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This paper reports results from a prospective study of the impact of a woman-focused development programme on child survival in Matlab, a rural area of Bangladesh. The programme was targeted to households owning less than 50 decimals of land and members selling more than 100 days of labour for living in a year. Programme components included formation of women's groups for saving and credit, training on skill development, functional literacy including legal and social awareness, and technical and marketing support to projects undertaken with the loan money from the organization. A total of 13,549 children born alive during 1988?97 in the study area were included in the study. Hazards of mortality during pre- and post-intervention periods were compared among the programme participants and non-participants controlling the effects of other relevant variables. There has been a substantial reduction in mortality during the post-intervention period; however, the reduction was much greater for infants whose mothers participated in the development programme compared to infants of non-participant mothers from similar socioeconomic background. In a relative sense, there has been a 52% reduction of the pre-intervention level hazard of death of children during infancy of participant mothers compared to 31% reduction for the infants of non-participant mothers from similar socioeconomic background. There had also been a substantial reduction in hazard of death during childhood (1?4 year age group), however, the reduction was statistically similar for all groups of children irrespective of their mothers' participation in the development programmes. [ABSTRACT FROM AUTHOR]

Abstract: There has been significant interest in the rhetoric of health security in recent years from both global and local perspectives. Understanding health in the context of disaster vulnerability presents an opportunity to examine how improved health might reduce the effects of environmental disasters and other crises. To this end, a project was implemented in Bangladesh to establish the potential of a health security approach for disaster resilience amongst people living in high risk environments. This paper explores what we might mean by health security through engaging community level perspectives in the southeast coastal belt of Bangladesh, an area prone to cyclone and flood. This has been examined with respect to variation in gender and wealth of households. Household surveys, interviews and focus group discussions were some of the methods used to collect data. The findings show that health related coping strategies and agentive capabilities in the context of impending crises vary from one micro-context to the next. This suggests a dynamic and integrative resilience that could be built on further, but one which remains remote from wider discourses on health security. [Copyright &y& Elsevier]

Abstract: This paper explores the magnitude of physical violence by husbands, the disclosure of it and the help-seeking behavior of abused women in urban and rural Bangladesh. The data come from a larger study on domestic violence against women conducted in Bangladesh during 2000–2004. All ever-married women covered by the population-based survey component () conducted in 2001 were included in the current analysis. We also draw on in-depth interviews with 28 women who were physically abused by their husbands. Results show a high prevalence of lifetime physical spousal violence against women: 40% in urban and 42% in rural areas. Most of the abused women (66%) were silent about their experience. The main reasons behind this silence were high acceptance of violence, stigma and fear of greater harm. Sixty percent of urban and 51% of rural abused women never received any help from others. Only 2% ever sought help from institutional sources, from where support was not forthcoming. Women approached these sources only when they could not endure anymore or the violence became life threatening or children were at risk. The findings show that although providing appropriate services is absolutely necessary, it is also important to foster the use of such services and to help women overcome the barriers for accessing these services. [Copyright &y& Elsevier]

Explores the emotional stress experienced by the poor rural women of Matlab, Bangladesh. Feature of the poverty-alleviation efforts in Bangladesh; Income-generating opportunities for rural Bangladeshi women; Household circumstances of poor women reporting emotional stress; Individual characteristics of poor women reporting emotional stress; Women's responses to emotional stress.

Background Immunization is one of the most successful and effective health intervention to reduce vaccine preventable diseases for children. Recently, Bangladesh has made huge progress in immunization coverage. In this study, we compared the recent immunization coverage between boys and girls in a rural area of Bangladesh. Setting The study is based on data from Chakaria Health and Demographic Surveillance System (HDSS) of icddr,b, which covers a population of 90,000 individuals living in 16,000 households in 49 villages. Methods We calculated the coverage of fully immunized children (FIC) for 4584 children aged 12–23 months of age between January 9, 2012 and January 19, 2016. We analyzed immunization coverage using crude FIC coverage ratio (FCR) and adjusted FCR (aFCR) from binary regression models. The dynamic of gender inequality was examined across sociodemographic and economic conditions. Main outcome measure The adjusted female/male (F/M) FIC coverage ratios in various sociodemographic and economic categories. Results Among children who lived below the lower poverty line, the F/M aFCR was 0.89 (0.84–0.94) compared to 0.98 (0.95–1.00) for children from the households above lower poverty line (p = 0.003, test for interaction). For children of mothers with no high school education, the F/M aFCR was 0.94 (0.91–0.97), whereas it was 1.00 (0.96–1.04) for children of mothers who attended high school (p = 0.04, test for interaction). The F/M aFCR was 1.01 (0.96–1.06) for first born children but 0.95 (0.93–0.98) for second or higher birth order children (p = 0.04, test for interaction). Conclusions Fewer girls than boys were completely vaccinated by their first birthday due to girls’ lower coverage for measles vaccine. The tendency was most marked for children living below the poverty line, for children whose mothers did not attend high school, and for children of birth order two or higher. In the study setting and similar areas, sex differentials in coverage should be taken into account in ongoing immunization programmes. [ABSTRACT FROM AUTHOR]

Introduction: There are increasing numbers of mHealth initiatives in middle and low income countries aimed at improving health outcomes. Bangladesh is no exception with more than 20 mobile health (mHealth) initiatives in place. A recent study in Bangladesh examined community readiness for mHealth using a framework based on quantitative data. Given the importance of a framework and the complementary role of qualitative exploration, this paper presents data from a qualitative study which complements findings from the quantitative study.Methods: The study was conducted in the Chakaria sub-district of Bangladesh. In total, 37 in-depth interviews were conducted between December 2012 and March 2013. Participants included the general public, students, community leaders, school teachers, and formal and informal healthcare providers. Thematic analysis was used to develop a logical and relevant framework to examine community readiness. As in the quantitative exploration, this study approached the investigation with four types of readiness in mind: core readiness, technological readiness, human resource readiness and motivational readiness.Results: Community members, community leaders and healthcare providers expressed their interest in the use of mHealth in rural Bangladesh. Awareness of mHealth and its advantages was low among uneducated people. Participants who have used mHealth were attracted to the speed of access to qualified healthcare providers, time savings and low cost. Some participants did not see the value of using mobile phones for healthcare compared to a face-to-face consultation. Illiteracy, lack of English language proficiency, lack of trust and technological incapability were identified as barriers to mHealth use. However, a sense of ownership, evidence of utility, a positive attitude to the use of mHealth, and intentions towards future use of mHealth were driving forces in the adoption of mHealth services.Conclusions: This study re-affirmed the mHealth readiness conceptual framework with different dimensions of readiness and identified potential barriers and possible solutions for mHealth. Moving forward, emphasis should be placed on training users, providing low-cost services and improving trust of users. [ABSTRACT FROM AUTHOR]

Introduction Evidence in favor of mHealth for healthcare delivery in settings where trained health workforce is limited or unavailable is accumulating. With rapid growth in access to mobile phones and an acute shortage of health workforce in Bangladesh, mHealth initiatives are increasing with more than 20 current initiatives in place. “Readiness” is a crucial prerequisite to the successful implementation of telehealth programs. However, systematic assessment of the community readiness for mHealth-based services in the country is lacking. We report on a recent study describing the influence of community readiness for mHealth of a rural Bangladesh community. Methods A conceptual framework for mHealth readiness was developed, which included three categories: technological, motivational and resource readiness. This guided the questionnaire development for the survey conducted in the Chakaria sub-district of Bangladesh from November 2012 to April 2013. Multivariate logistic regression was used to examine ownership of mobile phones, use of the technology, and knowledge regarding awareness of mHealth services as predictors of the community readiness to adopt mHealth. Results A total of 4915 randomly selected household members aged 18 years and over completed the survey. The data explained the sub-categories of the readiness dimensions. In terms of access, 45% of respondents owned a mobile phone with ownership higher among males, younger participants and those in the highest socioeconomic quintiles. Results related to technological readiness showed that among mobile phone owners, 50% were aware of SMS but only sending and receiving SMS. Only 37% generally read the received SMS. Only 5% of respondents used the internet capabilities on their phone and 25% used voice messages. The majority (73%) of the participants were interested in joining mHealth programs in the future. Multivariate analysis showed that ownership of a mobile phone (aOR 1.3, 95% CI 1.1–1.5), younger age (aOR 2.6, 95% CI 2.1–3.3), males (aOR 1.8, 95% CI 1.6–2.1), educated respondents (11 years or more education) (aOR 11.1, 95% CI 6.2–19.2) and those belonging to the highest socio-economic group (aOR 3.7, 95% CI 2.9–4.7) were significantly independently associated with knowledge regarding awareness of current mHealth services. Conclusions We developed a conceptual framework to assess community readiness for mHealth. We described three high level dimensions of readiness and have partially tested the conceptual framework in a rural sub-district in Bangladesh. We found that the community has some technological readiness but inequity was observed for human resource readiness and technological capabilities. The study population is motivated to use mHealth. Our conceptual framework is a promising tool to assist policy-makers in planning and implementing mHealth programs. [ABSTRACT FROM AUTHOR]

Studies the relationship among gender, socioeconomic development and health-seeking behavior in Bangladesh. Reduction of gender and socioeconomic disparities in health of populations; Group and gender differences in care seeking.