Women's Health Commons^™

Improving Acceptability, Use, And Continuation Of Iud In Bangladesh, Sharif M.I. Hossain, Abdullah Al Mahmud Shohag, Zakaria Hossain, Shongkour Roy, Ubaidur Rob

Sexual and Reproductive Health, Rights, and Choices

Although the nonhormonal copper intra-uterine device (IUD) is the safest and cheapest long-acting contraceptive method, its use has been declining day-by-day in Bangladesh. Less than 1% of married women 15-49 years of age who currently use a contraceptive method use an IUD. Researchers conducted a quasi-experimental pre-post-test non-equivalent control group designed study to test a simple intervention intended to increase acceptance, use, and continuation of the IUD among married women of reproductive age (18 to 45 years) in Keraniganj, Savar, and Nawabganj Upazilas (sub-districts) in Bangladesh. The study was conducted in a real-life situation of Union Health and Family Welfare …

Understanding Fertility Behavior Of The Forcibly Displaced Myanmar Nationals In Bangladesh: A Qualitative Study, Md Anwer Hossain, Mohammad Bellal Hossain

Faculty, Staff and Student Publications

INTRODUCTION: Rohingya- the Forcibly Displaced Myanmar Nationals (FDMN)- are largely characterized by a high total fertility rate (TFR) and a low contraceptive prevalence rate. This study aimed to explore the reasons behind their high fertility behavior by utilizing the Theory of Planned Behavior.

DATA AND METHOD: We adopted a cross-sectional qualitative research approach. Fifteen semi-structured, face-to-face in-depth interviews were conducted with the Rohingya husbands, wives, and community leaders (Majhi and Imam/Khatib) living in Camps 1 and 2 of Ukhiya Refugee Camp, Cox's Bazar, Bangladesh. We analyzed the qualitative data using the thematic analysis approach.

RESULTS: The Muslim-majority FDMN predominantly constructed …

The Community Health System In Bangladesh: An Overview, Frontline Health Project

Reproductive Health

This brief provides an overview of the community health system in Bangladesh. Bangladesh is divided into eight administrative divisions, 64 districts, and 545 subdistricts, known as upazilas. Each rural area within an upazila is divided into union parishads and mouzas, which are further divided into villages. The Ministry of Health and Family Welfare has an extensive health infrastructure that is pluralistic and follows the country’s administrative pattern. Union parishads are the smallest administrative unit in rural areas. At the lowest administrative level, traditional healers, nonqualified allopathic practitioners, and community health workers (CHWs) are typically the only providers available. This brief …

Effects Of Son Preference On Contraceptive Use In Bangladesh, Mohammad Nazmul Hoq

Kesmas

Son preference resulting from traditional beliefs, social customs and economic benefits including support of aging parents is widespread not only in Bangladesh but also in many Asian and African countries, which are believed for low levels of contraceptive use. To carry out the research task effectively and efficiently, the research work extracted 16,858 currently married women aged 15-49 out of 17,863 ever-married women from a nationally representative 2014 Bangladesh Demographic and Health Survey Data (BDHS, 2014) set. Levels of contraceptive prevalence rate of the respondents having only daughters is found only 48.4, which is remarkably lower than the national average …

Hypertensive Disorders In Pregnancy: Assessing Postnatal Quality Of Care And Outcomes For Women And Their Infants In Bangladesh, Sharif M.I. Hossain, Kanij Sultana, Salma Rouf, Rabeya Akter, Shongkour Roy, Sumaiya Anwar, Karen Kirk, Charlotte E. Warren

Reproductive Health

Hypertensive disorders in pregnancy (HDPs) are the second leading cause of maternal mortality in Bangladesh, responsible for 24 percent of maternal deaths. Various factors, such as lack of health-care provider capacities for detecting, preventing, and managing pre-eclampsia and eclampsia (PE/E), late referrals, late (or lack of) antenatal care (ANC), and poor awareness of PE/E, are factors in most of these deaths. While some information was available on the prenatal and postnatal periods, an evidence gap existed in information after delivery through the first year postnatal, and beyond. In this prospective cohort study, the Ending Eclampsia project recruited married women ages …

Assessing The Feasibility Of Primary Health Care Provider Prescription Of Anti-Hypertensive Medication To Pregnant Women In Bangladesh, Sharif M.I. Hossain, Kanij Sultana, Shongkour Roy, Pooja Sripad, Charlotte E. Warren

Reproductive Health

Hypertensive disorders of pregnancy (HDPs)—which are major contributors of maternal and newborn mortality, morbidity, and disability—are preventable. About 24 percent of maternal deaths in Bangladesh each year are due to pre-eclampsia and eclampsia (PE/E). A known cause of death in women with PE/E is cerebrovascular accident, which occurs due to rapidly increasing blood pressure (BP). Elevated BP associated with pregnancy should be detected and appropriately managed before onset of convulsions (eclampsia) and other life-threatening complications. For women presenting with severe PE/E, magnesium sulphate (MgSO4) is the recommended drug for convulsion management. Anti-hypertensive medicines are also recommended for control of high …

Expanding Access To Family Planning For Married Adolescent Girls In The Urban Slums Of Dhaka, Fauzia Akhter Huda, Nancy Termini Lachance

Reproductive Health

Early pregnancy is associated with adverse health, social, and economic consequences for girls, and Bangladesh has an adolescent fertility rate that is among the highest in the region. Poor, slum-dwelling girls are especially vulnerable. This policy brief outlines a project that icddr,b, a STEP UP project partner, initiated to test three innovative strategies aiming to support the unmet family planning needs of these girls. This brief concludes with government-level policy and program recommendations based on the evidence of this project for leveraging existing government health programs to better serve the needs of married adolescent girls and reduce their risks of …

Expanding Access To Integrated Family Planning Intervention Packages For Married Adolescent Girls In Urban Slums Of Dhaka, Bangladesh, Fauzia Akhter Huda, Hassan Rushekh Mahmood, Sadia Afrin, Anisuddin Ahmed, Nafis Al Haque, Bidhan Krishna Sarker

Reproductive Health

This research report describes an intervention study conducted among married adolescent girls aged 15–19 years in four urban slums of Dhaka, Bangladesh. Objectives of the study were to examine the acceptability and feasibility of forming married adolescent girls’ clubs, and involving community health volunteers (Shasthya Skebikas) and marriage registrars to increase access to family planning (FP) information and services, to promote the uptake of long-acting reversible contraceptive methods, and to provide FP information to newlywed couples at the time of marriage registration. The study findings revealed that a noteworthy number of married adolescent girls received FP-related information, mostly from the …

Bangladesh: Using Strong Evidence And Strategic Collaboration To Increase Access To Menstrual Regulation With Medication, Nancy Termini Lachance, Sharif M.I. Hossain

Reproductive Health

Through close cooperation with the Ministry of Health and Family Welfare of Bangladesh, and other partners, STEP UP generated strong evidence and cultivated ongoing collaboration that contributed to policy changes and program expansions to increase access to menstrual regulation with medication (MRM). Study results demonstrate that MRM is acceptable and effective in Bangladesh, and has thus been legalized and folded into the national FP program and scaled up nationwide. However, ongoing observation and studies are still needed to understand whether the efficacy and acceptability of MRM remains the case when services are delivered at scale on a national level. Furthermore, …

Introduction And Approval Of Menstrual Regulation With Medication In Bangladesh: A Stakeholder Analysis, Fauzia Akhter Huda, Sadia Afrin, Bidhan Krishna Sarker, Hassan Rushekh Mahmood, Anadil Alam

Reproductive Health

Despite the significant progress that the government of Bangladesh has made toward introducing menstrual regulation with medication (MRM) into the national health program, there has been no systematic documentation on the introduction of MRM in Bangladesh, and on the approval process of local manufacturing of the mifepristone-misoprostol combination for menstrual regulation. This Research Report presents findings from the stakeholder analysis which was initiated to document the entire process of introducing MRM in the country. Findings from key informant interviews indicated some crucial factors that facilitated the process; these are presented here according to a four-part policy analysis framework: context, content, …

Women's Perceptions And Experiences Of Family Planning By Contraceptive Methods In Kenya And Bangladesh: Preliminary Results, Kazuyo Machiyama, Joyce Mumah, Caroline W. Kabiru, George Odwe, Francis Obare, Fauzia Akhter Huda, John C. Cleland, John B. Casterline

Reproductive Health

No abstract provided.

Reasons For Unmet Need For Family Planning, With Attention To The Measurement Of Fertility Preferences In Kenya And Bangladesh, Joyce Mumah, Kazuyo Machiyama, Caroline W. Kabiru, George Odwe, Francis Obare, Fauzia Akhter Huda, John B. Casterline, John C. Cleland

Reproductive Health

No abstract provided.

A Systematic Review Of The Treatment And Management Of Pre-Eclampsia And Eclampsia In Bangladesh, Karen Kirk, Amy Dempsey

Reproductive Health

By 2015, at the conclusion of the Millennium Development Goals, Bangladesh had achieved a reduction in maternal deaths, however, despite the progress, there are still between 5,000 and 6,000 maternal deaths every year, with 20 percent the result of pre-eclampsia and eclampsia (PE/E). To fully understand the key challenges, gaps, and interventions related to the prevention and treatment of PE/E at the national level, Ending Eclampsia conducted a systematic review of papers in Bangladesh published between 2000 and 2015 specifically looking at issues around the quality of care, gaps in the evidence, and barriers to accessing PE/E services. The main …

Adolescent Friendly Health Corners (Afhcs) In Selected Government Health Facilities In Bangladesh: An Early Qualitative Assessment, Sigma Ainul, Iqbal Ehsan, Tasmiah Tanjeen, Laura Reichenbach

Reproductive Health

With high rates of early marriage, especially among girls, a significant proportion of adolescents in Bangladesh need sexual and reproductive health services (SRH), including contraceptive information. To address this gap and ensure that adolescents throughout the country, including unmarried adolescents, have access to SRH services through public health facilities, the Maternal and Child Health Services Unit of the Directorate General of Family Planning, with financial and technical assistance from development partners, has begun establishing Adolescent Friendly Health Corners (AFHCs) at selected government facilities at district and union levels. The Evidence Project/Population Council was asked to assess the implementation of the …

Evaluation Of The Effectiveness Of The Herhealth Model For Improving Sexual And Reproductive Health And Rights Knowledge And Access Of Female Garment Factory Workers In Bangladesh, Md. Irfan Hossain, Abdullah Al Mahmud Shohag, Ashish Bajracharya, Ubaidur Rob, Laura Reichenbach

Reproductive Health

The Population Council, under its USAID-funded Evidence Project, partnered with Bangladesh’s Business for Social Responsibility program to conduct operational research to evaluate the effectiveness of the HERhealth model for improving female factory workers’ health, and to find ways to optimize program inputs and processes to support future scale-up of the intervention. This report presents findings from a pre- and post-intervention quantitative study of female factory workers from 10 factories; a qualitative study with factory managers, service providers, and implementing partners; and self-administered retention assessments of the Peer Health Educators from six factories in Dhaka, Gazipur, and Narayanganj districts. Findings from …

Evaluation Of The Herhealth Intervention In Bangladesh: Baseline Findings From An Implementation Research Study, Md. Irfan Hossain, Abdullah Al Mahmud Shohag, Ashish Bajracharya, Ubaidur Rob, Laura Reichenbach

Reproductive Health

The Business for Social Responsibility's (BSR) HERproject is a collaborative initiative that strives to empower low-income women working in global supply chains in 14 countries worldwide. One of the HERproject’s three pillars is HERhealth, which seeks to improve the health-related knowledge and behaviors, and access to health services and products, of low-income working women. In Bangladesh, HERhealth specifically addresses reproductive health and family planning needs. BSR asked the Evidence Project/Population Council to conduct an implementation science study assessing the effectiveness of BSR’s HERhealth model in Bangladesh. This study is one of the first studies of female garment workers in Dhaka …

Policies For Pre-Eclampsia And Eclampsia Prevention And Management In Bangladesh, Kanij Sultana, Amy Dempsey

Reproductive Health

Bangladesh experiences between 5,000 and 6,000 maternal deaths each year. Of those deaths, 20 percent are from pre-eclampsia and eclampsia (PE/E), the second most common direct cause of maternal mortality in the country. In Bangladesh, best practices to prevent PE/E using aspirin and calcium and managing it through task sharing and use of magnesium sulphate and anti-hypertensive drugs have not been optimally examined. To appreciate the enormity of the problem, the Population Council conducted a landscape analysis in 12 upazilas in four districts. The study was cross sectional, and data collection activities included in-depth interviews (IDIs) with policymakers, development partners, …

Results From Systematic Literature Review On Pe/E In Bangladesh, Karen Kirk, Amy Dempsey

Reproductive Health

By 2015, at the conclusion of the Millennium Development Goals, Bangladesh had achieved a reduction in maternal death from 550 per 100,000 live births in 1990, to 170 maternal deaths per 100,000 live births in 2015. Despite this progress, there are still between 5,000 and 6,000 maternal deaths every year in Bangladesh, where 20 percent are the result of pre-eclampsia and eclampsia (PE/E). This systematic review of peer-reviewed literature published between January 2000 and July 2016 identified interventions adopted to manage PE/E throughout Bangladesh. Specifically, it looked at issues around quality of care, gaps in the evidence, and barriers to …

Diagnostic Methods To Determine Microbiology Of Postpartum Endometritis In South Asia: Laboratory Methods Protocol Used In The Postpartum Sepsis Study: A Prospective Cohort Study, Sadia Shakoor, Megan E. Reller, Amnesty Lefevre, Aneeta Hotwani, Shahida M. Qureshi, Farheen Yousuf, Mohammad Shahidul Islam, Nicholas Connor, Iftekhar Rafiqullah, Fatima Mir

Department of Paediatrics and Child Health

Background: The South Asian region has the second highest risk of maternal death in the world. To prevent maternal deaths due to sepsis and to decrease the maternal mortality ratio as per the World Health Organization Millenium Development Goals, a better understanding of the etiology of endometritis and related sepsis is required. We describe microbiological laboratory methods used in the maternal Postpartum Sepsis Study, which was conducted in Bangladesh and Pakistan, two populous countries in South Asia.
Methods/Design: Postpartum maternal fever in the community was evaluated by a physician and blood and urine were collected for routine analysis and culture. …

Assessing Maternal And Newborn Health Commodities In Bangladesh, Population Council

Reproductive Health

The UN Commission on Life-Saving Commodities for Women and Children aims to increase access to 13 commodities in 50 countries. As part of this global effort, the Population Council conducted a landscape analysis in Bangladesh to review policies, guidelines, availability, and use of these commodities. The landscaping exercise had two objectives: 1) to provide a comprehensive description of maternal and newborn health (MNH) commodity issues from policy to point of care; and 2) to engage stakeholders in rolling out the UN Commission recommendations. Based on its findings the analysis recommends: stronger advocacy with pharmaceutical companies to manufacture a single loading …

Adolescents In Bangladesh: Programmatic Approaches To Sexual And Reproductive Health Education And Services, Sigma Ainul, Ashish Bajracharya, Laura Reichenbach

Reproductive Health

There is a gap in knowledge and understanding of effective adolescent sexual and reproductive health (ASRH) programming in Bangladesh, especially programming at scale. Initiatives to address ASRH have been implemented at different times by both the Government of Bangladesh and NGOs, but these activities have often been fragmented and are not well documented or evaluated, making it difficult to know what worked well and what did not. This policy brief presents selected findings from a comprehensive review and analysis of ASRH programming in Bangladesh, carried out by the Population Council’s Evidence Project, with financial support from USAID/Bangladesh, as part of …

A Model For Providing 24-Hour Normal Delivery Services At Union Health And Family Welfare Centers In Bangladesh, Md. Noorunnabi Talukder, Ubaidur Rob, A.K.M. Zafar Ullah Khan, Forhana Rahman Noor, Afsana Fatema Noor

Reproductive Health

In rural areas of Bangladesh, emergency obstetric care services are available at the upazila level and above. At lower levels, Union Health and Family Welfare Centers (UHFWCs) located in the proximity of women’s homes provide normal delivery services. Recently, the Directorate General of Family Planning (DGFP) undertook an initiative to provide 24-hour normal delivery services in newly upgraded UHFWCs. The Population Council, with financial support from UKaid is providing technical assistance to the DGFP to implement an operations research study to test the effectiveness of this model. This brief presents an overview of the project, describes the implementation of project …

Burundi Program Implementation Workshop, 3–5 June 2014: Link Up Meeting Report, Population Council, Alliance Burundaise Contre Le Sida

HIV and AIDS

Link Up is a global consortium of international and local nongovernmental organizations led by the International HIV/AIDS Alliance. Link Up aimed to improve the sexual and reproductive health and rights of young people in Bangladesh, Burundi, Ethiopia, Myanmar, and Uganda who are living with HIV or are affected by the HIV pandemic. At a workshop held in Burundi, 3–5 June 2014, the Population Council, Alliance Burundaise contre le SIDA, and local partners in Burundi identified successful activities, highlighted important challenges and best practices, and found innovative ways to improve Link Up programming. This document contains a selection of the most …

Sexual And Reproductive Health Among Young Female Sex Workers In Bangladesh Brothels—Baseline Findings From Link Up, Population Council

HIV and AIDS

Link Up is a global consortium of international and local nongovernmental organizations led by the International HIV/AIDS Alliance. Link Up aimed to improve the sexual and reproductive health and rights of young people in Bangladesh, Burundi, Ethiopia, Myanmar, and Uganda who are living with HIV or are affected by the HIV pandemic. Consortium members PIACT Bangladesh and Marie Stopes Bangladesh implemented a brothel-based program for female sex workers to address sexual and reproductive health and rights. Working in eight brothels in seven districts, trained female sex worker peer educators provided face-to-face education, including referrals to on-site and off-site health care …

Understanding Factors Influencing Adverse Sex Ratios At Birth In Bangladesh, Md. Noorunnabi Talukder, Ubaidur Rob, Md. Irfan Hossain, Forhana Rahman Noor

Poverty, Gender, and Youth

Nationally, the sex ratio at birth has persisted at its natural level of 105 male per 100 female newborns for the past half century in Bangladesh. However, at the regional level, Bangladesh is characterized by an east-west divide in sex ratios at birth. While the western region shows normal sex ratios at birth, the eastern region displays distorted sex ratios. To understand the factors that contribute to regional variations, a household survey was conducted among married women aged 18–49 years who had at least two living children. Views of health-care providers on gender-biased sex selection and of program implementers on …

Gender-Biased Sex Selection In South Asia: The Situation And Promising Approaches To Restore Balance, Population Council

Poverty, Gender, and Youth

This project summary indicates that sex ratios at birth in South Asia vary considerably. While the sex ratios at birth in Bangladesh and Pakistan have been normal at the country level (103 and 102.5 males per 100 females, respectively), Nepal is showing signs of disturbed sex ratios at birth, with a sex ratio of 106 males per 100 females, and the situation in India is particularly adverse, with a sex ratio at birth of 110 males per 100 females. In all of these countries, preconditions for a deterioration of the sex ratio at birth are evident. Preferences are expressed for …

Union Health And Family Welfare Centers In Chittagong And Munshiganj: Are They Ready To Provide 24-Hour Normal Delivery Services? (Brief), Population Council

Reproductive Health

To date, the Directorate General of Family Planning (DGFP) of Bangladesh’s Ministry of Health and Family Welfare has established approximately 3,900 Union Health and Family Welfare Centers (UHFWCs) in rural areas providing: family planning; menstrual regulation; vaccinations; and general, reproductive, and maternal health services six days a week. About 1,500 UHFWCs have been upgraded with the necessary staff and equipment to provide normal delivery services round-the-clock in rural areas. In rural areas, public-sector health facilities, including UHFWCs, contribute to only 12 percent of institutional deliveries. Until now, Family Welfare Visitors (FWVs) posted at UHFWCs performed only 0.3 percent of deliveries. …

Union Health And Family Welfare Centers In Chittagong And Munshiganj: Are They Ready To Provide 24-Hour Normal Delivery Services?, Md. Noorunnabi Talukder, Ubaidur Rob, A.K.M. Zafar Ullah Khan, Forhana Rahman Noor, Shongkour Roy, Afsana Fatema Noor

Reproductive Health

To date, the Directorate General of Family Planning (DGFP) of Bangladesh’s Ministry of Health and Family Welfare has established approximately 3,900 Union Health and Family Welfare Centers (UHFWCs) in rural areas providing: family planning; menstrual regulation; vaccinations; and general, reproductive, and maternal health services six days a week. About 1,500 UHFWCs have been upgraded with the necessary staff and equipment to provide normal delivery services round-the-clock in rural areas. Yet, Family Welfare Visitors (FWVs) posted at UHFWCs perform only 0.3 percent of deliveries. This means that UHFWCs and FWVs are not optimally utilized to increase the rate of institutional deliveries. …

Emerging Priorities In Reproductive, Maternal, And Newborn Health, Population Council

Reproductive Health

The Population Council’s Ending Eclampsia project seeks to expand access to proven, underutilized interventions and commodities for the prevention, early detection, and treatment of pre-eclampsia and eclampsia (PE/E) and to strengthen global partnerships. Ending Eclampsia is working in Nigeria and Bangladesh to assess the level of program activities, gaps, and challenges around prevention and treatment of PE/E and magnesium sulfate (MgSO4). The project will build upon this landscape analysis to expand services to detect and manage PE/E, develop and support implementation of strategic plans for replicating the intervention package, and increase global PE/E evidence shared through knowledge and learning platforms. …

Balika Fact Sheet: Highlight On Livelihoods, Population Council

Poverty, Gender, and Youth

There are few income-earning opportunities for adolescent girls in the Bangladeshi Association for Life Skills, Income, and Knowledge for Adolescents (BALIKA) study area, and livelihoods opportunities vary considerably by economic status and education. The ability to acquire livelihood-relevant skills, networks, and work experience during adolescence can be an important predictor of productive capacity later in life. However, across the study districts, the proportion of adolescent girls who are working is low. Most girls work as tutors or are engaged in the agricultural and poultry sector. Better-educated girls are more likely to be engaged in paid work. This BALIKA “Highlight on …