Abbas Bhuiya

International Centre for Diarrhoeal Disease Research, Bangladesh | ICDDR,B

Background Bangladesh has made substantial progress in maternal health. However, persistent inequities in service use undermine the achievements at the national level. In 2007, the government introduced a Maternal Health Voucher Scheme (MHVS) to reduce barriers to service utilization. The current study explores the impact of MHVS on reducing distan...

Why was the cohort set up? Bangladesh has experienced rapid urbanization in recent decades. The urban population was negligible (<5%) until the early 1970s but has since risen to more than 30%, and about one-third of the urban population of Bangladesh lives in slum settlements.¹ The population of Bangladesh is projected to increase from 167 million...

Bangladesh initiated the Maternal Health Voucher Scheme (MHVS) in 2007 to improve maternal and child health practices and bring equity to the mainstream of health systems by reducing financial and institutional barriers. In this study, we investigated whether the MHVS has an association with immunization coverage in a rural area of Bangladesh. Betw...

This study aimed to assess completeness of antenatal care coverage following implementation of a voucher scheme for maternal health in Bangladesh. The investigation used interview data from a survey conducted in Bangladesh in 2017 of 2400 randomly selected women aged 15–49 with children aged 0–23 months in four geographical areas where voucher sche...

Background The government of Bangladesh initiated community clinics (CC) to extend the reach of public health services and these facilities were planned to be run through community participation. However, utilisation of CC services is still very low. Evidence indicates community score card is an effective tool to increase utilisation of services fr...

Background Engaging communities in health facility management and monitoring is an effective strategy to increase health system responsiveness. Many developing countries have used community scorecard (CSC) to encourage community participation in health. However, the use of CSC in health in Bangladesh has been limited. In 2017, icddr,b initiated a C...

Background: Globally, the rapid growth of technology and its use as a development solution has generated much interest in digital health. In line with global trends, Bangladesh is also integrating technology into its health system to address disparities. Strong political endorsement and uptake of digital platforms by the government has influenced t...

Diphtheria-tetanus-pertussis (DTP) vaccine may be associated with excess female deaths. There are few studies of possible nonspecific effects of the DTP-containing vaccine Penta (DTP-hepatitis B-Haemophilus influenzae type b). We therefore investigated whether Penta vaccinations were associated with excess female deaths in rural Bangladesh. Between...

Rapid urbanization and persistent health inequity are two significant phenomena in contemporary developing world. Urban population, albeit with more modern facilities and amenities at their proximity, are subject to extreme variation depending on economic abilities and living conditions. This results in disparate health status among population sub-...

This chapter highlights key policy issues of West Bengal and Bangladesh. In both the countries, the primary aim of the national programmes is to inform, clarify, strengthen and prioritize the role of the government in shaping country in all its dimensions—investments in different sectors, promotion of good economic and human development through cro...

To date, non-pharmacological interventions (NPI) have been the mainstay for controlling the coronavirus disease-2019 (COVID-19) pandemic. While NPIs are effective in preventing health systems overload, these long-term measures are likely to have significant adverse economic consequences. Therefore, many countries are currently considering to lift t...

Background: Improving maternal health is a major development goal, with ambitious targets set for high-mortality countries like Bangladesh. Following a steep decline in the maternal mortality ratio over the past decade in Bangladesh, progress has plateaued at 196/100,000 live births. A voucher scheme was initiated in 2007 to reduce financial, geogr...

BACKGROUND The rapid growth of technology and its use as development solutions have generated much interest in eHealth, globally. In line with global trends, Bangladesh too is integrating technology into its health system to address disparities. Strong political endorsement and uptake of digital platforms by the government has influenced the rapid...

Background Globally, the rapid growth of technology and its use as a development solution has generated much interest in digital health. In line with global trends, Bangladesh is also integrating technology into its health system to address disparities. Strong political endorsement and uptake of digital platforms by the government has influenced th...

This chapter explores the health outcomes of recent and long-term migrants living in the Urban Health and Demographic Surveillance area. Using the surveillance database, 1,100 respondents aged 18 years or more were selected randomly to examine whether long-term migrants are healthier than recent-migrants, and whether recent-migrants are healthier t...

This paper introduces the Thematic Issue on Innovation in Health Systems in Low- and Middle-Income Countries.

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...

Background: Micro health insurance (MHI) has proved to be a potential health-financing tool for many developing countries. Bangladesh also included MHI in its current health-financing strategy which aims to achieve universal health coverage. However, low uptake, low renewal and high dropouts have historically challenged financial sustainability of...

Background Socioeconomic inequality in health and mortality remains a disturbing reality across nations including Bangladesh. Inequality drew renewed attention globally. Bangladesh though made impressive progress in health, it makes an interesting case for learning. This paper examined the trends and changing pattern of socioeconomic inequalities i...

Background and objectives mHealth offers a new opportunity to ensure access to qualified healthcare providers. Therefore, to better understand its potential in Bangladesh, it is important to understand how young people use mobile phones for healthcare. Here we examine the knowledge, attitudes and intentions to use mHealth services among young popul...

Background Traditional gender roles result in women lagging behind men in the use of modern technologies, especially in developing countries. Although there is rapid uptake of mobile phone use in Bangladesh, investigation of gender differences in the ownership, access and use of mobile phones in general and mHealth in particular has been limited. T...

Background: Mobile phone-based technology has been used in improving the delivery of healthcare services in many countries. However, data on the effects of this technology on improving primary healthcare services in resource-poor settings are limited. The aim of this study is to develop and test a mobile phone-based system to improve health, popul...

Background: Out-of-pocket (OOP) healthcare expenditure is a major obstacle for achieving universal health coverage in low-income countries including Bangladesh. Sixty-three percent of the USD 27 annual per-capita healthcare expenditure in Bangladesh comes from individuals’ pockets. Although health insurance is a financial tool for reducing OOP, use...

Background Health literacy (HL) helps individuals to make effective use of available health services. In low-income countries such as Bangladesh, the less than optimum use of services could be due to low levels of HL. Bangladesh’s health service delivery is pluralistic with a mix of public, private and informally trained healthcare providers. Empha...

This quantitative analysis examines evidence for the impacts of mothers’ death on the schooling of their left-behind children (ages 6–17 years) in the Matlab Health and Demographic Surveillance System (HDSS) area of the International Centre for Diarrhoeal Disease Research, Bangladesh. The analysis compared the completed levels of primary and junior...

Background: The health hazards associated with the use of smokeless tobacco (SLT) are similar to those of smoking. However, unlike smoking, limited initiatives have been taken to control the use of SLT, despite its widespread use in South and Southeast Asian countries including Bangladesh. It is therefore important to examine the prevalence of SLT...

Introduction: Globally, policy makers and other health actors are showing considerable interest in eHealth to address prevailing political, financial and technical barriers to access to healthcare. Considering the rapid growth of cellular and internet technologies, ownership of a device (mobile phone or computer) and/or network often are presented...

Background People’s participation in health, enshrined in the 1978 Alma Ata declaration, seeks to tap into community capability for better health and empowerment. One mechanism to promote participation in health is through participatory action research (PAR) methods. Beginning in 1994, the Bangladeshi research organization ICDDR,B implemented a pro...

Background: High salt consumption is an important risk factor of elevated blood pressure. In Bangladesh about 20 million people are at high risk of hypertension due to climate change induced saline intrusion in water. The objective of this study is to assess beliefs, perceptions, and practices associated with salt consumption in coastal Bangladesh...

Health security is a relatively new concept in terms of how it is practised in disaster-prone locales. We observed 10 rural households in Bangladesh for four months using informal interviews, field diaries, and observation. The findings suggest that the everyday practises of health security involve the capabilities of “caring for themselves” in res...

Bangladesh is facing serious shortage of trained health professionals. In the pluralistic healthcare system of Bangladesh, formal health care providers constitute only 5 % of the total workforce; the rest are informal health care providers. Information Communication Technologies (ICTs) are increasingly seen as a powerful tool for linking the commun...

There is increasing concern regarding adverse effects of prenatal arsenic exposure on the neurodevelopment of children. We analyzed mortality data for children, who were born to 11,414 pregnant women between 2002 and 2004, with an average age of 5 years of follow-up. Individual drinking-water arsenic exposure during pregnancy was calculated using t...

Background: Healthcare financing in Bangladesh suffers from insufficient spending ($27 per-capita), inefficient resource use and high out-of-pocket (OOPs) expenses (64%) impeding universal health coverage (UHC). The country’s current national health-financing strategy highlights the need for an insurance mechanism to raise more funds, ensure effici...

Objective Village doctors, informal health care providers practicing modern medicine, are dominant health care providers in rural Bangladesh. Given their role, it is important to examine their prescription pattern and inappropriate use of medication. Methods These cross-sectional study data were collected through surveys of patients seen by villag...

Informally trained village doctors supply the majority of healthcare services to the rural poor in many developing countries. This study describes the demographic and socio-economic differences between medical representatives (MRs) and village doctors in rural Bangladesh, and explores the nature of their interactions. This study was conducted in Ch...

Introduction Bangladesh has a serious shortage of qualified health workforce. The limited numbers of trained service providers are based in urban areas, which limits access to quality healthcare for the rural population. mHealth provides a new opportunity to ensure access to quality services to the population. A recent review suggested that there a...

Background: Bangladesh has achieved remarkable gains in health indicators during the last four decades despite low levels of economic development. However, the persistence of inequities remains disturbing. This success was also accompanied by health and demographic transitions, which in turn brings new challenges for a nation that has yet to come...

Because most deaths in Africa and Asia are not well documented, estimates of mortality are often made using scanty data. The INDEPTH Network works to alleviate this problem by collating detailed individual data from defined Health and Demographic Surveillance sites. By registering all deaths over time and carrying out verbal autopsies to determine...

As the HIV/AIDS pandemic has evolved over recent decades, Africa has been the most affected region, even though a large proportion of HIV/AIDS deaths have not been documented at the individual level. Systematic application of verbal autopsy (VA) methods in defined populations provides an opportunity to assess the mortality burden of the pandemic fr...

Malaria continues to be a major cause of infectious disease mortality in tropical regions. However, deaths from malaria are most often not individually documented, and as a result overall understanding of malaria epidemiology is inadequate. INDEPTH Network members maintain population surveillance in Health and Demographic Surveillance System sites...

Background: Childhood mortality, particularly in the first 5 years of life, is a major global concern and the target of Millennium Development Goal 4. Although the majority of childhood deaths occur in Africa and Asia, these are also the regions where such deaths are least likely to be registered. The INDEPTH Network works to alleviate this proble...

Mortality from external causes, of all kinds, is an important component of overall mortality on a global basis. However, these deaths, like others in Africa and Asia, are often not counted or documented on an individual basis. Overviews of the state of external cause mortality in Africa and Asia are therefore based on uncertain information. The IND...

Mortality from non-communicable diseases (NCDs) is a major global issue, as other categories of mortality have diminished and life expectancy has increased. The World Health Organization's Member States have called for a 25% reduction in premature NCD mortality by 2025, which can only be achieved by substantial reductions in risk factors and improv...

Nearly all of the global population growth in the next three decades will occur in urban areas, and the growth in Bangladesh’s urban population is set to outstrip by a wide margin that in rural areas. This rapid urban growth, including the slum settlements, already taken place in the recent decades demonstrates that slums will likely be an increasi...

Background The health system of Bangladesh is haunted by challenges of accessibility and affordability. Despite impressive gains in many health indicators, recent evidence has raised concerns regarding the utilization, quality and equity of healthcare. In the context of new and unfamiliar public health challenges including high population density a...

Background Evidence from numerous studies suggests that salt intake is an important determinant of elevated blood pressure. Robust data about salt consumption among adults in Bangladesh is sparse. However, much evidence suggests saline intrusion due to sea level rise as a result of climate change exposes more than 20 million people to adverse effec...

Recent disasters caused by human negligence have gained widespread global attention. The devastating Savar building collapse in Bangladesh in April 2013 has been described as the deadliest industrial accident and worst structural failure in modern human history after 9/11, highlighting the need for significant policy changes to improve the health,...

Crude rates such as the crude death rate are functions of both the age-specific rates and the age composition of a population. However, differences in the age structure between two populations or two time periods can result in specious differences in the corresponding crude rates making direct comparisons between populations or across time inapprop...

IDS is a charitable company limited by guarantee and registered in England (No. 877338). The IDS programme on Strengthening Evidence-based Policy works across seven key themes. Each theme works with partner institutions to co-construct policy-relevant knowledge and engage in policy-influencing processes. This material has been developed under the H...

Arsenic in drinking water causes increased coronary artery disease (CAD) and death from CAD, but its association with stroke is not known. Prospective cohort study with arsenic exposure measured in well water at baseline. 61074 men and women aged 18 years or older on January 2003 were enrolled in 2003. The cohort was actively followed for an averag...

With regards to children who are born shortly before their mother's death (index), the cumulative proportion of survival up to 60 months of age was significantly lower (0.39 vs. 0.81) than those born just before the last child (penultimate) of the same mother. Such a difference is mainly due to high mortality in the first six months of age. Over th...

Background: Childhood mortality, particularly in the first 5 years of life, is a major global concern and the target of Millennium Development Goal 4. Although the majority of childhood deaths occur in Africa and Asia, these are also the regions where such deaths are least likely to be registered. The INDEPTH Network works to alleviate this problem...

Background: As the HIV/AIDS pandemic has evolved over recent decades, Africa has been the most affected region, even though a large proportion of HIV/AIDS deaths have not been documented at the individual level. Systematic application of verbal autopsy (VA) methods in defined populations provides an opportunity to assess the mortality burden of the...

Background: As the HIV/AIDS pandemic has evolved over recent decades, Africa has been the most affected region, even though a large proportion of HIV/AIDS deaths have not been documented at the individual level. Systematic application of verbal autopsy (VA) methods in defined populations provides an opportunity to assess the mortality burden of the...

Bangladesh, the eighth most populous country in the world with about 153 million people, has recently been applauded as an exceptional health performer. In the first paper in this Series, we present evidence to show that Bangladesh has achieved substantial health advances, but the country's success cannot be captured simplistically because health i...

Introduction: Bangladesh has started her transition towards universal health coverage along with the rest of the world. Considering the evidences, health insurance is being suggested as the vehicle to achieve it. However the country lacks in appropriate efforts of health risk pooling with commercial design for long term sustainability. This paper c...

Health is a core aspect of human security. Meanwhile human security is considered to reduce disaster risk. However, despite this logically derived association, we could find no studies that provide evidence of how people residing in the world's most environmentally at risk locations view health as a defence against disasters. This article therefore...

Arsenic in drinking water was associated with increased risk of all-cause, cancer, and cardiovascular death in adults. However, the extent to which exposure is related to all-cause and deaths from cancer and cardiovascular condition in young age is unknown. Therefore, we prospectively assessed whether long-term and recent arsenic exposures are asso...

Selected characteristics of childhood cardiovascular and cancer death participants in relation to baseline arsenic exposure. (DOC)

Cumulative survival function of all-cause, cancer and cardiovascular related mortality in childhood participants’ mortality plotted against time for time-weighted lifetime average (average) and cumulative arsenic exposure categories. (TIF)

Causes of child and adolescent mortality in relation with different exposures. (DOCX)

Comparison of the distribution of included mortality cases and survivors, as well as loss to follow-up cases. (DOCX)

Objective: This study was conducted to measure the impact of a hygiene intervention on the contamination of weaning food in Bangladesh. Methods: Sixty households were selected: 30 study and 30 control households. Samples of weaning food were collected from all the 60 households at baseline and examined for faecal coliforms (FC), faecal streptoco...

Over the past few decades, there has been increasing attention focused on the ethics of health research, particularly in low- and middle-income countries. Despite the increasing focus on the literature addressing human protection, community engagement, appropriate consent procedures and ways to mitigate concerns around exploitation, there has been...