Taposh Biswas - Academia.edu (original) (raw)

Papers by Taposh Biswas

Research paper thumbnail of A newly developed tool for measuring the availability of human resources for emergency obstetric and newborn care services: prospective analytic study in two district-level public facilities in Bangladesh

Background: In Bangladesh, while the infrastructure of public health facilities to provide matern... more Background: In Bangladesh, while the infrastructure of public health facilities to provide maternal and newborn care services is adequate, services are not always available due to insufficient staffing. A human resource availability index for health facilities is needed for monitoring and advocacy. This study aimed to develop indices for measuring the availability of different types of human resources to provide round-the-clock emergency obstetric and newborn care (EmONC) service at district-level public facilities. Methods: As part of a larger intervention study, 30 days of prospective observation of providers was done at a district hospital (DH) and a mother and child welfare centre (MCWC) in one district of Bangladesh using checklists. A scoring system was developed to create an index to quantify the availability of providers for maternal and newborn care. Results: Based on the newly developed index, medical doctors in the emergency department of the DH were 100% available, but ranged from 27 to 41% availability in the obstetrics/gynecology (ob/gyn) and pediatric wards. In MCWC, the corresponding indices ranged from 32 to 36%. In the DH, the availability of nurses in the ob/gyn ward (96%) was relatively better than in the pediatric ward (65%) but that in operation theatre was only 31%. In the MCWC, the index for the presence of a paramedic or nursing aid was 82% in the ob/gyn ward and 63% in the operation theatre. However, the availability scores of facility support staff for maintenance and security were generally high (over 90%) in both facilities. Conclusions: Our newly developed index on availability of providers demonstrated huge gaps in availability of providers in evening and night shifts in most of the disciplines in the study facilities. This provider availability index is easy to create and can be used as a meaningful tool to quantify gaps in human resources by type in various types of district-level health facilities. Further studies are needed for adaptation of this tool in different types of health facilities and to assess its implication as an advocacy tool.

Research paper thumbnail of Medical Waste Management: An Assessment of District-Level Public Health Facilities in Bangladesh

Cureus

Background Due to the huge patient load and different types of services, public health facilities... more Background Due to the huge patient load and different types of services, public health facilities produce a bulk of medical waste (MW) in Bangladesh. Improper disposal of MW increases the risk of infection among healthcare service personnel, patients, and attendants. To ensure quality services, this study aimed to assess the practices of MW management and quantify those to find out the shortcomings in the specific steps of waste management. Methodology As part of a larger interventional study, a facility assessment was conducted from February to April 2016 at a District Hospital (DH) and a Mother and Child Welfare Centre (MCWC) in one district. Non-participatory observation of MW management was done using a checklist that was developed following the Guideline for Medical Waste Management of Bangladesh. Scoring was applied for various activities of MW management performed in the study facilities. Results The overall scores for bin management, segregation, and collection of waste were 64.5%, 58.1%, and 62.0% in DH and 53.1%, 41.5%, and 48.0% in MCWC, respectively. The performance of operation theater in MCWC was the lowest among different corners (16.7% to 36.0%). Reusable waste was segregated poorly (32% in DH and 0% in MCWC), and almost none was shredded (4% in DH and 0% in MCWC). Waste was transported from in-house to out-house temporary storage area in an open bin without any trolley or specific route. The storage area was accessible to unauthorized persons, for example, a waste picker in DH. While DH segregated 84% of its infectious waste at the source, it eventually got mixed up with other waste in the storage area and delivered to the municipality to be dumped. MCWC could segregate only 40% of its infectious waste at the source and disposed of them using the pit method. Both the facilities disposed of sharp MW by open-air burning and liquid waste through sewerage without any treatment. Conclusions The performance of MW management was poor in both study facilities. Advocacy to the healthcare personnel and refresher training along with supportive supervision and monitoring may improve the situation. Moreover, a larger study is needed to find out the reasons behind such poor MW management.

Research paper thumbnail of Medical Waste Management: An Assessment at District-Level Public Health Facilities in Bangladesh

Background Due to the heavy patient-load and various types of services, the public health facilit... more Background Due to the heavy patient-load and various types of services, the public health facilities produce a bulk of medical wastes (MW) in Bangladesh. Improper disposal of MW increases the risk of infection among the healthcare service personnel, patients, and attendants. The current study aimed to assess the practices of MW management and quantify those to find out the gaps in the specific steps of waste management.Methods As part of a larger intervention study, a facility assessment was conducted during November 2015 to March 2016 at a District Hospital (DH) and a Mother and Child Welfare Centre (MCWC) both being located in the same district, Non-participatory observation of MW management was done using a checklist developed following the Guideline for Medical Waste Management of Bangladesh. Scoring was applied for various activities of MW management performed in the study facilities.Results The overall scores in bin management, segregation, and collection of wastes were 64.5%,...

Research paper thumbnail of MOESM7 of Quality of maternal and newborn healthcare services in two public hospitals of Bangladesh: identifying gaps and provisions for improvement

Additional file 7. Checklist_PNC.doc (PNC checklist).

Research paper thumbnail of MOESM8 of Quality of maternal and newborn healthcare services in two public hospitals of Bangladesh: identifying gaps and provisions for improvement

Additional file 8. Checklist_Sick Newborn Care.docx (Sick newborn care checklist).

Research paper thumbnail of MOESM6 of Quality of maternal and newborn healthcare services in two public hospitals of Bangladesh: identifying gaps and provisions for improvement

Additional file 6. Checklist_Management of Maternal Complications.docx (Maternal complications ma... more Additional file 6. Checklist_Management of Maternal Complications.docx (Maternal complications management checklist).

Research paper thumbnail of MOESM5 of Quality of maternal and newborn healthcare services in two public hospitals of Bangladesh: identifying gaps and provisions for improvement

Additional file 5. Checklist_Infection Orevention.doc (Infection prevention checklist).

Research paper thumbnail of MOESM1 of Quality of maternal and newborn healthcare services in two public hospitals of Bangladesh: identifying gaps and provisions for improvement

Additional file 1. Checklist _Normal Vaginal Delivery.doc (Nomal delivery checklist).

Research paper thumbnail of MOESM3 of Quality of maternal and newborn healthcare services in two public hospitals of Bangladesh: identifying gaps and provisions for improvement

Additional file 3. Checklist_Blood Transfustion.docx (Blood transfussion checklist).

Research paper thumbnail of MOESM2 of Quality of maternal and newborn healthcare services in two public hospitals of Bangladesh: identifying gaps and provisions for improvement

Additional file 2. Checklist_ANC.docx (ANC Checklist).

Research paper thumbnail of Pathways into homelessness and problems of homeless people in Dhaka city

Research paper thumbnail of MOESM4 of Quality of maternal and newborn healthcare services in two public hospitals of Bangladesh: identifying gaps and provisions for improvement

Additional file 4. Checklist_Caesarean Section Delivery.doc (Cesarean delivery checklist).

Research paper thumbnail of Mental Healthcare-Seeking Behavior during The Perinatal Period among Rural Women in Bangladesh

Introduction: Mental health conditions are of rising concern due to their increased contribution ... more Introduction: Mental health conditions are of rising concern due to their increased contribution to the global burden of disease. Mental health issues are inextricably linked with other sociocultural and health dimensions, especially in the rural areas in developing countries. The complex relationship between mental health issues and sociocultural settings may largely toll upon the healthcare-seeking behavior. Evidence suggests that mental illness affects more than 10% of women and one year after childbirth. So, it urges to document the current status of mental healthcare-seeking behavior during the perinatal period among rural women in Bangladesh to develop a context-specific intervention in the future.Methods: This study was carried out in one sub-district in Bangladesh from April 2017 to June 2018. We conducted 21 In-depth Interviews and seven Focus Group Discussions with different groups of purposively selected participants such as perinatal women, head of the family, community ...

Research paper thumbnail of Quality of maternal and newborn healthcare services in two public hospitals of Bangladesh: identifying gaps and provisions for improvement

BMC Pregnancy and Childbirth

Background Healthcare service delivery systems need to ensure standard quality of care (QoC) for ... more Background Healthcare service delivery systems need to ensure standard quality of care (QoC) for achieving expected health outcomes. Although Bangladesh has a good healthcare service delivery system, there are major concerns about the quality of maternal and newborn health (MNH) care services, which is imperative for achievements in health. The study aimed to measure the QoC for different MNH services in two selected public health facilities of Bangladesh. This study also documented the specific areas of each care which needs intervention. Methods The study was conducted in two district-level public health facilities—a district hospital (DH) and a mother and child welfare centre (MCWC). A total of 228 cases of MNH services were observed by using contextualized checklist ‘Standards-based Management and Recognition (S-BMR)’ for 8 selected MNH care services. For scoring, performed activities were calculated as percentages of the total recommended activities and categorized as high (&gt...

Research paper thumbnail of A newly developed tool for measuring the availability of human resources for emergency obstetric and newborn care services: prospective analytic study in two district-level public facilities in Bangladesh

BMC health services research, Jan 4, 2018

In Bangladesh, while the infrastructure of public health facilities to provide maternal and newbo... more In Bangladesh, while the infrastructure of public health facilities to provide maternal and newborn care services is adequate, services are not always available due to insufficient staffing. A human resource availability index for health facilities is needed for monitoring and advocacy. This study aimed to develop indices for measuring the availability of different types of human resources to provide round-the-clock emergency obstetric and newborn care (EmONC) service at district-level public facilities. As part of a larger intervention study, 30 days of prospective observation of providers was done at a district hospital (DH) and a mother and child welfare centre (MCWC) in one district of Bangladesh using checklists. A scoring system was developed to create an index to quantify the availability of providers for maternal and newborn care. Based on the newly developed index, medical doctors in the emergency department of the DH were 100% available, but ranged from 27 to 41% availabil...

Research paper thumbnail of Emergency obstetric and newborn care signal functions in public and private facilities in Bangladesh

PloS one, 2017

Signal functions for emergency obstetric and newborn care (EmONC) are the major interventions for... more Signal functions for emergency obstetric and newborn care (EmONC) are the major interventions for averting maternal and neonatal mortalities. Readiness of the facilities is essential to provide all the basic and comprehensive signal functions for EmONC to ensure emergency services from the designated facilities. The study assessed population coverage and availability of EmONC services in public and private facilities in Bangladesh. An assessment was conducted in all the public and private facilities providing obstetric care in to in-patients 24 districts. Data were collected on the performance of signal functions for EmONC from the study facilities in the last three months prior to the date of assessment. Trained data-collectors interviewed the facility managers and key service providers, along with review of records, using contextualized tools. Population coverage of signal functions was assessed by estimating the number of facilities providing the signal functions for EmONC compar...

Research paper thumbnail of Use of a geographic information system to assess accessibility to health facilities providing emergency obstetric and newborn care in Bangladesh

International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics, Jan 28, 2017

To use a geographic information system (GIS) to determine accessibility to health facilities for ... more To use a geographic information system (GIS) to determine accessibility to health facilities for emergency obstetric and newborn care (EmONC) and compare coverage with that stipulated by UN guidelines (5 EmONC facilities per 500 000 individuals, ≥1 comprehensive). A cross-sectional study was undertaken of all public facilities providing EmONC in 24 districts of Bangladesh from March to October 2012. Accessibility to each facility was assessed by applying GIS to estimate the proportion of catchment population (comprehensive 500 000; basic 100 000) able to reach the nearest facility within 2 hours and 1 hour of travel time, respectively, by existing road networks. The minimum number of public facilities providing comprehensive and basic EmONC services (1 and 5 per 500 000 individuals, respectively) was reached in 16 and 3 districts, respectively. However, after applying GIS, in no district did 100% of the catchment population have access to these services. A minimum of 75% and 50% of ...

Research paper thumbnail of Coverage of emergency obstetric care and availability of services in public and private health facilities in Bangladesh

International Journal of Gynecology & Obstetrics, 2015

To assess the coverage of emergency obstetric care (EmOC) and the availability of obstetric servi... more To assess the coverage of emergency obstetric care (EmOC) and the availability of obstetric services in Bangladesh. In a national health facility assessment performed between November 2007 and July 2008, all public EmOC facilities and private facilities providing obstetric services in the 64 districts of Bangladesh were mapped. The performance of EmOC services in these facilities during the preceding month was investigated using a semi-structured questionnaire completed through interviews of managers and service providers, and record review. In total, 8.6 (2.1 public and 6.5 private) facilities per 500000 population offered obstetric care services. Population coverage by obstetric care facilities varied by region. Among 281 public facilities designated for comprehensive EmOC, cesarean delivery was available in only 215 (76.5%) and blood transfusion services in 198 (70.5%). In the private sector (for profit and not for profit), these services were available in more than 80% of facilities. In all facility types, performance of assisted vaginal delivery (range 12.2%-48.4%) and use of parenteral anticonvulsants to treat pre-eclampsia/eclampsia (range 48.6%-80.8%) were low. The main reason for non-availability of EmOC services was a lack of specialist/trained providers. Bangladesh needs to increase the availability of EmOC services through innovative public-private partnerships. In the public sector, additional trained manpower supported by an incentivized package should be deployed.

Research paper thumbnail of Postnatal care for newborns in Bangladesh: The importance of health-related factors and location

Journal of global health, 2017

Bangladesh achieved Millennium Development Goal 4, a two thirds reduction in under-five mortality... more Bangladesh achieved Millennium Development Goal 4, a two thirds reduction in under-five mortality from 1990 to 2015. However neonatal mortality remains high, and neonatal deaths now account for 62% of under-five deaths in Bangladesh. The objective of this paper is to understand which newborns in Bangladesh are receiving postnatal care (PNC), a set of interventions with the potential to reduce neonatal mortality. Using data from the Bangladesh Maternal Mortality Survey (BMMS) 2010 we conducted logistic regression analysis to understand what socio-economic and health-related factors were associated with early postnatal care (PNC) by day 2 and PNC by day 7. Key variables studied were maternal complications (during pregnancy, delivery or after delivery) and contact with the health care system (receipt of any antenatal care, place of delivery and type of delivery attendant). Using data from the BMMS 2010 and an Emergency Obstetric and Neonatal Care (EmONC) 2012 needs assessment, we also ...

Research paper thumbnail of A newly developed tool for measuring the availability of human resources for emergency obstetric and newborn care services: prospective analytic study in two district-level public facilities in Bangladesh

Background: In Bangladesh, while the infrastructure of public health facilities to provide matern... more Background: In Bangladesh, while the infrastructure of public health facilities to provide maternal and newborn care services is adequate, services are not always available due to insufficient staffing. A human resource availability index for health facilities is needed for monitoring and advocacy. This study aimed to develop indices for measuring the availability of different types of human resources to provide round-the-clock emergency obstetric and newborn care (EmONC) service at district-level public facilities. Methods: As part of a larger intervention study, 30 days of prospective observation of providers was done at a district hospital (DH) and a mother and child welfare centre (MCWC) in one district of Bangladesh using checklists. A scoring system was developed to create an index to quantify the availability of providers for maternal and newborn care. Results: Based on the newly developed index, medical doctors in the emergency department of the DH were 100% available, but ranged from 27 to 41% availability in the obstetrics/gynecology (ob/gyn) and pediatric wards. In MCWC, the corresponding indices ranged from 32 to 36%. In the DH, the availability of nurses in the ob/gyn ward (96%) was relatively better than in the pediatric ward (65%) but that in operation theatre was only 31%. In the MCWC, the index for the presence of a paramedic or nursing aid was 82% in the ob/gyn ward and 63% in the operation theatre. However, the availability scores of facility support staff for maintenance and security were generally high (over 90%) in both facilities. Conclusions: Our newly developed index on availability of providers demonstrated huge gaps in availability of providers in evening and night shifts in most of the disciplines in the study facilities. This provider availability index is easy to create and can be used as a meaningful tool to quantify gaps in human resources by type in various types of district-level health facilities. Further studies are needed for adaptation of this tool in different types of health facilities and to assess its implication as an advocacy tool.

Research paper thumbnail of Medical Waste Management: An Assessment of District-Level Public Health Facilities in Bangladesh

Cureus

Background Due to the huge patient load and different types of services, public health facilities... more Background Due to the huge patient load and different types of services, public health facilities produce a bulk of medical waste (MW) in Bangladesh. Improper disposal of MW increases the risk of infection among healthcare service personnel, patients, and attendants. To ensure quality services, this study aimed to assess the practices of MW management and quantify those to find out the shortcomings in the specific steps of waste management. Methodology As part of a larger interventional study, a facility assessment was conducted from February to April 2016 at a District Hospital (DH) and a Mother and Child Welfare Centre (MCWC) in one district. Non-participatory observation of MW management was done using a checklist that was developed following the Guideline for Medical Waste Management of Bangladesh. Scoring was applied for various activities of MW management performed in the study facilities. Results The overall scores for bin management, segregation, and collection of waste were 64.5%, 58.1%, and 62.0% in DH and 53.1%, 41.5%, and 48.0% in MCWC, respectively. The performance of operation theater in MCWC was the lowest among different corners (16.7% to 36.0%). Reusable waste was segregated poorly (32% in DH and 0% in MCWC), and almost none was shredded (4% in DH and 0% in MCWC). Waste was transported from in-house to out-house temporary storage area in an open bin without any trolley or specific route. The storage area was accessible to unauthorized persons, for example, a waste picker in DH. While DH segregated 84% of its infectious waste at the source, it eventually got mixed up with other waste in the storage area and delivered to the municipality to be dumped. MCWC could segregate only 40% of its infectious waste at the source and disposed of them using the pit method. Both the facilities disposed of sharp MW by open-air burning and liquid waste through sewerage without any treatment. Conclusions The performance of MW management was poor in both study facilities. Advocacy to the healthcare personnel and refresher training along with supportive supervision and monitoring may improve the situation. Moreover, a larger study is needed to find out the reasons behind such poor MW management.

Research paper thumbnail of Medical Waste Management: An Assessment at District-Level Public Health Facilities in Bangladesh

Background Due to the heavy patient-load and various types of services, the public health facilit... more Background Due to the heavy patient-load and various types of services, the public health facilities produce a bulk of medical wastes (MW) in Bangladesh. Improper disposal of MW increases the risk of infection among the healthcare service personnel, patients, and attendants. The current study aimed to assess the practices of MW management and quantify those to find out the gaps in the specific steps of waste management.Methods As part of a larger intervention study, a facility assessment was conducted during November 2015 to March 2016 at a District Hospital (DH) and a Mother and Child Welfare Centre (MCWC) both being located in the same district, Non-participatory observation of MW management was done using a checklist developed following the Guideline for Medical Waste Management of Bangladesh. Scoring was applied for various activities of MW management performed in the study facilities.Results The overall scores in bin management, segregation, and collection of wastes were 64.5%,...

Research paper thumbnail of MOESM7 of Quality of maternal and newborn healthcare services in two public hospitals of Bangladesh: identifying gaps and provisions for improvement

Additional file 7. Checklist_PNC.doc (PNC checklist).

Research paper thumbnail of MOESM8 of Quality of maternal and newborn healthcare services in two public hospitals of Bangladesh: identifying gaps and provisions for improvement

Additional file 8. Checklist_Sick Newborn Care.docx (Sick newborn care checklist).

Research paper thumbnail of MOESM6 of Quality of maternal and newborn healthcare services in two public hospitals of Bangladesh: identifying gaps and provisions for improvement

Additional file 6. Checklist_Management of Maternal Complications.docx (Maternal complications ma... more Additional file 6. Checklist_Management of Maternal Complications.docx (Maternal complications management checklist).

Research paper thumbnail of MOESM5 of Quality of maternal and newborn healthcare services in two public hospitals of Bangladesh: identifying gaps and provisions for improvement

Additional file 5. Checklist_Infection Orevention.doc (Infection prevention checklist).

Research paper thumbnail of MOESM1 of Quality of maternal and newborn healthcare services in two public hospitals of Bangladesh: identifying gaps and provisions for improvement

Additional file 1. Checklist _Normal Vaginal Delivery.doc (Nomal delivery checklist).

Research paper thumbnail of MOESM3 of Quality of maternal and newborn healthcare services in two public hospitals of Bangladesh: identifying gaps and provisions for improvement

Additional file 3. Checklist_Blood Transfustion.docx (Blood transfussion checklist).

Research paper thumbnail of MOESM2 of Quality of maternal and newborn healthcare services in two public hospitals of Bangladesh: identifying gaps and provisions for improvement

Additional file 2. Checklist_ANC.docx (ANC Checklist).

Research paper thumbnail of Pathways into homelessness and problems of homeless people in Dhaka city

Research paper thumbnail of MOESM4 of Quality of maternal and newborn healthcare services in two public hospitals of Bangladesh: identifying gaps and provisions for improvement

Additional file 4. Checklist_Caesarean Section Delivery.doc (Cesarean delivery checklist).

Research paper thumbnail of Mental Healthcare-Seeking Behavior during The Perinatal Period among Rural Women in Bangladesh

Introduction: Mental health conditions are of rising concern due to their increased contribution ... more Introduction: Mental health conditions are of rising concern due to their increased contribution to the global burden of disease. Mental health issues are inextricably linked with other sociocultural and health dimensions, especially in the rural areas in developing countries. The complex relationship between mental health issues and sociocultural settings may largely toll upon the healthcare-seeking behavior. Evidence suggests that mental illness affects more than 10% of women and one year after childbirth. So, it urges to document the current status of mental healthcare-seeking behavior during the perinatal period among rural women in Bangladesh to develop a context-specific intervention in the future.Methods: This study was carried out in one sub-district in Bangladesh from April 2017 to June 2018. We conducted 21 In-depth Interviews and seven Focus Group Discussions with different groups of purposively selected participants such as perinatal women, head of the family, community ...

Research paper thumbnail of Quality of maternal and newborn healthcare services in two public hospitals of Bangladesh: identifying gaps and provisions for improvement

BMC Pregnancy and Childbirth

Background Healthcare service delivery systems need to ensure standard quality of care (QoC) for ... more Background Healthcare service delivery systems need to ensure standard quality of care (QoC) for achieving expected health outcomes. Although Bangladesh has a good healthcare service delivery system, there are major concerns about the quality of maternal and newborn health (MNH) care services, which is imperative for achievements in health. The study aimed to measure the QoC for different MNH services in two selected public health facilities of Bangladesh. This study also documented the specific areas of each care which needs intervention. Methods The study was conducted in two district-level public health facilities—a district hospital (DH) and a mother and child welfare centre (MCWC). A total of 228 cases of MNH services were observed by using contextualized checklist ‘Standards-based Management and Recognition (S-BMR)’ for 8 selected MNH care services. For scoring, performed activities were calculated as percentages of the total recommended activities and categorized as high (&gt...

Research paper thumbnail of A newly developed tool for measuring the availability of human resources for emergency obstetric and newborn care services: prospective analytic study in two district-level public facilities in Bangladesh

BMC health services research, Jan 4, 2018

In Bangladesh, while the infrastructure of public health facilities to provide maternal and newbo... more In Bangladesh, while the infrastructure of public health facilities to provide maternal and newborn care services is adequate, services are not always available due to insufficient staffing. A human resource availability index for health facilities is needed for monitoring and advocacy. This study aimed to develop indices for measuring the availability of different types of human resources to provide round-the-clock emergency obstetric and newborn care (EmONC) service at district-level public facilities. As part of a larger intervention study, 30 days of prospective observation of providers was done at a district hospital (DH) and a mother and child welfare centre (MCWC) in one district of Bangladesh using checklists. A scoring system was developed to create an index to quantify the availability of providers for maternal and newborn care. Based on the newly developed index, medical doctors in the emergency department of the DH were 100% available, but ranged from 27 to 41% availabil...

Research paper thumbnail of Emergency obstetric and newborn care signal functions in public and private facilities in Bangladesh

PloS one, 2017

Signal functions for emergency obstetric and newborn care (EmONC) are the major interventions for... more Signal functions for emergency obstetric and newborn care (EmONC) are the major interventions for averting maternal and neonatal mortalities. Readiness of the facilities is essential to provide all the basic and comprehensive signal functions for EmONC to ensure emergency services from the designated facilities. The study assessed population coverage and availability of EmONC services in public and private facilities in Bangladesh. An assessment was conducted in all the public and private facilities providing obstetric care in to in-patients 24 districts. Data were collected on the performance of signal functions for EmONC from the study facilities in the last three months prior to the date of assessment. Trained data-collectors interviewed the facility managers and key service providers, along with review of records, using contextualized tools. Population coverage of signal functions was assessed by estimating the number of facilities providing the signal functions for EmONC compar...

Research paper thumbnail of Use of a geographic information system to assess accessibility to health facilities providing emergency obstetric and newborn care in Bangladesh

International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics, Jan 28, 2017

To use a geographic information system (GIS) to determine accessibility to health facilities for ... more To use a geographic information system (GIS) to determine accessibility to health facilities for emergency obstetric and newborn care (EmONC) and compare coverage with that stipulated by UN guidelines (5 EmONC facilities per 500 000 individuals, ≥1 comprehensive). A cross-sectional study was undertaken of all public facilities providing EmONC in 24 districts of Bangladesh from March to October 2012. Accessibility to each facility was assessed by applying GIS to estimate the proportion of catchment population (comprehensive 500 000; basic 100 000) able to reach the nearest facility within 2 hours and 1 hour of travel time, respectively, by existing road networks. The minimum number of public facilities providing comprehensive and basic EmONC services (1 and 5 per 500 000 individuals, respectively) was reached in 16 and 3 districts, respectively. However, after applying GIS, in no district did 100% of the catchment population have access to these services. A minimum of 75% and 50% of ...

Research paper thumbnail of Coverage of emergency obstetric care and availability of services in public and private health facilities in Bangladesh

International Journal of Gynecology & Obstetrics, 2015

To assess the coverage of emergency obstetric care (EmOC) and the availability of obstetric servi... more To assess the coverage of emergency obstetric care (EmOC) and the availability of obstetric services in Bangladesh. In a national health facility assessment performed between November 2007 and July 2008, all public EmOC facilities and private facilities providing obstetric services in the 64 districts of Bangladesh were mapped. The performance of EmOC services in these facilities during the preceding month was investigated using a semi-structured questionnaire completed through interviews of managers and service providers, and record review. In total, 8.6 (2.1 public and 6.5 private) facilities per 500000 population offered obstetric care services. Population coverage by obstetric care facilities varied by region. Among 281 public facilities designated for comprehensive EmOC, cesarean delivery was available in only 215 (76.5%) and blood transfusion services in 198 (70.5%). In the private sector (for profit and not for profit), these services were available in more than 80% of facilities. In all facility types, performance of assisted vaginal delivery (range 12.2%-48.4%) and use of parenteral anticonvulsants to treat pre-eclampsia/eclampsia (range 48.6%-80.8%) were low. The main reason for non-availability of EmOC services was a lack of specialist/trained providers. Bangladesh needs to increase the availability of EmOC services through innovative public-private partnerships. In the public sector, additional trained manpower supported by an incentivized package should be deployed.

Research paper thumbnail of Postnatal care for newborns in Bangladesh: The importance of health-related factors and location

Journal of global health, 2017

Bangladesh achieved Millennium Development Goal 4, a two thirds reduction in under-five mortality... more Bangladesh achieved Millennium Development Goal 4, a two thirds reduction in under-five mortality from 1990 to 2015. However neonatal mortality remains high, and neonatal deaths now account for 62% of under-five deaths in Bangladesh. The objective of this paper is to understand which newborns in Bangladesh are receiving postnatal care (PNC), a set of interventions with the potential to reduce neonatal mortality. Using data from the Bangladesh Maternal Mortality Survey (BMMS) 2010 we conducted logistic regression analysis to understand what socio-economic and health-related factors were associated with early postnatal care (PNC) by day 2 and PNC by day 7. Key variables studied were maternal complications (during pregnancy, delivery or after delivery) and contact with the health care system (receipt of any antenatal care, place of delivery and type of delivery attendant). Using data from the BMMS 2010 and an Emergency Obstetric and Neonatal Care (EmONC) 2012 needs assessment, we also ...