Browsing by Author "Adams, Alayne M"

Now showing 1 - 6 of 6

Advancing universal health coverage in South Asian cities: A framework
(BMJ Open, 11/29/2018) Adams, Alayne M; Nambiar, Devaki; Siddiqi, Sameen; Alam, Bushra Binte; Reddy, Srinath
Changing health-seeking behaviour in the context of development interventions: experiences from Matlab, Bangladesh
(BRAC Research and Evaluation Division (RED), 2002) Ahmed, Syed Masud; Adams, Alayne M; Chowdhury, Mushtaque; Bhuiya, Abbas
It is generally assumed that socioeconomic development interventions will enhance the-material and social capacities of the poor who are disenfranchised to prevent ill health, and to seek appropriate and timely care. Using cross-sectional data from surveys undertaken in 1995 and 1999 as part of the BRAC-ICDDR, B Joint Research Project in Matlab, Bangladesh, this paper explores patterns of health-seeking behaviour over time, with the hypothesis that exposure to integrated socioeconomic development activities will enhance gender equity in care-seeking, and the use of qualified medical care. While there is tentative evidence of greater gender equity in treatment choice among households benefiting from development interventions, a preference for qualified medical care is not apparent. Findings reveal a striking and generalized rise in selftreatment over the four year period that is attributed to the repercussions of a major flood in 1998, and greater heath awareness due to the density of community health workers in Matlab. Also noteworthy is the substantial reliance on informal and often unqualified practitioners (over 20%) such as pharmacists and itinerant drug sellers. Factors associated with the type of health care sought were identified using logistic regression. Self-care is associated with female gender, the absence of low cost health services, and illnesses of relatively short duration. Medical care, on the other hand, is positively predicted by male gender, geographic location, greater socioeconomic status, and serious illness of long duration. The paper concludes by emphasizing the importance of enhancing local capacities to determine whether self-treatment is indicated, to self-treat appropriately, or in cases where health care is sought, to judge provider competence and evaluate whether treatment costs are justified. The provision of training on the rational and informed use of allopathic drugs to the full spectrum of informal health care providers is also recommended.
Explaining equity gains in child survival in Bangladesh: scale, speed, and selectivity in health and development
(© 2013 The Lancet, 2013) Adams, Alayne M; Rabbani, Atonu; Ahmed, Shamim; Mahmood, Shehrin Shaila; Al-Sabir, Ahmed; Rashid, Sabina F; Evans, Timothy G
By disaggregating gains in child health in Bangladesh over the past several decades, signifi cant improvements in gender and socioeconomic inequities have been revealed. With the use of a social determinants of health approach, key features of the country's development experience can be identifi ed that help explain its unexpected health trajectory. The systematic equity orientation of health and socioeconomic development in Bangladesh, and the implementation attributes of scale, speed, and selectivity, have been important drivers of health improvement. Despite this impressive pro-equity trajectory, there remain signifi cant residual inequities in survival of girls and lower wealth quintiles as well as a host of new health and development challenges such as urbanisation, chronic disease, and climate change. Further progress in sustaining and enhancing equity-oriented achievements in health hinges on stronger governance and longer-term systems thinking regarding how to eff ectively promote inclusive and equitable development within and beyond the health system.
Explaining equity gains in child survival in Bangladesh: scale, speed, and selectivity in health and development
(© 2013 The Lancet, 2013) Adams, Alayne M; Rabbani, Atonu; Ahmed, Shamim; Mahmood, Shehrin Shaila; Al-Sabir, Ahmed; Rashid, Sabina F; Evans, Timothy G
By disaggregating gains in child health in Bangladesh over the past several decades, signifi cant improvements in gender and socioeconomic inequities have been revealed. With the use of a social determinants of health approach, key features of the country's development experience can be identifi ed that help explain its unexpected health trajectory. The systematic equity orientation of health and socioeconomic development in Bangladesh, and the implementation attributes of scale, speed, and selectivity, have been important drivers of health improvement. Despite this impressive pro-equity trajectory, there remain signifi cant residual inequities in survival of girls and lower wealth quintiles as well as a host of new health and development challenges such as urbanisation, chronic disease, and climate change. Further progress in sustaining and enhancing equity-oriented achievements in health hinges on stronger governance and longer-term systems thinking regarding how to eff ectively promote inclusive and equitable development within and beyond the health system.
Supporting the role and enabling the potential of community health workers in Bangladesh’s rural maternal and newborn health programs: A qualitative study
(Journal of Global Health Reports, 5/15/2020) Adams, Alayne M; Vuckovic, Myriam; Graul, Emily; Rashid, Sabina F; Sarker, Malabika
Background In the global journey towards Universal Health Coverage (UHC), strong primary healthcare systems are essential. This includes the frontline health workers, the bedrock of which are community health workers (CHWs). In Bangladesh, this largely female workforce plays a critical role in health promotion and linking communities with the formal health care system. With the launch of the new national strategy on CHWs, and its ambitions around the implementation of harmonized systems of financing, certification, job harmonization, performance assessment and supportive supervision, it is important to reference the perceptions, experiences, needs and aspirations of CHWs themselves. Methods This qualitative exploratory study examines three UNICEF supported maternal and newborn health (MNH) programs in rural Bangladesh, with two districts sampled for each program. In-depth interviews were conducted with CHWs, community members, other health workers, and program managers. Data were analyzed using a thematic analysis approach, with a particular focus on the voice and experience of CHWs and the programmatic features that support them in serving their communities. Results Across all three programs, CHWs function as critical local agents for health promotion and referral whose recruitment from and support by the community, enhances their effectiveness. Regular communication and collaboration between CHWs and public-sector frontline workers were perceived as important in enabling their role in increasing the coverage of essential services. Support for structured systems of training, supervision and monitoring which encompass the support of referral decisions, was also apparent. Of particular note were the needs and aspirations of CHWs regarding work-life balance, job satisfaction and desire for professional development. These concerns emphasize the importance of flexibility in how the CHW workforce is configured such that roles, responsibilities and remuneration are keyed to experience and qualifications, and the dynamic needs and aspirations of CHWs over the life course. Conclusions As Bangladesh pursues its UHC agenda, CHWs are pivotal in linking underserved communities to the formal health system. Flexibility in the scope of CHW roles and responsibilities, as well as supportive supervision, regular training and fair remuneration, will optimize their contributions towards UHC and better MNH outcomes.
Urban Health Atlas (UHA): an interactive web-based tool for evidence-based healthcare planning
(icddr,b, 2021-10) Hasan, Shaikh Mehdi; Das, Susmita; Rakib, Nibras Ar; Islam, Rubana; Islam, Rahenul; Ahmed, Shakil; Adams, Alayne M
This research was funded by the Foreign, Commonwealth & Development Office (FCDO), Deutsche Gesellschaft für Internationale Zusammenarbeit (GIZ) GmbH, Options Consultancy Services Limited, and International Development Research Centre (IDRC).