Browsing by Author "Chowdhury, AMR"

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A study of the impact of BRAC's programme on the community networks in a village Matlab, Bangladesh
(BRAC Research and Evaluation Division (RED), 1998-09) Ara, Shamin; Bhuiya, Abbas; Chowdhury, AMR
Adaptation of Kangaroo Mother Care for community-based application
(BRAC Research and Evaluation Division (RED), 2002-08) Quasem, Md. Iftekhar; Sloan, Nancy L.; Chowdhury, Anita; Ahmed, Salahuddin; Winikoff, Beverly; Chowdhury, AMR
Objective: Working with a multi-disciplinary team of Ecuadorians, Bangladeshis and Americans, we developed a simple protocol for community-based implementation of kangaroo mother care (CKMC) that does not require birth weight or clinical judgment to identify which newborns should receive CKMC. CKMC could stabilize newborns and possibly reduce neonatal mortality where there is little medical care for newborns and low birth weight (LBW) is common. Study Design: During their CKMC training, community-based workers identified 35 expectant or recently delivered women in the pilot study area and taught them about CKMC. Women were interviewed at one month postpartum to evaluate their experience with CKMC. Results: 77% of mothers initiated skin-to-skin care and 85% with LBW babies did so (37% were LBW). CKMC mothers delayed newborn bathing. Few slept upright with their newborns. Conclusions: CKMC was quickly and popularly adopted. A randomized controlled cluster trial is planned to determine whether CKMC reduces neonatal mortality.
Anemia and iron deficiency during pregnancy in rural Bangladesh
(BRAC Research and Evaluation Division (RED), 2000) Hyder, S.M. Ziauddin; Persson, Lars-Ake; Chowdhury, AMR; Lonnerdal, B; Ekstrom, Eva-Charlotte
Objective: To assess the prevalence of anemia, iron deficiency and iron deficiency anemia (IDA) among pregnant women in rural Bangladesh Design: Baseline data on 215 pregnant women who were invited to participate in an iron supplementation trial were used. The women were in their second trimester and selected at registration from 50 antenatal care centers. Hemoglobin (Hb) concentration of venous blood samples was measured by HemoCue® system. Serum was collected for \ . assessment of ferritin by imrnuno-radiometric assay and transferrin receptors (sTtR) by immunoassay double sandwich method. , Anemia was defined as having Hb concentration <110 giL, iron deficiency as serum ferritin <12 f.Lg/L and/or sTtR >8.5 mg/L and IDA as the combination of anemia and iron deficiency. High sTfR/serum ferritin ration was >500. Setting: The central part of Bangladesh, in a rural area of Mymensingh district between May-November, 1997. Results: Mean (SD) of Hb was 110 giL (14 giL), while median serum ferritin, sTfR and sTfRJserum ferritin was 13.7 f.Lg/L, 6.2 mg!L and 458, respectively. The prevalence of anemia was 50%, iron deficiency 54% and high sTfR/serum ferritin 48%. None of the study women had severe anemia. The ·prevalence of IDA was 33%. Of the anemic women 66% had iron deficiency and 64% high sTfR/serum ferritin. Conclusion: Both anemia and iron deficiency were highly prevalent. About two-thirds of the anemia cases were associated with iron deficiency. Sponsorship: The study was financially supported by Sida/SAREC, Sweden and BRAC, Bangladesh. Descriptors: Anemia, iron deficiency, iron deficiency anemia, serum transferrin receptor, serum ferritin, pregnant women, Bangladesh
Arsenic testing of newly installed tubewells and quality control
(BRAC Research and Evaluation Division (RED), 1999-04) Jakariya, Md.; Johnstony, Richard; Chowdhury, AMR
The presence of arsenic in groundwater in Bangladesh has aroused widespread concern. It is estimated that over half of the Bangladesh population are at risk of arsenic poising. The source of arsenic in drinking water is from the tubewells. There are over four million tubewells in Bangladesh. During 1997-1998, DPHE installed over 13,000 tubewells in a UNICEF supported Safe Water Supply Project .. At the request of UNICEF, BRAC test all the above mentioned tubewells for Arsenic contamination. In doing this, BRAC need a field kit and the quality of the testing was also assessed by simultaneous testing in a laboratory. The proportion of tubewells with an arsenic content above the acceptable limit (=1< 50 ppb) was found to be 4.27% of 12,604 tubewells tested. Tubewells above the accepted limit were painted red , whereas those within the accepted limit were painted green by the field testers. The quality of testing by the field testers was found to be high ana the effectiveness of the field kits was found to be adequate. DPHE have been relatively successful to avoid arsenic affected areas as the number of tubewells contaminated with arsenic above the acceptable limit was low. The sub assistant engineers also mentioned that one of the main reasons for not installing all the allocated tubewells particularly in the arsenic affected areas was due to arsenic contamination in ground water. Caretakers of each tubewell were given information on what to do if the tubewell tested arsenic contaminated. They were also given a leaflet provided by UNICEF containing information on arsenic and altenative safe water options.
Beneath the shadows of the BRAC Centre slums of Mohakhali
(BRAC Research and Evaluation Division (RED), 1997-07) Khan, Suhaila H; Chowdhury, AMR; Karim, Fazlul
This exploratory slum study looked at the demographic, socio-economic, health related, educational, and political characteristics of the slum dwellers living around the BRAC Centre. The study was conducted from April to June 199.7. Data was collected primarily by the lead researcher with an open ended semi-structured questionnaire, and information was collected from the key informants living in the slums. The slums could be distinguished by their size. The smaller slums were used by the inhabitants to eat, sleep and reside in, but the larger ones had shops, bazaars, schools, madrasas, mosques, playgrounds, and even graveyards. The physical structure of the huts was worse in the smaller than in the larger slums. For example, huts in the smaller slums were made of chatai, sack, and plastic sheets. In the larger slums the huts were made of tin roofs and bamboo walls. All huts had earthen floors irrespective of their size. In general the socio-economic conditions of the smaller slum dwellers were worse than of the larger slum dwellers. Although located within municipal limits, the slums had limited access to important urban services, such as, water, electricity and gas, but some slum dwellers managed to get supply/tap water from various sources and some illegal electricity. The environmental conditions of the slums were very poor due to high population density, poor housing and pollution of the area by human and factory wastes. Most slums were established outside the legal framework of the city management. The possibility of eviction of slum dwellers by land owners was quite high but the slum dwellers were not overtly anxious over the issue.
BRAC/DPHE/UNICEF collaboration on community-based Arsenic response
(BRAC Research and Evaluation Division (RED), 1999) Jakariya, Md.; Haque, Salma R.; Nickson, Ross T.; Hossain, Md. Zabed; Chowdhury, AMR
The severity of the problem of arsenic in ground water in Bangladesh is now well recognized. 97% of the population relics on ground water for drinking and cooking purposes and it is estimated that half of the country may have arsenic in the subsurface. The source of the arsenic is geological and due to the sedimentary processes which lead to accumulation of arsenic and release to groundwater the level found in tubewell water are spatially variable-one well may be highly contaminated whereas nearby another is not The severity of arsenic poising, or arsenicosis, also varies dependent on the length of exposure, the level of arsenic being ingested and the socio-economic (or nutritional) status of the individual concern. BRAC, a non-governmental organisation, in conjunction with DPHE and UNICEF have begun efforts to assess and mitigate the arsenic problem in two thanas of Bangladesh - Sonargaon and Jhikorgacha. Testing has so far been carried out in one union, Boiderbazar union of Sonargaon Thana. 61 % wells of this union were contaminated with arsenic above the Bangladesb standard of 0.05 mgIl. Instantiation and assessment of safe water options has begun. The options being advocated are: treatment of ground water with home based candle filters, treatment of surface water with Pond Sand Filter (PSF), Rain Water Harvesting (RWH). These options are being assessed on several criteria: initial and operating costs; ease of implementation, operation and maintenance; continuity of supply; susceptibility of bacteriological contamination and acceptability to the community. AD of these options have their limitations and none are as easy as obtaining tubewell water directly, however, at present home based filter are proving most popular due to low cost, ease of use and acceptability. Continued manufacturing quality of these home based filter must be ensured and the lifetime of the candle assessed.
CARE: Training immunisers in the community approach (TICA)
(BRAC, 1989) Chowdhury, AMR; Huda, Khawja Shamsul
Case study of low immunization coverage area in Bhairab thana
(BRAC Research and Evaluation Division (RED), 1998-07) Ara, Shamim; Chowdhury, AMR; Karim, Fazlul; Bhuiya, Abbas; Aziz, KMA
Combating a deadly menace: early experiences with a community-based arsenic mitigation project in Bangladesh
(BRAC Research and Evaluation Division (RED), 2000-08) Chowdhury, AMR; Hossain, Md. Zabed; Nickson, Ross; Rahman, Mizanur; Jakariya, Md.; Sharnimuddin, Md.
Bangladesh is facing the problem of arsenic poisoning in drinking water. Around 27% of the tubewells, which supply drinking water to most of the population, have arsenic concentrations above the government of Bangladesh limit of 50 t.g per litre. This means that a quarter of the • country's population is exposed to arsenic poisoning which is alarming and unprecedented in history. BRAC, a non-governmental organisation, in conjunction with the Department of Public Health Engineering (DPHE) of the government of Bangladesh and UNICEF, has implemented a project titled, 'Action Research into Community-Based Arsenic Mitigation' in two upazilas of Bangladesh - from June 1999 to June 2000. The aim of the project was to assess the technical viability as well as the effectiveness of different alternative safe water options and to figure out the community acceptance of such options. The activities included the determination of the extent of arsenic contamination in water of all the tubewells of the project area; involvement of community members in choosing, implementing and maintaining alternative sources for safe drinking water, determination of the viability and effectiveness of different mitigation option and assess their relative acceptance by villagers; identification of arsenic-affected patients and providing treatment; and make the community people aware of arsenic poisoning. This report presents the experiences of the initial course of project implementation.
Comparing changes in basic competency, literacy and enrolment of children in Matlab between 1992 and 1995
(BRAC Research and Evaluation Division (RED), 2000-08) Rana, AKM Masud; Chowdhury, AMR; Ahmed, Syed Masud; Bhuiya, Abbas
In 1995, three year after the baseline survey and initiation of the BRAC-ICDDR'B Joint Research Project in Matlab, a follow up survey was carried out to explore changes in the areas of education. These included enrolment, literacy and basic competency of children. A total of 1703 children took part in the test in 1995. Of these 315 were from BRAC households, 670 from eligible non-members and the other 718 from non-eligible households. The children selected were between 11 to 15 years irrespective of whether they enrolled in the school or not. The results showed improvement in each of the above areas since 1992. Literacy as measured through verbal reporting, increased from 34.4 % to 43.8% and was more noticeable among from BRAC organised households (p<.05). Enrolment of children has increased significantly more in case of girls and the lesser poor. The BRAC schools set up in the area in this time played an important role in these changes. This is true particularly for girls who constitute about 70% of BRAC school's enrolment. The percentage of children qualifying for basic competency increased from 18% in 1992 to 26% in 1995. The rate of increase was almost equal for boys and girls but was higher for the 'less poor' than the poorest children. Children belonging to the BRAC schools performed much better than those in the government primary schools. The improvement was minimal in villages where there was no school at all.
Competence of the programme organizers in antenatal care an issue of the quality of care
(BRAC Research and Evaluation Division (RED), 1996-04) Afsana, Kaosar; Chowdhury, AMR; Mahmud, Shah Noor; Karim, Fazlul
Controlling a forgotten disease: using voluntary health workers for tuberculosis control in rural Bangladesh
(Brac University, 1991) Chowdhury, AMR; Ishikawa, N; Islam, M.S; Hussain, S.; Cash, R.A; Abed, F.H.
Credit for the poor: the case of BRAC in Bangladesh
(BRAC, 1991) Chowdhury, AMR; Mahmood, M; Abed, FH
As the rural population of Bangladesh increases, landlessness among people once dependent upon agriculture is a growing problem. The Bangladesh Rural Advancement Committee (BRAC) has been working with the rural poor since 1972, and in 1979 it began to provide credit via its 81 branches through the Rural Development Programme (RDP). Ten years later the success of the RDP in generating incomes and employment through small businesses and building up assets has been evaluated, and this article describes the results of the evaluation.
Credit programme, women's autonomy a reproductive behaviour evidence from BRAC villages, Bangladesh
(BRAC Research and Evaluation Division (RED), 1996-12) Hadi, Abdullahel; Nath, Samir R; Chowdhury, AMR
This paper investigates the role of women's autonomy on their acceptance of contraceptive method in 87 BRAC villages in Manikganj district of Bangladesh. Data for this study were obtained from 1995 sample survey of married women of reproductive age in these villages. Findings reveal that women's autonomy, as measured by the extent to which she believes that the wife should have a decision-making role in five different areas of family life, is positively associated with contraceptive use. While socioeconomic differentials in the acceptance of contraceptive are noticeable in terms of age, number of children ever born, years of schooling. exposure to mass media. land size and occupation of husband, the contraceptive practice among women involved in credit programme is found significantly higher than those not similarly involved. The multivmiate analysis reveals that participation in credit programmes is positively associated with women's empowerment when socioeconomic differentials are taken into account On the other hand, women having high autonomy score are nearly 36 percent more likely to use contraceptives (p<.OS) than those having low autonomy score, controlling for age and number of children ever born of the women. When other factors such as involvement in credit programme. years of schooling. household ownership of land. occupation of husband and exposure to mass media are systematically added to the regression equation, the influence of women's autonomy on contraceptive usc remains high with the same level of significance. The paper concludes that credit-based income generating programme has the potential to bring a significant change in reproductive behaviour of women through increased autonomy.
Differentials of the immunization program in rural Bangladesh
(BRAC Research and Evaluation Division (RED), 1996) Kamal, Firoz M.; Hadi, AbduUahel; Chowdhury, AMR
This study investigated the association of immunization coverage with some selected socioeconomic variables in rural Bangladesh. It was conducted in 75 villages in I 0 areas of five administrative divisions. The eligible interviewees were the mothers having a child of age 12 to 23 months living in the ~elected villages. Both paternal and maternal education of 4-5 years of schooling were found to have a significant influence on immunization. No significant association exists between immunization coverage and child's sex. household land and labor sale. Parental religion impacts significantly. Exposure to media like radio increases predictability of immunization by about two folds. Most people favor none or minimal userfee, therefore restricting the self-sustainability of the program. An increase in parental education enhances affordability of userfees.
Do side-effects reduce compliance to iron supplementation? a study of daily- and weekly-dose regimens in pregnancy
(Springer, 2002-06) Hyder, S.M. Ziauddin; Persson, Lars Åke; Chowdhury, AMR; Ekström, Eva-Charlotte
Side-effects of iron supplementation lead to poor compliance. A weekly-dose schedule of iron supplementation rather than a daily-dose regimen has been suggested to produce fewer side-effects, thereby achieving a higher compliance. This study compared side-effects of iron supplementation and their impact on compliance among pregnant women in Bangladesh. These women were assigned to receive either weekly doses of 2×60 mg iron (one tablet each Friday morning and evening) or a daily dose of 1×60 mg iron. Fifty antenatal care centres were randomly assigned to prescribe either a weekly- or a daily-supplementation regimen (86 women in each group). Side-effects were assessed by recall after one month of supplementation and used for predicting compliance in the second and third months of supplementation. Compliance was monitored using a pill bottle equipped with an electronic counting device that recorded date and time whenever the pill bottle was opened. Of five gastrointestinal side-effects (heartburn, nausea, vomiting, diarrhoea, or constipation) assessed, vomiting occurred more frequently in the weekly group (21%) than in the daily group (11%, p<0.05). Compliance (ratio between observed and recommended tablet intake) was significantly higher in the weekly-supplementation regimen (93%) than in the daily-supplementation regimen (61%, p<0.05). Overall, gastrointestinal side-effects were not significantly associated with compliance. However, the presence of nausea and/or vomiting reduced compliance in both the regimens—but only among women from the lower socioeconomic group. In conclusion, weekly supplementation of iron in pregnancy had a higher compliance compared to daily supplementation of iron despite a higher frequency of side-effects. The findings support the view that gastrointestinal side-effects generally have a limited influence on compliance, at least in the dose ranges studied. Efforts to further reduce side-effects of iron supplementation may not be a successful strategy for improving compliance and effectiveness of antenatal iron supplementation.
Does a community based nutrition project work? an evaluation of the Muktagachha pilot nutrition initiative in Bangladesh
(Research and Evaluation Division, Brac, 2001) Hyder, SM Ziauddin; Jalal, Chowdhury S B; Roy, Rita Das; Chowdhury, AMR; Yusuf, HKM
A study was undertaken to evaluate the impact of the multidisciplinary Muktagacha pilot nutrition project on the nutritional status of under-2 children, adolescent girls and pregnant and lactating mothers in three areas covered by the project - Paratongi, Gabtoli and Chcchua. Both quantitative and qualitative methods were used in the study. Quantitative data included infonnation on nutritional status of the target population. Data were taken only for January and July of the years from 1994 to 2000. Qualitative data, collected mainly through focal group discussions (FGD), included infonnation on health and nutrition status of the target population and perception at household, village and community levels about the nutrition project. Results showed that the project made partial success in achieving the target objectives.
Does food supplementation increase efficacy of a school-based nutrition education programme for adolescent girls? lessons learned at BRAC
(BRAC Research and Evaluation Division (RED), 2000) Roy, Rita Das; Hyder, S.M. Ziauddin; Chowdhury, AMR; Mahmud, Zeba
Does involvement of women in BRAC influence sex bias in intra-household food distribution?
(BRAC Research and Evaluation Division (RED), 1997) Roy, Rita Das; Hyder, SM Ziauddin; Chowdhury, AMR; Adams, Alayne
This study aimed to assess the sex preference in intra-household food distribution among school going siblings in a rural area of Bangladesh. The study also examines the effect of women's involvement in BRAC's rural development programme in reducing gender gaps in intrahousehold food allocation. The study was conducted in 14 villages of :Matlab thana as one of the sub-studies of the BRAC-ICDDR,B joint research project. A total of 376 school-going siblings (188 brothers and 188 sisters) aged 10-14 years from BRAC member and no~-member households were included in this study. Both quantitative and qualitative research methods were used for data collection. One of the villages was chosen for direct observation of food distnoution behaviour of the food servers. The methodology also included six focus group discussions with mothers of the siblings in two selected villages; this helped to have further understanding of the issue. The survey found no significant sex bias in food distribution for 3 major daily meals. However, boys were given preference in distributing special foods such as meat, fish and milk products. Brothers conswned higher amount of special foods compared to their sisters (p<0.001). Direct observation of food distribution and focus group discussions indicated that preferential food distribution pattern favouring sons, which existed in the rural community irrespective of social classes. It was also found that food was more equitably distributed between sons and daughters within BRAC member households compared to non-member households.
Does mobilisation help change mothers' behaviour towards health and nutrition?
(BRAC Research and Evaluation Division (RED), 2000) Hyder, S.M. Ziauddin; Jalal, Chowdhury S B; Roy, Rita Das; Chowdhury, AMR; Yusuf, Harun KM
A study was done to assess the impact of mobilization on the change of mothers' behaviour towards health and nutrition practices. Mobilization was given by adolescent girls trained on various aspects of health and nutrition. Like regular growth monitoring of their children, immunization, colostrums feeding, complementary feeding, night blindness, hookworm infestation and hand washing practices before eating and after defecation. The adolescent girls were trained in BRAC non-formal schools in some villages of Muktagachha Upazila of Mymensingh district. They made house to house visits and mobilized and motivated the mothers on the above subjects. Mothers living in neighbouring areas but not visited by the ·adolescent girls were considered as non-mobilized. Results show that mobilization has important effects on some aspects of health and nutrition behaviour such as age at which complementary feeding should be started, vegetables as sources of vitamin A nightblindness, and personal hygiene like hand washing practice before eating. However, no significant difference was found between mobilized and non-mobilized mothers in respect of importance of growth monitoring, immunization, colostrum feeding and washing of hand after defecation. The reason for this is not know at present but it may be due to weakness of the mobilization procedure/programme, leakage of information from mobilized mothers to non-mobilized mothers, or gaining of knowledge by the non-mobilized mothers from other source like radio and TV. Further in-depth study is needed to resolve the question.