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INTRODUCTION: Presbyopia, difficulty in seeing close-ups, affects a billion people globally. Mobile financial services (MFS) have been mandated since January 2021 for Bangladesh government social safety net payments, including old age allowance (OAA) and widow allowance (WA). We report the protocol for the Transforming Households with Refraction and Innovative Financial Technology randomised trial assessing the impact on the use of online banking of providing presbyopic safety net beneficiaries with reading glasses, and brief smartphone and mobile banking app training. METHODS AND ANALYSES: Eligible participants (n=484) are OAA (men aged 65-70 years; women aged 62-70) or WA recipients (women aged 48-60) with presbyopia as their only vision problem, passing a smartphone-based test of numeracy, cognition and dexterity, and not currently owning a smartphone or independently using MFS. All participants receive smartphones loaded with a mobile banking app and a transaction-tracking app and are randomised 1:1 to receive immediate free near-vision glasses and half-day training for smartphone and banking app use (intervention), or glasses and training 12 months later (control). The primary outcome is the mean quarterly number of mobile bank transactions over the 12-month follow-up period, comparing study groups, with and without adjustment. Secondary outcomes include food security, healthcare access and social connectedness. ETHICS AND DISSEMINATION: The protocol was approved by ethics committees at Queens University Belfast (reference #MHLS22_69) and BRAC James P Grant School of Public Health (reference #IRB-21 August22-028). The trial is conducted in accordance with the Declaration of Helsinki and national regulations in Bangladesh, and results will be published in open-access, peer-reviewed journals. TRIAL REGISTRATION NUMBER: NCT05510687; ClinicalTrials.gov.

Introduction Health is central to the 2030 agenda of the United Nations (UN) sustainable development goals (SDG), and primary health care is a strategy to achieve most of the SDG [...], Objective To assess the availability of information on indicators of the World Health Organization and United Nations Children's Fund primary health-care measurement framework in Bangladesh, India, Nepal, Pakistan and Sri Lanka and to outline the opportunities for and challenges to using the framework in these countries. Methods We reviewed global and national data repositories for quantitative indicators of the framework and conducted a desk review of country documents for qualitative indicators in February-April 2023. We assessed data sources and cross-sectional survey tools to suggest possible sources of information on framework indicators that were not currently reported in the countries. We also identified specific indicators outside the framework on which information is collected in the countries and which could be used to measure primary healthcare performance. Findings Data on 54% (32/59) of the quantitative indicators were partially or completely available for the countries, ranging from 41% (24/59) in Pakistan to 64% (38/59) in Nepal. Information on 41% (66/163) of the qualitative subindicators could be acquired through desk reviews of country-specific documents. Information on input indicators was more readily available than on process and output indicators. The feasibility of acquiring information on the unreported indicators was moderate to high through adaptation of data collection instruments. Conclusion The primary health-care measurement framework provides a platform to readily assess and track the performance of primary health care. Countries should improve the completeness, quality and use of existing data for strengthening of primary health care. [phrase omitted] [phrase omitted] Objectif Etudier la disponibilite des informations concernant les indicateurs du cadre devaluation des soins de sante primaires de l'Organisation mondiale de la Sante et du Fonds des Nations Unies pour l'enfance au Bangladesh, en Inde, au Nepal, au Pakistan et au Sri Lanka, mais aussi presenter les opportunites et enjeux de l'application d'un tel cadre dans ces pays. Methodes Nous avons explore les referentiels de donnees nationaux et internationaux a la recherche d'indicateurs lies au cadre, puis nous avons effectue un examen preliminaire des documents de chaque pays pour y trouver des indicateurs qualitatifs entre fevrier et avril 2023. Nous avons evalue la provenance des donnees et les outils d'enquete transversale en vue de suggerer des sources potentielles d'informations sur certains indicateurs relatifs au cadre qui n'apparaissaient pas encore dans les pays susmentionnes. Nous avons par ailleurs identifie des indicateurs specifiques en dehors du cadre, sur lesquels les pays collectent des informations et qui pourraient servir a mesurer les performances des soins de sante primaires. Resultats Des donnees sur 54% (32/59) des indicateurs quantitatifs etaient partiellement ou entierement disponibles dans les differents pays, allant de 41% (24/59) au Pakistan a 64% (38/59) au Nepal. Des examens preliminaires de documents propres a chaque pays ont permis de recueillir des informations sur 41% (66/163) des sous-indicateurs qualitatifs. Il etait plus facile d'obtenir des precisions sur les indicateurs de moyens que sur les indicateurs de processus et de resultats. Enfin, le degre de faisabilite de l'acquisition d'informations sur les indicateurs non mentionnes etait modere a eleve, a condition d'adapter les instruments de collecte de donnees. Conclusion Le cadre d'evaluation des soins de sante primaires offre une plateforme permettant d'evaluer et de suivre aisement les performances en la matiere. Les pays devraient ameliorer l'exhaustivite, la qualite et l'utilisation des donnees existantes pour renforcer les soins de sante primaires. [phrase omitted] Objetivo Evaluar la disponibilidad de informacion sobre los indicadores del marco de medicion de la atencion primaria de salud de la Organizacion Mundial de la Salud y el Fondo de las Naciones Unidas para la Infancia en Bangladesh, India, Nepal, Pakistan y Sri Lanka, y exponer las oportunidades y los desafios que plantea la aplicacion del marco en estos paises. Metodos Se revisaron los repositorios de datos mundiales y nacionales para los indicadores cuantitativos del marco y se realizo una revision preliminar de los documentos de los paises para los indicadores cualitativos entre febrero y abril de 2023. Se evaluaron las fuentes de datos y las herramientas de encuestas transversales para sugerir posibles fuentes de informacion sobre los indicadores del marco que actualmente no se comunican en los paises. Tambien se identificaron indicadores especificos ajenos al marco sobre los que se recopila informacion en los paises y que se podrian aplicar para medir los resultados de la atencion primaria. Resultados Los datos sobre el 54% (32/59) de los indicadores cuantitativos estaban parcial o totalmente disponibles para los paises, oscilando entre el 41% (24/59) de Pakistan y el 64% (38/59) de Nepal. La informacion sobre el 41% (66/163) de los subindicadores cualitativos se pudo obtener mediante revisiones preliminares de documentos especificos de cada pais. La informacion sobre los indicadores de insumos fue mas facil de obtener que sobre los indicadores de procesos y productos. La viabilidad de adquirir informacion sobre los indicadores no declarados fue de moderada a alta mediante la adaptacion de los instrumentos de recopilacion de datos. Conclusion El marco de medicion de la atencion primaria proporciona una plataforma para evaluar y seguir facilmente el rendimiento de la atencion primaria. Los paises deben mejorar la exhaustividad, la calidad y el uso de los datos existentes para reforzar la atencion primaria.

BackgroundBangladesh has achieved major gains in maternal and newborn survival, facility childbirth and skilled birth attendance between 1991 and 2010, but excess maternal mortality persists. High-quality maternal health care is necessary to address this burden. Implementation of WHO Safe Childbirth Checklist (SCC), whose items address the major causes of maternal deaths, is hypothesized to improve adherence of providers to essential childbirth practices.MethodThe SCC was adapted for the local context through expert consultation meetings, creating a total of 27 checklist items. This study was a pre-post evaluation of SCC implementation. Data were collected over 8 months at Magura District Hospital. We analysed 468 direct observations of birth (main analysis using 310 complete observations and sensitivity analysis with the additional 158 incomplete observations) from admission to discharge. The primary outcome of interest was the number of essential childbirth practices performed before compared to after SCC implementation. The change was assessed using adjusted Poisson regression models accounting for clustering by nurse-midwives.ResultAfter checklist introduction, significant improvements were observed: on average, around 70% more of these safe childbirth practices were performed in the follow-up period compared to baseline (from 11 to 19 out of 27 practices). Substantial increases were seen in communication between nurse-midwives and mothers (counselling), and in management of complications (including rational use of medicines). In multivariable models that included characteristics of the mothers and of the nurse-midwives, the rate of delivering the essential childbirth practices was 1.71 times greater in the follow-up compared to baseline (95% CI 1.61-1.81).ConclusionImplementation of SCC has the potential to improve essential childbirth practice in resource-poor settings like Bangladesh. This study emphasizes the need for health system strengthening in order to achieve the full advantages of SCC implementation.

EcoCyc (http://EcoCyc.org) is a comprehensive model organism database for Escherichia coli K-12 MG1655. From the scientific literature, EcoCyc captures the functions of individual E. coli gene products; their regulation at the transcriptional, post-transcriptional and protein level; and their organization into operons, complexes and pathways. EcoCyc users can search and browse the information in multiple ways. Recent improvements to the EcoCyc Web interface include combined gene/protein pages and a Regulation Summary Diagram displaying a graphical overview of all known regulatory inputs to gene expression and protein activity. The graphical representation of signal transduction pathways has been updated, and the cellular and regulatory overviews were enhanced with new functionality. A specialized undergraduate teaching resource using EcoCyc is being developed.

Edutainment intervention is a popular and inexpensive behavioural change communication toolkit to raise positive social norms through broadcast media. We evaluated a 26-episode nationally broadcasted television series targeted to improve attitudes towards preventing child marriage in Bangladesh. We applied a randomised encouragement design to motivate our subjects to watch the series, addressing their self-selection issues concerning viewership. We randomly assigned a sample of 1,162 households into three arms: (T1) received weekly SMS reminders, (T2) received weekly SMSs and telephone calls, and (C) pure control. We followed up with 1,096 households, collected information on viewership and self-reported attitudes, and conducted a dictator game experiment to understand their revealed attitudes towards child marriage. We found considerable variations in viewership across the arms, suggesting associations with reminder intensity. Compared to the average control group viewership of about 0.15 episodes (SD = 0.82), T2 generated a difference of about 1.50–1.93 episodes (P < 0.01), depending on the respondent types. Following an instrumental variable approach, we found that exposure was not associated with both stated and revealed attitudes towards preventing child marriage. However, we found behavioural experiment was less prone to social desirability bias in assessing sensitive topics such as child marriage. [ABSTRACT FROM AUTHOR]