weak. A more holistic approach of looking at the process of AT service delivery, from first contact right through to follow-up and device maintenance, with a single door service delivery system, free of cost at the point of service is recommended in these countries. Although we found significant weaknesses in AT delivery in all three countries, there are some good AT service delivery practices and opportunities for these countries to learn from one another. A systematic and stepwise approach to assessing current AT service delivery processes in the three countries – examining the delivery system as a whole, from initiation to repair and management – can help identify opportunities to improve the process for (prospective) AT users. A more coherent single door system of AT service delivery will increase the quality and efficiency of the fragmented AT service delivery practices in Bangladesh, India and Nepal. [ABSTRACT FROM AUTHOR]

Objective To describe a systematic process of transforming paper registers into a digital system optimized to enhance service provision and fulfil reporting requirements. Methods We designed a formative study around primary health workers providing reproductive, maternal, newborn and child health services in three countries in Bangladesh, Indonesia and Pakistan. The study ran from November 2014 to June 2018. We developed a prototype digital application after conducting a needs assessment of health workers' responsibilities, workflows, routine data requirements and service delivery needs. Methods included desk reviews, focus group discussions, in-depth interviews; data mapping of paper registers; observations of health workers; co-design workshops with health workers; and usability testing. Finally, we conducted an observational feasibility assessment to monitor uptake of the application. Findings Researchers reviewed a total of 17 paper registers across the sites, which we transformed into seven modules within a digital application running on mobile devices. Modules corresponded to the services provided, including household enumeration, antenatal care, family planning, immunization, nutrition and child health. A total of 65 health workers used the modules during the feasibility assessment, and average weekly form submissions ranged from 8 to 234, depending on the health worker and their responsibilities. We also observed variability in the use of modules, requiring consistent monitoring support for health workers. Conclusion Lessons learnt from this study shaped key global initiatives and resulted in a software global good. The deployment of digital systems requires well-designed applications, change management and strengthening human resources to realize and sustain health system gains. [ABSTRACT FROM AUTHOR]

Introduction: Smokeless tobacco (ST) is a significant South Asian public health problem. This paper reports a qualitative study of a sample of South Asian ST users.Methods: Interviews, using a piloted topic guide, with 33 consenting, urban dwelling adult ST users explored their ST initiation, continued use, and cessation attempts. Framework data analysis was used to analyze country specific data before a thematic cross-country synthesis was completed.Results: Participants reported long-term ST use and high dependency. All reported strong cessation motivation and multiple failed attempts because of ease of purchasing ST, tobacco dependency, and lack of institutional support.Conclusions: Interventions to support cessation attempts among consumers of South Asian ST products should address the multiple challenges of developing an integrated ST policy, including cessation services.Implications: This study provides detailed understanding of the barriers and drivers to ST initiation, use, and cessation for users in Bangladesh, India, and Pakistan. It is the first study to directly compare these three countries. The insight was then used to adapt an existing behavioral support intervention for ST cessation for testing in these countries. [ABSTRACT FROM AUTHOR]

Objective: Chronic aflatoxin exposure has been associated with childhood stunting (length-for-age/height-for-age < -2 sd), while data lacks for Bangladesh, a country with substantial burden of childhood stunting. This paper examined the association between aflatoxin exposure and childhood stunting in a slum setting of Dhaka city.Design: In this MAL-ED aflatoxin birth cohort study, plasma samples were assayed for aflatoxin B1-lysine adduct (AFB1-lys) by MS at 7, 15, 24 and 36 months of age for 208, 196, 173 and 167 children to assess chronic aflatoxin exposure. Relationship between aflatoxin exposure and anthropometric measures was examined by mixed-effects logistic regression models.Setting and Participants: The study was conducted in Mirpur, Dhaka, where children were followed from birth to 36 months.Results: Prevalence of stunting increased from 21 % at 7 months to 49 % at 36 months of age. Mean AFB1-lys concentrations at 7, 15, 24 and 36 months were 1·30 (range 0·09-5·79), 1·52 (range 0·06-6·35), 3·43 (range 0·15-65·60) and 3·70 (range 0·09-126·54) pg/mg albumin, respectively, and the percentage of children with detectable AFB1-lys was 10, 21, 18 and 62 %, respectively. No association was observed between aflatoxin exposure and stunting in multivariable analyses. Factors associated with childhood stunting were age, low birth weight, maternal height, stool myeloperoxidase and number of people sleeping in one room.Conclusions: A relatively lower exposure to aflatoxin may not influence the linear growth of children. This finding indicates a threshold level of exposure for linear growth deficit and further investigation in other areas where higher concentrations of aflatoxin exposure exist. [ABSTRACT FROM AUTHOR]

Global health research partnerships are increasingly taking the form of consortia. Recent scholarship has proposed what features of governance may be necessary for these consortia to advance justice in global health. That guidance purports three elements of global health research consortia are essential — their research priorities, research capacity development strategies, research translation strategies — and should be structured to promote the health of the worst-off globally. This paper adopted a reflective equilibrium approach, testing the proposed ethical guidance against the experience of a global health research consortium with equity objectives. Case study research was performed with Future Health Systems (FHS), a health systems research consortium funded over two phases. Data on FHS Phase-2 were gathered through in-depth interviews with steering committee members and junior researchers and collection of consortium-related documents. Thematic analysis of the data for consistency with the proposed guidance generated recommendations for how the guidance might be better articulated and identified areas where it could usefully be expanded. Factors facilitating FHS alignment with the ethical guidance were also identified, including early engagement and partnership with low and middle-income country stakeholders, the learning developed during FHS Phase-1, and aspects of the grant program funding it. [ABSTRACT FROM AUTHOR]

Armed conflict affects the biological diversity and biological research regime of a country. This paper takes a low-intensity armed conflict in the biologically and ethnically diverse Chittagong Hill Tracts (CHT) of Bangladesh, as an example, and assesses the response of biologists to this conflict. The study spans the last 50 years dividing it into three periods: pre-conflict (1961−1974), conflict (1975–1997) and post-conflict (1998–2011). Interactions with selected researchers and a literature survey showed that sporadic, intermittent biological research was conducted in this region even during the conflict. The number of research initiatives substantially increased and became more diverse over the last decade. Research opportunity has increased mainly because of improved security and accessibility. Nevertheless, despite the research capacity and a positive attitude among the researchers, some fundamental issues still limit long-term research in this area. The continuing volatile situation due to slow implementation of the 1997 Peace Accord and the tension between rebel factions and indigenous and settler communities in some areas continue to be serious concerns for studying and conserving the biodiversity of this region. Innovative research approaches and the full implementation of the peace agreement are vital to improving the situation for biological research in the CHT. The paper underlines the importance of a biologist’s self-motivation to respond to low-intensity armed conflicts. [ABSTRACT FROM PUBLISHER]

Aim: To determine the proportion of children with cerebral palsy (CP) who had major congenital anomalies, describe the types of disorders, and report on the children's functional outcomes.Method: Data were extracted from the Bangladesh Cerebral Palsy Register (BCPR). Descriptive analyses were conducted on children with CP and major congenital anomalies. Odds ratios (ORs) with 95% confidence intervals (CIs) were calculated to measure the association between major congenital anomalies, clinical severity, and presence of comorbidities.Results: Between January 2015 and December 2016, 726 children with CP were newly registered with the BCPR (277 females, 449 males; mean age [SD] at registration 90mo [54mo], 4mo-18y). Seventy-eight children (11%) had a major congenital anomaly. Neurological (86%) and musculoskeletal congenital anomalies (10%) were the most common. Microcephaly was the most common congenital anomaly (83%). The odds of severe functional motor limitations (OR=2.4, 95% CI=1.9-2.9), epilepsy (OR=1.6, 95% CI=1.1-2.1), visual impairment (OR=2.6, 95% CI=2.0-3.2), presence of strabismus (OR=3.9, 95% CI=3.8-4.4), hearing (OR=1.2, 95% CI=0.6-1.9), speech (OR=5.4, 95% CI=4.6-6.2), and intellectual impairments (OR=2.3, 95% CI=1.8-2.8) were higher in children with congenital anomalies compared to children without.Interpretation: The proportion of children with major congenital anomalies in the BCPR (11%) was lower than that identified in higher-income countries. This may be because of differences in how congenital anomalies are diagnosed as well as the impact of survival bias. In Bangladesh, children with CP and major congenital anomalies are more likely to have severe functional motor limitations and associated comorbidities.What This Paper Adds: Eleven per cent of children with cerebral palsy (CP) in Bangladesh had major congenital anomalies. Neurological and musculoskeletal congenital anomalies were the most common. Severe functional motor limitations and associated comorbidities were more common in children presenting with CP and major congenital anomalies. [ABSTRACT FROM AUTHOR]

Background: Globally, an estimated two-thirds of all deaths occur in the community, the majority of which are not attended by a physician and remain unregistered. Identifying and registering these deaths in civil registration and vital statistics (CRVS) systems, and ascertaining the cause of death, is thus a critical challenge to ensure that policy benefits from reliable evidence on mortality levels and patterns in populations. In contrast to traditional processes for registration, death notification can be faster and more efficient at informing responsible government agencies about the event and at triggering a verbal autopsy for ascertaining cause of death. Thus, innovative approaches to death notification, tailored to suit the setting, can improve the availability and quality of information on community deaths in CRVS systems.Improving the Notification Of Community Deaths: Here, we present case studies in four countries (Bangladesh, Colombia, Myanmar and Papua New Guinea) that were part of the initial phases of the Bloomberg Data for Health Initiative at the University of Melbourne, each of which faces unique challenges to community death registration. The approaches taken promote improved notification of community deaths through a combination of interventions, including integration with the health sector, using various notifying agents and methods, and the application of information and communication technologies. One key factor for success has been the smoothing of processes linking notification, registration and initiation of a verbal autopsy interview. The processes implemented champion more active notification systems in relation to the passive systems commonly in place in these countries.Conclusions: The case studies demonstrate the significant potential for improving death reporting through the implementation of notification practices tailored to a country's specific circumstances, including geography, cultural factors, structure of the existing CRVS system, and available human, information and communication technology resources. Strategic deployment of some, or all, of these innovations can result in rapid improvements to death notification systems and should be trialled in other settings. [ABSTRACT FROM AUTHOR]

Aim: This paper aimed to analyse the association between small for size at birth, stunting, recovery from stunting and pubertal development in a rural Bangladeshi cohort.Methods: The participants were 994 girls and 987 boys whose mothers participated in the Maternal and Infant Nutrition Interventions in Matlab trial. The birth cohort was followed from birth to puberty 2001-2017. Pubertal development according to Tanner was self-assessed. Age at menarche was determined and in boys, consecutive height measurements were used to ascertain whether pubertal growth spurt had started. The exposures and outcomes were modelled by Cox's proportional hazards analyses and logistic regression.Results: There was no difference in age at menarche between girls that were small or appropriate for gestational age at birth. Boys born small for gestational age entered their pubertal growth spurt later than those with appropriate weight. Children who were stunted had later pubertal development, age at menarche and onset of growth spurt than non-stunted children. Children who recovered from infant or early childhood stunting had similar pubertal development as non-stunted children.Conclusion: Infant and childhood stunting was associated with a later pubertal development. Recovery from stunting was not associated with earlier puberty in comparison with non-stunted children. [ABSTRACT FROM AUTHOR]

Aim: To determine the mortality rate, immediate cause of death (CoD), and predictors of death in children with cerebral palsy (CP) in rural Bangladesh.Method: We carried out a prospective population-based surveillance study of children with CP aged 0 to 18 years registered with the Bangladesh Cerebral Palsy Register (BCPR) between January 2015 and December 2016, with subsequent follow-up until December 2017. Verbal autopsy was applied to assign immediate CoD. Crude mortality rates, hazard ratios of death, and survival probabilities were estimated.Results: Twenty-nine of the 678 children in the BCPR died during the study period, resulting in a crude mortality rate of 19.5 per 1000 person-years of observation (total follow-up duration 1486.8 person-years; mean 2y [standard deviation 6mo]). The leading immediate CoD was meningitis (n=9) and pneumonia (n=8). Survival probability and hazard ratio of death was significantly associated with age, Gross Motor Functional Classification System level, and associated impairments. Severe underweight and/or severe stunting was significantly overrepresented among deceased children than others in the cohort (p<0.05) when compared with the World Health Organization reference population.Interpretation: The majority of deaths were due to potentially preventable causes. The life expectancy of these children could have been extended by ensuring primary healthcare and nutritional supplementation.What This Paper Adds: Mortality rate in children with cerebral palsy (CP) in rural Bangladesh is 19.5 per 1000 person-years. The majority of children with CP died from potentially preventable and treatable conditions. Motor severity, associated impairments, and malnutrition make children with CP vulnerable to premature death in rural Bangladesh. [ABSTRACT FROM AUTHOR]

The paper offers a first-person experiential observational study by a newcomer to the use of research initiatives to combat poverty in two geographic regions and Dhaka, the capital city of Bangladesh. Drawing on participatory action research and the tradition of ‘the animateur’ (catalyst-facilitation), the work of the sponsoring local agency, Research Initiatives Bangladesh (RIB) is described as illuminating a range of quite powerful applications. The paper is part of a larger project to bring to a western audience knowledge of the use of these methodologies in the Indo-Asian region, and some comparative reflections on them. [ABSTRACT FROM AUTHOR]

The paper reports a study into children's literacy in Bangladesh. It presents reading and writing profiles of a stratified random sample of ten year-old children. The paper argues that while these profiles might be a valuable source of information for the Government of Bangladesh as well as for the international donor community, especially in that they provide diagnostic information of children's literacy development, they do not portray fully the potential of children as meaning-makers. A small number of children from those who performed poorly in assessments of reading and writing were subjected to a further study in which they participated in a 'designing and making' activity. Here, the multiple modes through which children communicated meaning and understanding became the focus of the assessment. This means that we did not look solely at the linguistic mode but focused also on 'mediated action' as a mode through which meaning is made. Thus the potential of children to represent meaning and to create and shape 'new' texts through collaborative engagement with each other, as well as with the material and linguistic resources being used in the activity, became the prime focus of assessment. The paper shows that children who performed poorly on tests of reading and writing were potentially creative meaning-makers when other modes of representation like action and speech were considered. The paper concludes that large-scale studies of children's literacy are necessary and will continue to provide important sources of information for governments attempting to alleviate poverty and create equitable access to education and other social services. On the other hand, data obtained in this fashion mask the potential of children as creative meaning-makers. The study reported here shows that teacher-based assessment, expanded to recognize modes of meaning-making other than language, can be a vital, additional source of information for those interested in children as... [ABSTRACT FROM AUTHOR]

Realist evaluation furnishes valuable insight to public health practitioners and policy makers about how and why interventions work or don't work. Moving beyond binary measures of success or failure, it provides a systematic approach to understanding what goes on in the 'Black Box' and how implementation decisions in real life contexts can affect intervention effectiveness. This paper reflects on an experience in applying the tenets of realist evaluation to identify optimal implementation strategies for scale-up of Maternal and Newborn Health (MNH) programmes in rural Bangladesh. Supported by UNICEF, the three MNH programmes under consideration employed different implementation models to deliver similar services and meet similar MNH goals. Programme targets included adoption of recommended antenatal, post-natal and essential newborn care practices; health systems strengthening through improved referral, accountability and administrative systems, and increased community knowledge. Drawing on focused examples from this research, seven steps for operationalizing the realist evaluation approach are offered, while emphasizing the need to iterate and innovate in terms of methods and analysis strategies. The paper concludes by reflecting on lessons learned in applying realist evaluation, and the unique insights it yields regarding implementation strategies for successful MNH programming. [ABSTRACT FROM AUTHOR]

Background: The 'Sponsoring National Processes for Evidence-Informed Policy Making in the Health Sector of Developing Countries' program was launched by the Alliance for Health Policy and Systems Research, WHO, in July 2008. The program aimed to catalyse the use of evidence generated through health policy and systems research in policymaking processes through (1) promoting researchers and policy advocates to present their evidence in a manner that is easy for policymakers to understand and use, (2) creating mechanisms to spur the demand for and application of research evidence in policymaking, and (3) increased interaction between researchers, policy advocates, and policymakers. Grants ran for three years and five projects were supported in Argentina, Bangladesh, Cameroon, Nigeria and Zambia. This paper seeks to understand why projects in some settings were perceived by the key stakeholders involved to have made progress towards their goals, whereas others were perceived to have not done so well. Additionally, by comparing experiences across five countries, we seek to illustrate general learnings to inform future evidence-to-policy efforts in low- and middle-income countries.Methods: We adopted the theory of knowledge translation developed by Jacobson et al. (J Health Serv Res Policy 8(2):94-9, 2003) as a framing device to reflect on project experiences across the five cases. Using data from the projects' external evaluation reports, which included information from semi-structured interviews and quantitative evaluation surveys of those involved in projects, and supplemented by information from the projects' individual technical reports, we applied the theoretical framework with a partially grounded approach to analyse each of the cases and make comparisons.Results and Conclusion: There was wide variation across projects in the type of activities carried out as well as their intensity. Based on our findings, we can conclude that projects perceived as having made progress towards their goals were characterized by the coming together of a number of domains identified by the theory. The domains of Jacobson's theoretical framework, initially developed for high-income settings, are of relevance to the low- and middle-income country context, but may need modification to be fully applicable to these settings. Specifically, the relative fragility of institutions and the concomitantly more significant role of individual leaders point to the need to look at leadership as an additional domain influencing the evidence-to-policy process. [ABSTRACT FROM AUTHOR]

Background: In low-income settings, community health workers (CHWs) are frequently the first point of contact for newborns. Mobile technology may aid health workers in classifying illness and providing referral and management guidance for newborn care. This study evaluates the potential for mobile health technology to improve diagnosis and case management of newborns in Bangladesh.Methods: A mobile application based on Bangladesh's Comprehensive Newborn Care Package national guidelines (mCNCP) was developed to aid CHWs in identifying and managing small and sick infants. After a 2-day training, CHWs assessed newborns at Sylhet Osmani Medical College Hospital and in the Projahnmo research site (Sylhet, Bangladesh) using either mCNCP or a comparable paper form (pCNCP), similar to standard IMCI-formatted paper forms. CHWs were randomized to conduct a block of ~ 6 newborn assessments starting with either mCNCP or pCNCP, then switched to the alternate method. Physicians using mCNCP served as gold standard assessors. CHW performance with mCNCP and pCNCP were compared using chi-squared tests of independence for equality of proportions, and logistic regressions clustered by CHW.Results: Two hundred seven total CHW assessments were completed on 101 enrolled infants. mCNCP assessments were more often fully completed and completed faster than pCNCP assessments (100% vs 23.8%, p < 0.001; 17.5 vs 23.6 min; p < 0.001). mCNCP facilitated calculations of respiratory rate, temperature, and gestational age. CHWs using mCNCP were more likely to identify small newborns (Odds Ratio (OR): 20.8, Confidence Interval (CI): (7.1, 60.8), p < 0.001), and to correctly classify 7 out of 16 newborn conditions evaluated, including severe weight loss (OR: 13.1, CI: (4.6, 37.5), p < 0.001), poor movement (OR: 6.6, CI: (2.3, 19.3), p = 0.001), hypothermia (OR: 14.9, CI: (2.7, 82.2), p = 0.002), and feeding intolerance (OR: 2.1, CI: (1.3, 3.3), p = 0.003). CHWs with mCNCP were more likely to provide counseling as needed on 4 out of 7 case management recommendations evaluated, including kangaroo mother care.Conclusions: CHWs in rural Bangladesh with limited experience using tablets successfully used a mobile application for neonatal assessment after a two-day training. mCNCP may aid frontline health workers in Bangladesh to improve completion of neonatal assessment, classification of illnesses, and adherence to neonatal management guidelines. [ABSTRACT FROM AUTHOR]

Purpose The purpose of this paper is to investigate the association between social capital (SC) and health care access problem among the older people in Bangladesh.Design/methodology/approach This study applied a random sampling method to select 310 older adults (all aged 60 years) in Bangladesh. Exploratory factor analysis was employed to extract SC dimensions. Logistic regression was applied to measure the association of SC dimensions and access.Findings The logistic regression result shows that with a one-unit increase in social network, norms of reciprocity, and civic participation, health care access problem will be decreased by OR= 0.732 (95% CI =0.529–1.014); OR=0.641 (95% CI = 0.447–0.919); and OR=0.748 (95% CI = 0.556–1.006) units. Respondents who have economic hardship were 3.211 (OR=3.211, CI = 0.84–5.59) times more likely to say that they had health care access problem compared with who had no economic hardship.Research limitations/implications The study showed that the lower level of SC and presence of economic hardship increased the probability to health care access problem among the older people. Improving SC may be helpful in reducing health care access problem. However, economic hardship reductions are also important to reduce the health care access problem. Improving SC and reducing economic hardship thus should be implemented at the same time.Practical implications The study showed that low SC and economic hardship increased the probability to health care access problem. Improving SC may be helpful in reducing health inequity. However, economic hardship reductions also important to health care access. Therefore, improving SC and reducing economic hardship should be implemented at the same time.Originality/value This study has a great policy importance in regard to reducing health care access problem among the older adult in Bangladesh as SC has a potential to bring about a concomitant improvement in the condition of the health care access. [ABSTRACT FROM AUTHOR]

Background: In striving to contribute towards improved health outcomes, health research institutions generate and accumulate huge volumes of relevant but often underutilized data. This study explores activities undertaken by researchers from the International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), an international research institution that promotes the utilization of their findings in the policymaking processes in Bangladesh. Methods: The study used an exploratory case study design and employed qualitative methods to explore activities implemented to promote research utilization and the extent to which researchers felt that their findings contributed to the policymaking process. Data were collected between September and December 2011 through key informant interviews, focus group discussions with study investigators, and database and document reviews. We reviewed findings from 19 reproductive health studies conducted and completed by icddr,b researchers between 2001 and 2011. We interviewed 21 key informants, including 13 researchers, two policy makers, and six programme implementers. Data were entered into Microsoft Word and analyzed manually following a thematic framework approach. Following the World Health Organization/Turning Research into Practice (WHO/TRIP) framework, three case studies of how research findings were utilized in the policymaking processes in Bangladesh were documented. Results: Activities implemented to promote research utilization included conducting dissemination workshops, publishing scientific papers, developing policy briefs, providing technical assistance to policymakers and programme implementers, holding one-on-one meetings, and joining advocacy networks. The majority of the researchers (12 of 13) reported that their study findings were utilized to influence policymaking processes at different levels. However, some researchers reported being unaware of whether and how their findings were utilized. As regards actual utilization of research findings, the evidence from the three case studies indicate that research findings can be utilized instrumentally, conceptually and symbolically, and at different stages within the policymaking process, including agenda setting and policy formulation and implementation. Conclusions: The results show that research findings from icddr,b were promoted and utilized in health policymaking processes in Bangladesh using a variety of utilization approaches. These results suggest a need for using multiple approaches to promote utilization of research findings in health policymaking processes. [ABSTRACT FROM AUTHOR]

Background: Short birth intervals are associated with an increased risk of adverse perinatal outcomes. However, reduction of rates of short birth intervals is challenging in low-resource settings where majority of the women deliver at home with limited access to family planning services immediately after delivery. This study examines the feasibility of integrating a post-partum family planning intervention package within a community-based maternal and newborn health intervention package, and evaluates the impact of integration on reduction of rates of short birth intervals and preterm births.Methods: In a quasi-experimental trial design, unions with an average population of about 25 000 and a first level health facility were allocated to an intervention arm (n = 4) to receive integrated post-partum family planning and maternal and newborn health (PPFP-MNH) interventions, or to a control arm (n = 4) to receive the MNH interventions only. Trained community health workers were the primary outreach service providers in both study arms. The primary outcomes of interest were birth spacing and preterm births. We also examined if there were any unintended consequences of integration.Results: At baseline, short birth intervals of less than 24 months and preterm birth rates were similar among women in the intervention and control arms. Integrating PPFP into the MNH intervention package did not negatively influence maternal and neonatal outcomes; during the intervention period, there was no difference in community health workers' home visit coverage or neonatal care practices between the two study arms. Compared to the control arm, women in the intervention arm had a 19% lower risk of short birth interval (adjusted relative risk (RR) = 0.81, 95% confidence interval (CI) = 0.69-0.95) and 21% lower risk of preterm birth (adjusted RR = 0.79; 95% CI = 0.63-0.99).Conclusions: Study findings demonstrate the feasibility and effectiveness of integrating PPFP interventions into a community based MNH intervention package. Thus, MNH programs should consider systematically integrating PPFP as a service component to improve pregnancy spacing and reduce the risk of preterm birth. [ABSTRACT FROM AUTHOR]

Childhood stunting is a significant public health concern in Bangladesh. This study analysed the data from the Healthy Village programme, which aims to address childhood stunting in southern coastal Bangladesh. The aim was to assess childhood stunting prevalence over time and explore the risk factors in the programme areas. A cross-sectional, secondary data analysis was conducted for point-prevalence estimates of stunting from 2018 to 2021, including 132,038 anthropometric measurements of under-five children. Multivariate logistic regression analyses were conducted for risk factor analysis (n = 20,174). Stunting prevalence decreased from 51% in 2018 to 25% in 2021. The risk of stunting increased in hardcore poor (aOR: 1.46, 95% CI: 1.27, 1.68) and poor (aOR: 1.50, 95% CI: 1.33, 1.70) versus rich households, children with mothers who were illiterate (aOR: 1.25, 95% CI: 1.09, 1.44) and could read and write (aOR: 1.35, 95% CI: 1.16, 1.56) versus mothers with higher education, and children aged 1–2 years compared with children under one year (aOR: 1.32, 95% CI: 1.20, 1.45). The stunting rate was halved over three years in programme areas, which is faster than the national trend. We recommend addressing socioeconomic inequalities when tackling stunting and providing targeted interventions to mothers during the early weaning period. [ABSTRACT FROM AUTHOR]

Purpose – The main aim of this paper is to assess Dhaka University students' perceptions of ease-of-use and their satisfaction with University Library's online public access catalogue (DUL OPAC). Design/methodology/approach – A survey questionnaire was developed and used to collect data on students' demographics, online catalogue use and their perceptions of ease-of-use and satisfaction with OPAC. In order to analyze the influence of students' demographic and individual characteristics on their perceptions and satisfaction, Mann-Whitney and Kruskal-Wallis tests were carried out. Findings – The results showed that students are overwhelmingly satisfied with the DUL OPAC. Although there are some differences in students' perceptions of and satisfaction with the university OPAC, a formal task-based usability testing and adopting a user-centered design can ensure the usability of the OPAC in the future. The paper suggested some heuristic guidelines for designing interfaces for online catalogues. Originality/value – This is the first time an effort has been made to assess students' perceptions of and satisfaction with a library OPAC in Bangladesh. The authors feel this study may encourage more such research on usability evaluation of OPACs in Bangladesh and beyond. [ABSTRACT FROM AUTHOR]

Purpose — This paper seeks to analyse the current poverty situation and poverty alleviation efforts of the NGOs in Bangladesh with emphasis on the impacts of two NGO programmes in two villages of Barisal district. Design/methodology/approach — This research has employed both qualitative and quantitative approaches. The research has primarily used first-hand empirical data. In order to substantiate primary data, relevant secondary information has also been used. Data were collected through household survey by applying both open- and closed-ended questionnaires. With a view to analysing data, inferential as well as descriptive statistics have been applied. Findings — The findings revealed that the economic condition of the poor in the study areas has not improved much when judged against some selected indicators, namely, income, food and non-food expenditure, productive and non-productive asset, food security, and employment creation. The Foster Greer Thorbecke index shows that the majority of the NGO beneficiaries remained below the poverty line in terms of income and the overwhelming majority of them remained below the underemployment line (less than 260 days of work in a year). The regression analysis shows that the income of the households is determined by landholding size, family labour, days suffered from morbidities and employment opportunity. The qualitative data on the perception of beneficiaries on the causes of poverty endorse this finding. Originality/value — Controversies over the issue of widespread poverty in Bangladesh have been revolving among the government, NGOs and the donor agencies as well. NGOs have been claiming the entire success of the economic wellbeing made to the rural poor. However, this study has directly challenged their claims by casting an empirical lens on the impact of their interventions. This study has detected the paucities of the NGO interventions and gaps between their objectives and their achievement. [ABSTRACT FROM AUTHOR]

The paper offers an analysis of how to operationalize the development goal of promoting well-being, and provides an exemplar. It focuses on one element of a comprehensive methodology to operationalize empirical research into the social and cultural construction of well-being in developing countries. This research uses a definition of well-being that combines objective and subjective dimensions and locates these in the social and cultural relationships of particular societies. We focus here on the Resources and Needs Questionnaire (RANQ), a research instrument specifically developed for this work. This explores the relationships between the resources that households command and the levels of needs satisfaction which household members experience. Preliminary analysis of data for Bangladesh and Peru identifies a number of significant relationships between the distribution of resources that households command and the levels of needs satisfaction they achieve. These outcome results then represent a foundation for further analysis using complementary qualitative and process-oriented data. JEL Classifications: A12, I32, Z1 [ABSTRACT FROM AUTHOR]

Background: Bangladesh has made significant progress in reducing maternal mortality. Many factors have contributed to this; one is the socio-economic development of the country. The ready-made garment industry is at the forefront of this development creating employment for many women. However, the work environment has the potential to create health problems, particularly for vulnerable groups such as pregnant women. This paper explores perceptions of health problems during pregnancy of factory workers, in this important industry in Bangladesh. Methods: This study was conducted in four factories using qualitative research methods to provide a view of pregnant workers' health risks beyond a bio-medical approach. Data was collected through in-depth interviews of pregnant workers and observations of their homes and workplaces. Further, key informant interviews with factory health care providers, government officials and employers revealed different perspectives and experiences. Data was collected in the local language (Bengali), then transcribed and analysed using a framework analysis approach. Results: Female workers reported that participation in paid work created an opportunity for them to earn money but pregnancy and the nature of the job, including being pressured to meet the production quota, pressure to leave the job because of their pregnancy and withholding of maternity benefits, cause stress, anxiety and may contribute to hypertensive disorders of pregnancy. This was confirmed by factory doctors who suggested that developing hypertensive disorders during pregnancy was influenced by the nature of work and stress. The employers seemed focused on profit and meeting quotas and the health of pregnant workers appeared to be a lower priority. This study found that the government lacks the resources to understand the extent of the problem or the level of compliance with maternity related regulations. Conclusions: These results indicate the vulnerability of female workers to physical and mental stress at work and associations with their health problems during pregnancy. It identifies the deficiencies of family, workplace and health service support for these pregnant workers, highlighting the urgent need for government and non-government organisations to work with this important export industry to improve health surveillance and monitoring and the enforcement of existing laws to protect the rights and conditions of pregnant women. [ABSTRACT FROM AUTHOR]

Objectives: There have been increasing calls for more research on interventions to successfully translate evidence-based knowledge into improved health policy and practices. This paper reports on an exploratory study of knowledge translation interventions conducted with participants of global health meetings held in Bangladesh in 2012 and in South Africa in 2013. We measured stakeholders' uptake of evidence-based knowledge in terms of their translation of this knowledge into actions around public health policy and practice. The research sought to determine whether participants shared and used knowledge from the meetings to improve health policy and practices in their settings and the factors influencing sharing and use. Study design: An exploratory study employed quantitative and qualitative methods of online surveys and in-depth interviews to collect data from all meeting participants. Methods: All participants in the Bangladesh and South Africa meetings were invited to complete an online survey during the meetings and over the following six weeks. Of 411 participants in the 2012 Bangladesh meeting, 148 participants from 22 countries completed the survey. Eleven of these respondents (from eight countries) were interviewed. Of the 436 participants in the 2013 South Africa meeting, 126 respondents from 33 countries completed an online survey; none of these respondents were interviewed. Results: The analysis revealed that most respondents used new knowledge to advocate for policy change (2012: 65.5%; 2013: 67.5%) or improve service quality (2012: 60.1%; 2013: 70.6%). The type of knowledge that respondents most commonly shared was clinical or scientific information (2012: 79.1%; 2013: 66.7%) and country-specific information (2012: 73.0%; 2013: 71.4%). Most 2012 respondents shared knowledge because they thought it would be useful to a co-worker or colleague (79.7%). Discussion: Findings on knowledge use and sharing suggest that most respondents saw themselves as knowledge brokers or intermediaries in a position to influence the translation of knowledge into action in health policy and practices in their countries. Results suggest that supporting knowledge brokers working in a local and regional context to spur change, as described in the paper, has the potential to improve health outcomes. Further research is needed to isolate specific interventions and their knowledge translation outcomes. [ABSTRACT FROM AUTHOR]

Considering the high burden of injuries, the Health Authority - Abu Dhabi developed a draft electronic and paper-based injury and poisoning notification system (IPNS) to generate better data on the nature and severity of injuries. The pilot testing and evaluation of IPNS was conducted with the specific objectives to (1) identify the characteristics of injury cases, (2) explore potential risk factors, (3) illustrate the nature and type of data, and (4) the working mechanism of data collection. Data were collected from selected hospitals on patient demographics, injury information and clinical assessment. Descriptive, bivariate and multivariate analyses were conducted. Of 4226 injury cases, nearly three-fourths were male, majority were non-UAE nationals, and the mean age was 21.9. Multivariate findings suggested that compared to UAE nationals, non-UAE nationals were 27% more likely to experience fatal, severe or moderate injuries (p= 0.01). Individuals with health insurance were 31% less likely to suffer a fatal, severe or moderate injury compared to those having no health insurance (p< 0.001). This is the first systematically standardised collection of injury data across three facilities in Abu Dhabi, and provides initial information on characteristics and injury risk factors that will help identify the need for evidence-based intervention for injury prevention and control. [ABSTRACT FROM PUBLISHER]

The processes for implementing effective programs at scale in low-income countries have not been well-documented in the peer-reviewed literature. This article describes the initial steps taken by one such program--the BRAC Manoshi Project, which now reaches a population of 6.9 million. The project has achieved notable increases in facility births and reductions in maternal and neonatal mortality. The focus of the paper is on the initial steps--community engagement, social mapping, and census taking. Community engagement began with (1) engaging local leaders, (2) creating Maternal, Neonatal, and Child Health Committees for populations of approximately 10,000 people, (3) responding to advice from the community, (4) social mapping of the community, and (5) census taking. Social mapping involved community members working with BRAC staff to map all important physical features that affect how the community carries out its daily functions--such as alleys, lanes and roads, schools, mosques, markets, pharmacies, health facilities, latrine sites, and ponds. As the social mapping progressed, it became possible to conduct household censuses with maps identifying every household and listing family members by household. Again, this was a process of collaboration between BRAC staff and community members. Thus, social mapping and census taking were also instrumental for advancing community engagement. These three processes-community engagement, social mapping, and census taking--can be valuable strategies for strengthening health programs in urban slum settings of low-income countries. [ABSTRACT FROM AUTHOR]

Introduction: The utilization of facility delivery is crucial to achieve sustainable development goals by reducing maternal and neonatal deaths. This study aimed to compare the distributions and determinants of childbirth in health facilities in urban and rural regions of Bangladesh. Methods: Cross-sectional data from the 2017-2018 Bangladesh Demographic and Health Survey were analyzed. Multilevel logistic regression was applied. Results: A total of 4 751 women were included in the analyses. Only 50% of childbirths took place in health facilities, 63.4% and 44.6% in urban and rural regions, respectively. Overall, the odds of the association between facility delivery and the studied factors were similar. Multiparous women had significantly lower odds of facility delivery in both rural (adjusted odds ratio [AOR] = 0.3, 95% confidence interval [CI]: 0.2 to 0.5) and urban (AOR = 0.2, 95% CI: 0.1 to 0.5) regions. In both regions, women with higher education levels, highly educated husbands, antenatal care (ANC), and higher wealth indexes had significantly higher odds of facility delivery. Conclusion: Several common associated factors were identified. However, differences were observed regarding distributions of these factors. The differences in facility delivery utilization could result from lower ANC utilization, socioeconomic status, and transportation facilities in rural regions than urban regions; therefore, improving these conditions could increase facility delivery in these regions. [ABSTRACT FROM AUTHOR]

Aim To explore the experiences of women from three population groups of immediate skin-to-skin contact ( SSC) with their newborn babies. Method A mixed methods approach was adopted in a phenomenological study to elicit the experiences of English, Pakistani and Bangladeshi women. Audiotaped diaries, semi-structured interviews, photographs and video recordings were employed. Concept mapping was central to data analysis. Results This paper reports novel findings that women contextualized and accepted secretions and bodily fluids from birth. This contradicts the beliefs of midwives that Asian women find bodily secretions abhorrent and culturally unacceptable. All participants reported positive experiences of SSC despite varying degrees of soiling from birth fluids. Limitations The study was conducted in a single setting, and participants may not have been representative of others in their cultural groups. Third-party translation may have added an unsought layer of interpretation. The imposition of cultural expectations by peers in the recruitment process excluded some potential participants. Conclusion Stereotypical assumptions about cultural background often characterize professional responses. When this stereotyping was put aside, women of all three cultures, whether breastfeeding or bottle-feeding, were able to enjoy SSC with their babies. Implications for Nursing and Health Policy The findings suggest that changes will be needed in professional practice to be more open to women's expressed preferences, in local policy to ensure that choices are made clear and are available, and in national strategic direction to ensure widespread adoption of positive practices for opportunities to increase breastfeeding, promote parent-child bonding and support patient choice to be realized. [ABSTRACT FROM AUTHOR]

Since the inception of the information age, employees in both developed and developing countries have become 'knowledge workers'. In their work, knowledge workers apply knowledge as well as skills, while labour is provided by tools and machines (Maclean & Wilson, 2009). Contemporary employees require appropriate knowledge to be able to share this knowledge through their advanced skills. Hence, an advanced university education is pivotal. However, Jones's (2013) study indicates a paucity of research into the learning and assessment of PhD programmes (p. 6). As a result, many PhD graduates--especially those from developing countries--are finding themselves unemployed. If this continues, fewer skilled and knowledgeable PhD graduates--in other words, successful researchers--will qualify, particularly in developing countries. Hence, this paper aims to investigate why the existing learning and assessment practices of doctoral studies in Bangladesh need to be redesigned. The paper is significant because it comprises the initial research prior to more conclusive research into the learning and assessment practices of doctoral studies in Bangladesh. This paper will help to close a knowledge gap by providing significant insights into the area of learning and assessment practices of PhD programmes in developing countries. [ABSTRACT FROM AUTHOR]

The purpose of this paper was to explore group drug taking behaviour in a slum area of Dhaka, Bangladesh. We set out to examine the relationships between those who met, at least weekly, to take illegal drugs together, and how these relationships might shape their drug behaviour. Sociometric and behavioural data were collected using questionnaires via semi-structured interviews. We found that the likelihood of injecting drugs and sharing needles increased with age, duration of group membership and length of drug use. Drug users were classified into two clusters: one was more cohesive and comprised longer-term users, who were more likely to inject drugs and had poorer physical and mental health. The other cluster comprised younger, better educated members who were more transient, less cohesive, less likely to inject drugs and had better health. Qualitative data suggested that members of the first cluster were less accepting of outsiders and confirmed more to group norms. We conclude that emotionally bonded cohesive subgroups acquire norms, which reinforce problematic drug-using behaviour. Thus, health initiatives need to consider group relationships and norms and those initiatives which work with networks may be more effective and more appropriate for low-income countries. [ABSTRACT FROM AUTHOR]

Drawing on my PhD field research in Bangladesh, this paper contributes to the growing body of methodological literature on young people's right to participate in research. I reflexively evaluate the approach and ethics that I employed in my research, arguing that we must recognise the social and spatial dimensions of participation, which shape ethical issues of access and the construction of obedience, privacy and confidentiality. I reflect critically on the impact of inter-generational power relations on young people's voluntary participation, and conclude by arguing that methodology - including ethical responses - needs to be context-specific. My experience reveals the challenges of translating rights-based research into practice. [ABSTRACT FROM AUTHOR]

In the last decade, geographic information systems (GIS) have become accessible to researchers in developing countries, yet guidance remains sparse for developing a GIS. Drawing on experience in developing a GIS for a large community trial in rural Bangladesh, six stages for constructing, maintaining, and using a GIS for health research purposes were outlined. The system contains 0.25 million landmarks, including 150,000 houses, in an area of 435 sq km with over 650,000 people. Assuming access to reasonably accurate paper boundary maps of the intended working area and the absence of pre-existing digital local-area maps, the six stages are: to (a) digitize and update existing paper maps, (b) join the digitized maps into a large-area map, (c) reference this large-area map to a geographic coordinate system, (d) insert location landmarks of interest, (e) maintain the GIS, and (f) link it to other research databases. These basic steps can produce a household-level, updated, scaleable GIS that can both enhance field efficiency and support epidemiologic analyses of demographic patterns, diseases, and health outcomes. [ABSTRACT FROM AUTHOR]

The analysis of natural resource management (NRM) institutions is drawn from two predominant theoretical schools -- New Institutional Economics (NIE) and Common Property Resource (CPR) theory. There remains a need to transfer usable messages from the theory to those closely engaged with NRM in the development context. The paper brings together the recent theoretical reappraisal of the 'institution' in NRM with research findings from Bangladesh to argue the importance of re-emphasizing a simple distinction between formal and informal institutions. Acknowledging the importance of the informal institutional environment is crucial for improved management and evaluation of NRM initiatives. [ABSTRACT FROM AUTHOR]

This paper analyses the rationale process for choosing the research methodology in studying the 'Perception of Effective Community Participation in Coastal Development Projects in Bangladesh'. The analysis is based on ontological, epistemological, and methodological assumptions of two competing paradigms: positivistic (as an alternative approach) and non-positivistic (adapted in this research project) paradigms in scientific inquiry. Finally, the paper will conclude what characterises the conceptualisation of studying community participation in coastal development projects, and how these influence the choice of the methodology (non-positivistic approach), the specific method (grounded theory), and the data collection techniques. A comparison between positivistic and non-positivistic orientation toward this research project has also been made. [ABSTRACT FROM AUTHOR]

Focuses on the Urban Livelihoods Study that has been conducted by the Institute for Development Policy Analysis and Advocacy in Bangladesh in the late nineties. Objectives of the study; Information on the contemporary discourses about urban vulnerability; Vulnerability issues which affect individuals.

Background: Water, sanitation, and hygiene (WASH) efficacy trials deliver interventions to the target population under optimal conditions to estimate their effects on outcomes of interest, to inform subsequent selection for inclusion in routine programs. A systematic and intensive approach to intervention delivery is required to achieve the high-level uptake necessary to measure efficacy. We describe the intervention delivery system adopted in the WASH Benefits Bangladesh study, as part of a three-paper series on WASH Benefits Intervention Delivery and Performance.Methods: Community Health Workers (CHWs) delivered individual and combined WASH and nutrition interventions to 4169 enrolled households in geographically matched clusters. Households were provided with free enabling technologies and supplies, integrated with parallel behaviour-change promotion. Behavioural objectives were drinking treated, safely stored water, safe feces disposal, handwashing with soap at key times, and age-appropriate nutrition behaviours (birth to 24 months). The intervention delivery system built on lessons learned from prior WASH intervention effectiveness, implementation, and formative research studies. We recruited local CHWs, residents of the study villages, through transparent merit-based selection methods, and consultation with community leaders. CHW supervisors received training on direct intervention delivery, then trained their assigned CHWs. CHWs in turn used the technologies in their own homes. Each CHW counseled six to eight intervention households spread across a 0.2-2.2-km radius, with a 1:12 supervisor-to-CHW ratio. CHWs met monthly with supervisor-trainers to exchange experiences and adapt technology and behaviour-change approaches to evolving conditions. Intervention uptake was tracked through fidelity measures, with a priori benchmarks necessary for an efficacy study.Results: Sufficient levels of uptake were attained by the fourth intervention assessment month and sustained throughout the intervention period. Periodic internal CHW monitoring resulted in discontinuation of a small number of low performers.Conclusions: The intensive intervention delivery system required for an efficacy trial differs in many respects from the system for a routine program. To implement a routine program at scale requires further research on how to optimize the supervisor-to-CHW-to-intervention household ratios, as well as other program costs without compromising program effectiveness.Trial Registration: ClinicalTrials.gov, ID: NCC01590095 . Registered on 2 May 2012. [ABSTRACT FROM AUTHOR]

Amid growing consensus that violence against women is structurally produced, neoliberalism produces an individualist understanding of violence that blames women while simultaneously framing it as personal failings of men, obscuring the link between the structural and the personal. Using examples from federal grant funding opportunities in the United States, activism in Bangladesh, and data from qualitative research, I analyze how such individual readings of violence get produced–reproduced. I call for radical responsibility to produce equitable and just research that serves the communities that we study, not just the interests of grant funders and the neoliberal university. [ABSTRACT FROM AUTHOR]

Transgender has come to be the accepted term for persons who do not fall in the physically, sexually defined categories of male and female. They are persons who have been called 'Kinnar1, 'Hijras1, 'Chakkas' or eunuchs. The manner of use of these connotations has been from indifference to even derogatory. Over the past few decades, there has been concern in the electronic and visual media about the socially impoverished lives these persons are forced to live. In several instances they have had to succumb to severe abuse from the rest of society. They have been insulted and even sexually assaulted through most of their lives. Countries the world over have attempted to ameliorate the situation of these marginalized members of society so that they are enabled to live a life free from stigma. The recent declaration of Section 377 of the Transgender Persons (Protection of Rights) Bill 2016 held forth a ray of hope for this person. However, the manner of implementation and the degree to which it is implemented have global ramifications. Primary data was used for the research conducted for this paper - Empirical investigative tools of research like focused group discussions were held among undergraduate students. The findings show that most youth favoured the Bill wholeheartedly while a few gave vent to the doubt that legislations cannot cure the deep rooted evil. And the act could be used only when the actual facts are brought to light. Meanwhile, the crimes against the transgender persons may well continue and their socio- psychological position may not change to any great extent. In fact, a large proportion of the transgender persons themselves, see the Act as a threat challenging their safety and livelihoods. [ABSTRACT FROM AUTHOR]

Two early childhood development aspects: carer involvement with children, and their ownership of age‐appropriate books, were evaluated. Children aged 0–4 years from Bangladesh, extracted from population‐based Multiple Indicator Cluster Survey 2019, were assessed using survey adjusted logistic regression models and district‐wise spatial distribution. Among 13 806 children, 11.2% had no shared activities with carers, and 60.7% had at least four shared activities. Among 22 796 children, 27.4% owned at least one book. Higher carer–child shared activities and more child‐friendly books in households were observed in the Western part of Bangladesh. Children from higher socioeconomic households with educated mothers and greater exposure to media, had higher carer–child interaction and greater availability of books. These findings can aid policies targeting psychological and cognitive development of children in Bangladesh. [ABSTRACT FROM AUTHOR]

Street harassment against women is an understudied form of gender‐based violence that severely limits women's safety and freedoms. One potential way of addressing street harassment is directly intervening against it, that is, the woman experiencing harassment confronts the perpetrator. However, this may be difficult to do in contexts where harassment is pervasive. In the context of a grassroots women's empowerment organisation in Dhaka, Bangladesh, I examined the relationship between women's positions in the social network structure of a group that espouses a norm of speaking up against street harassment, and their levels of displaying this behaviour. I hypothesised that an individual's network centrality would be associated with their engagement in behaviours that are prescribed by the group social norm; specifically, speaking up against street harassment. This hypothesis was not supported. However, exploratory analyses indicated that network centrality was a significant (negative) predictor of the participant's tendency to remove herself from the situation when harassed and a significant positive predictor of self‐efficacy for intervening against street harassment. This indicates that position in the network may play a role in confronting street harassment, though not through originally hypothesised mechanisms. Theoretical and pragmatic implications of these findings for engaging in intervention against street harassment are discussed. [ABSTRACT FROM AUTHOR]

Aim: The purpose of this empirical study was to understand, explore and analyse how the COVID-19 pandemic has affected the mothers of our society, with particular emphasis on Bangladesh, which has so far been a relatively unexplored area. Subject and methods: The study adopted qualitative and interpretative methods of social research, including content analysis and a perception study of 223 respondents through a semi-structured questionnaire survey, who were selected using purposive random sampling. The data obtained from the perception study was further complemented through phone interviews. Results: The study found that the pandemic has not affected all mothers uniformly; rather, the intensity of its impact varied depending on factors such as the occupation of mothers and their husbands and their family pattern. Despite such variation, all mothers experienced a subsequent increase in workload, challenges while availing routine health facilities and higher levels of stress, anxiety, depression and certain behavioural changes. Conclusion: However, the worst affected have been the mothers belonging to the lower socio-economic strata because the pandemic has made them and their husbands jobless, leading them towards an uncertain future. [ABSTRACT FROM AUTHOR]

This paper analyses disparities in learning outcomes among primary school students in Bangladesh associated with different background characteristics. The result of the study reveals that there is a clear disparity between the students from the poorest and richest households in achieving different learning skills while this gap increases over the primary school years. Moreover, there is a significant learning gap associated with parents' education, parents' awareness, and the overage status of the students, which continues to persist over the primary school years. However, we did not find any significant learning gap between male and female students. Finally, the study points to a regional disparity where the students from urban areas outperform their rural counterparts. • Disparities in learning outcomes among the primary school students in Bangladesh have been analysed. • The learning gap associated with wealth continues to grow over the learning trajectory of primary school years. • The overaged children performed significantly worse than those who are not overaged. • There is a spatial divide in achieving different learning skills. [ABSTRACT FROM AUTHOR]

Background: The polio eradication endgame called for the removal of trivalent oral poliovirus vaccine (OPV) and introduction of bivalent (types 1 and 3) OPV and inactivated poliovirus vaccine (IPV). However, supply shortages have delayed IPV administration to tens of millions of infants, and immunogenicity data are currently lacking to guide catch-up vaccination policies.Methods: We conducted an open-label randomized clinical trial assessing 2 interventions, full or fractional-dose IPV (fIPV, one-fifth of IPV), administered at age 9-13 months with a second dose given 2 months later. Serum was collected at days 0, 60, 67, and 90 to assess seroconversion, priming, and antibody titer. None received IPV or poliovirus type 2-containing vaccines before enrolment.Results: A single fIPV dose at age 9-13 months yielded 75% (95% confidence interval [CI], 6%-82%) seroconversion against type 2, whereas 2 fIPV doses resulted in 100% seroconversion compared with 94% (95% CI, 89%-97%) after a single full dose (P < .001). Two doses of IPV resulted in 100% seroconversion.Conclusions: Our study confirmed increased IPV immunogenicity when administered at an older age, likely due to reduced interference from maternally derived antibodies. Either 1 full dose of IPV or 2 doses of fIPV could be used to vaccinate missed cohorts, 2 fIPV doses being antigen sparing and more immunogenic.Clinical Trial Registration: NCT03890497. [ABSTRACT FROM AUTHOR]

Background: Reliable and rigorously collected sexual, reproductive, maternal, newborn, child, and adolescent health (SRMNCAH) data in humanitarian settings is often sparse and varies in quality across different humanitarian settings. To address this gap in quality data, the World Health Organization (WHO) developed a core set of indicators for monitoring and evaluating SRMNCAH services and outcomes, and assessed their feasibility in Bangladesh, Afghanistan, Jordan, and the Democratic Republic of Congo. Methods: The feasibility assessments aggregated information from global consultations and field-level assessments to reach a consensus on a set of core SRMNCAH indicators among WHO partners. The feasibility assessment in Bangladesh focused on the following constructs: relevance/usefulness of the core set of indicators, the feasibility of measurement, availability of systems and resources, and ethical issues during data collection and management. The field-level multi-methods assessment included five components; a desk review, key informant interviews, focus group discussions, and facility assessments including observations of facility-level data management. Results: The findings suggest that there is widespread support among stakeholders for developing a standardized core set of SRMNCAH indicators to be collected among all humanitarian actors in Bangladesh. There are numerous resources and data collection systems that could be leveraged, built upon, and improved to ensure the feasibility of collecting this proposed set of indicators. However, the data collection load requested from donors, the national government, international and UN agencies, coordination/cluster systems must be better harmonized, standardized, and less burdensome. Conclusion: This core set of indicators would only be useful if it has the buy-in from the international community that results in harmonizing and coordinating data collection efforts and relevant indicators' reporting requirements. Plain English Summary: Reliable data on sexual, reproductive, maternal, newborn, child and adolescent health (SRMNCAH) in humanitarian settings is very important for addressing the needs of the refugee population. However, the quality of data collected often varies across different humanitarian settings and organizations. To address this gap, WHO developed a core set of indicators, through global consultations and field-level assessments, for monitoring and evaluating SRMNCAH services and outcomes in humanitarian settings. In Bangladesh, the feasibility assessment was conducted in Rohingya camps in Cox's Bazar and assessed the feasibility in terms of relevance/usefulness of the indicators, feasibility of measurement, availability of systems and resources for data collection, and data collection and management related ethical issues in the Rohingya context in Bangladesh. The field-level assessment applied a multi-method approach including a desk review, key informant interviews, focus group discussions, and facility assessments. The findings revealed existing multiple sources and vertical systems of data collection by different organizations and the indicators also varied depending on the requirements of the Bangladesh government, donor agencies, UN agencies leading different sector/sub-sectors/clusters, and organizations' own priorities and mandates. All the stakeholders who participated in this study agreed on developing a harmonized and standardized core set of SRMNCAH indicators. However, they raised concerns regarding the adaptation of the core set of indications to the local context. They also emphasized on the importance of adequate resources for establishing strong reporting and data management systems, capacity development of human resources and the buy-in from the international community for effective implementation. [ABSTRACT FROM AUTHOR]

Background: Plasmodium vivax forms dormant liver stages that can reactivate weeks or months following an acute infection. Recurrent infections are often associated with a febrile illness and can cause a cumulative risk of severe anaemia, direct and indirect mortality, and onward transmission of the parasite. There is an increased risk of P. vivax parasitaemia following falciparum malaria suggesting a rationale for universal use of radically curative treatment in patients with P. falciparum malaria even in the absence of detectable P. vivax parasitaemia in areas that are co-endemic for both species.Methods: This is a multicentre, health care facility-based, randomized, controlled, open-label trial in Bangladesh, Indonesia and Ethiopia. Patients with uncomplicated falciparum malaria, G6PD activity of ≥70% of the adjusted male median (AMM) and haemoglobin levels ≥8g/dl are recruited into the study and randomized to either receive standard schizonticidal treatment plus 7-day high dose primaquine (total dose 7mg/kg) or standard care in a 1:1 ratio. Patients are followed up weekly until day 63. The primary endpoint is the incidence risk of any P. vivax parasitemia on day 63. Secondary endpoints include incidence risk on day 63 of symptomatic P. vivax malaria and the risk of any P. falciparum parasitaemia. Secondary safety outcomes include the proportion of adverse events and serious adverse events, the incidence risk of severe anaemia (Hb<5g/dl and <7g/dl) and/or the risk for blood transfusion, the incidence risk of ≥ 25% fall in haemoglobin with and without haemoglobinuria, and the incidence risk of ≥ 25% fall in haemoglobin to under 7g/dl with and without haemoglobinuria.Discussion: This study evaluates the potential benefit of a universal radical cure for both P. vivax and P. falciparum in different endemic locations. If found safe and effective universal radical cure could represent a cost-effective approach to clear otherwise unrecognised P. vivax infections and hence accelerate P. vivax elimination.Trial Registration: NCT03916003 . Registered on 12 April 2019. [ABSTRACT FROM AUTHOR]