Browsing by Author "Karim, Fazlul"

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A visit to a flood shelter in Dhaka City
(BRAC Research and Evaluation Division (RED), 1998) Karim, Fazlul; Sultan, Sania; Chowdhury, Mushtaque
Assessment of birth and death recording activities in reproductive health and disease control programme of BRAC
(BRAC Research and Evaluation Division (RED), 1996-07) Ali, Ahmed; Mahmud, Shah Noor; Islam, Md. Nazrul; Karim, Fazlul; Public health; Medicine, Preventive; Health planning; Health surveys--Bangladesh.
This report attempts to determine the accuracy of· recording births, deaths and stillbirths in all the 30 areas of 10 thanas former Women's Health and Development Programme (presently Reproductive Health and Disease Control Programme - RHDC) in 3 regions. One unit (village) having 250-300 households were randomly selected from each area. The survey was conducted during April-May 1995.
Barriers to Emergency Obstetric Care (EOC) and birth practices in rural Manikganj
(BRAC Research and Evaluation Division (RED), 1998-09) Gazi, Rukhsana; Goodbum, Liz; Chowdhury, A Mushtaque R; Karim, Fazlul
This study aimed to explore the situation during delivery in rural homes and to identify the barriers to emergency obstetric care (EOC). Twenty sO< pregnant women were followed-up at home by experienced female interviewers. No notes were taken during the conversations but a detailed diary of each visit was made immediately after they returned to the base. Women themselves were often not aware of self care. A fear of sin which was attributed to the presence of unknown male doctors in the hospital acted as barrier. Women's relationship with their in-laws was found to be important. An early assessment and indication for referral by traditional birth attendants (TBAs) was important in the decision making process. TBAs were often trying to manage the complications by themselves. The hospital is a unfamiliar place for rural people. A common perception was that the hospital people pay attention only to rich and educated people. In-laws and neighbours jointly undertook the decision for hospitalization. All members of the community need to be educated about the danger signs of obstetric emergencies. For this poster charts, audio visual aids, folk drama might be used as effective tools for the information campaign. TBA training interventions should give more emphasis to early recognition of complications and early indications for referral.
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.
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
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
Drinking water in the hilly region of Bangladesh: how is the quality?
(Carfax Publishing, 2002) Karim, Fazlul; Rafi, Mohammad
This paper assesses the chemical and bacteriological quality of drinking water in three districts of the Chittagong Hill Tract (CHT), a region within Bangladesh. Drawing water samples from tubewells, chharas /springs, lakes/canals, wells, and ponds, analysis was done on pH, alkalinity, arsenic, phosphate (PO 4 ), sulphate (SO 4 ), ammonium-nitrogen, conductivity, and faecal coliform bacteria. The PO 4 and SO 4 concentrations were within the permissible limits. In contrast, 100% of the water samples contained alkalinity below 400 mg/l. Varied proportions, ranging from 14% to 50%, of tubewells, chharas /springs, lakes/canals, and well water had a pH of less than 6.5. Three out of 16 (18.8%) tubewell water samples tested had arsenic contamination and 18% of the chhara /spring and 11% of the well water samples had an unacceptable level of conductivity. In addition, faecal coliform bacteria contaminated almost all sources of water, ranging from 81% to 100%. The water used for drinking in CHT in general is harmful for health.
Effects of family life education in improving adolescents’ knowledge and attitude on reproductive health
(BRAC Research and Evaluation Division (RED), 2000-05) Khan, Md. Iftakhar Hassan; Karim, Fazlul
The study assessed the effects of Family Life Education meant for the Adolescents (AFLE) in improving their knowledge and attitude on the fundamental elements of reproductive health vis-a-vis explored their pattern of sharing about the learning with the peers, and identified further information needs on reproductive health. Data were collected from 444 adolescents through one to one interviews (148 with BRAC AFLE and 148 without BRAC AFLE, and 148 adolescents who had never been enrolled in schools). Adolescents from the BRAC school (296) were chosen by using multistage sampling method while the never school going adolescents (148) were selected conveniently. The study outcomes were compared between the three groups of adolescents mentioned above. Bivariate analysis showed that a majority of AFLE students had significantly higher correct knowledge on puberty (95.3%), menstruation (98.6%), marriage and pregnancy ·(99.3%), STD/AIDS (78.4%), and family planning (95.3%) compared to the adolescents without AFLE as well as those who never went school. Except in the case of correct age at first marriage of a girl, the adolescents with AFLE had higher level of satisfactory knowledge on most of the specific RH issues than those other two groups. In the logistic regression analysis, the AFLE appeared to be the strongest influential predictor, followed by the respondents' age, TV-exposure, radioexposure, and sharing of RH lessons with others. Thus, it appears that AFLE has played a positive role in improving rural adolescents' knowledge and attitude on RH issues. But it warrants addressing sex inequality and involving peers and family.
Exploratory study on BRAC's NGO cooperation project
(BRAC Research and Evaluation Division (RED), 2000-08) Karim, Fazlul; Begum, Shamim Ara; Chowdhury, Kabir; Chowdhury, AMR
BRAC embarked on an NGO Cooperation Project to enhance efficiency of the small and medium NGOs in effective micro-finance management vis-a-vis augmentation of micro-finance activities for poverty alleviation. The newly set up NGO Cooperation Unit (NCU) at BRAC facilitates the implementation of the project. The NCU extended support to 74 NGOs (hereinafter called partner organisations or POs) between 1995 and 1999. Of the 74 POs, 59 were given both training and credit support, while 13 only training. BRAC disbursed maximum Tk. 1,400,000 to each PO as credit in 12 installments. For this BRAC charged 5% service charge from the recipient POs per annum.
Financing the BRAC Health Centres: their financial sustainability and cost-effectiveness
(BRAC Research and Evaluation Division (RED), 1998-01) Khan, Suhaila H; Mahmud, Shah Noor; Karim, Fazlul; Afsana, Kaosar
The Health ana Population Division (HPO) of BRAC aims to provide supportive secondary level health care services for the community through the BRAC Health Centres (BHCs) or Shushasthyos. The BHCs began operating in HPO areas in 1995. As of January 1998 there were 27 BHCs. All BHCs function through user fees in order to make the BHCs financially sustainable in the long run. HPD is endeavoring strategic planning in order to reduce donor dependence and meet the projected resource gaps through the implementation of certain systems such as, cost recovery and cost sharing through the BHCs, to ensure financial sustainability in the long run. The Research and Evaluation Division (RED) of BRAC aimed to evaluate how much cost recovery was occurring at the BHCs which contributed to BHCs' financially sustainability, and what modifications need consideration to support enhance this sustainability. This was a health facility based study done in 9 BHCs in three regions. Mymensingh, Bogra and Dinajpur. The variables considered for this study were related to cost. revenue, cost sharing and effects. The average or unit cost of operating a BHC was Tk. 422.092. The recurrent cost was Tk. 403 ,547 and capital cost was Tk. 18,545. Average income per BHC was Tk. 89,631. The cost recovery was 22% of recurrent costs and 21% of total costs. And if we considered the variables similar to HPD then cost recovery was 35% of recurrent costs and 33% of total costs. 23% of the indicators mentioned in the monthly disease profile cover gynaecologicals conditions. These constitute about 11% of the total general diseases being identified and/or treated at the BHCs. This is only possible due to having a facility such as a BHC. The unit cost per patient visit was Tk. 93. Some interventions, such as ANC and GM done at BHCs seemed to be cheaper compared to previous findings of WHOP and RDP-PHC.
Gender barriers to tuberculosis control: fade-out or in? key findings and recommendations from the preliminary analysis
(BRAC Research and Evaluation Division (RED), 2003-09) Karim, Fazlul; Begum, Insana; Islam, Akramul; Chowdhury, AMR
Growth and development pattern of low birth weight infants in rural Bangladesh
(BRAC Research and Evaluation Division (RED), 1998-02) Gazi, Rukhsana; Karim, Fazlul
Health insurance in rural Bangladesh: proposal on a pilot project
(BRAC Research and Evaluation Division (RED), 2000-07) Karim, Fazlul; Hossain, Monjur; Ahmed, Jalaluddin
Human rights violation in Bangladesh: lessons learned from the information gathering system of BRAC social development programme
(BRAC Research and Evaluation Division (RED), 2009-10) Karim, Fazlul; Qayum, Nayma; Hyder, Ziauddin; Fattah, Kazi Nazrul
Human rights violations deter sustainable development, and require effective preventive interventions. In Bangladesh non-governmental organisation-run programmes addressing HR violations suffer from serious lack of resources, and a lack of political will on the part of the government. Thus, programmes that assist survivors of violence are hampered. The absence of reliable data disguises the true scale of the problem. Recently, RED analyzed 3,000 cases of HR violations reported through the BRAC Social Development Program, from 61 districts of Bangladesh between 2006 and 2009. The analysis found that rape was the most frequent crime (31%), followed by murder (25%), acid throwing (15%), suicide (12%, often the result of rape), physical torture (7%) and attempted rape (7%). Adolescent girls (less than 15 years) were the most frequent victims of sexual assault (50% raped and 59% attempted rape victims). Rape often led to murder or shames victims to commit suicide. It is, therefore, likely that many reported suicide and murder victims were also victims of sexual violence. Acid attacks occurred across both sexes and in all age groups, although refusal of marriage or relationship posed a higher risk to the females. An alarming 86% of rape victims and 73% of physically tortured victims received no healthcare. HR violation is a criminal offence and it hinders any development and democratic process. Concerted effort is crucial to fight against the enemy.
Immunization divide who do get vaccinated in Bangladesh
(International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDR,B), 2003) Chowdhury, A.M..R.; Bhuiya, Abbas; Mahmud, Simeen; Salam, A.K.M. Abdus; Karim, Fazlul
Immunization Divide: who do get vaccinated in Bangladesh
(2003) Chowdhury, A Mushtaque R.; Bhuiya, Abbas Uddin; Mahmud, Simeen; Salam, A.K.M. Abdus; Karim, Fazlul
Impact of BRAC reproductive health and disease control programme on different health services utilisation
(BRAC Research and Evaluation Division (RED), 2001-12) Karim, Fazlul; Tripura, Abhilash; Gani, Md. Showkat
This study assessed the impact of BRAC's RHDC programme on different health services utilisation compared to the baseline status as well as the comparison area. In the baseline study (199:.?.) fertility and mortality data were collected from 12,073 households (programme 8,072 and comparison 4,001) representing a total of 261 villages (programme 184 and comparison 77). But, in the follow-up study clone in 2000, 103 villages (programme 80 and comparison 23) were revisited. Using the cluster survey method, data were collected from 8,033 households (programme 4,003 and comparison 4,030) in the follow-up study. The programme villages were drawn from Bogra and Dinajpur districts whilst the comparison villages from Jaipurhat district. It is to be noted that for measuring the level of different health service use data were collected from toe;~ and 25% of the total households covered for mortality and fertility estimate during the baseline and the follow-up studies respectively, because measurement of other service utilisation required lesser number of sample than the mortality and fertility estimates. However, the following sections present the key findings of the study.
Impact of BRAC reproductive health and disease control programme on practice of personal hygiene
(BRAC Research and Evaluation Division (RED), 2001-12) Karim, Fazlul; Tripura, Abhilash; Gani, Md. Showkat
The campaign on safe water, sanitation and hygiene practices has been an important priority in BRAC's health interventions including RHDC. The RHDC hygiene education is concerned with establishing or inducing changes in personal and group attitudes and behaviour that promote healthy living. Given the situation, one may ask about the achievements of RHDC in improving the sanitation and hygiene practice. Thus, this study evaluated the impact of BRAC's RHDC programme on different issues of personal hygiene compared to baseline status as well as the comparison area. In the baseline study (1992) fertility and morality data were collected from 12,073 households (programme 8,072 and comparison 4,001) representing a total of 261 villages (programme 184 and comparison 77). But, in the follow-up study done in 2000, 103 vi II ages (programme 80 and comparison 23) were revisited. Using the cluster survey method, data were collected from 8,033 households (programme 4,003 and comparison 4,030). The programme vilbges were drawn from Bogra and Dinajpur districts whilst the comparison villages from Jaipurhat district. It is to be noted that for measuring the level of different health service use and hygienic practices, data were collected from IQI'';(. and 25% on the total households covered for mortality and estimate during the baseline and the follow-up studies respective! y, because measurement of these issues required lesser number of sample than the mortality and fertility estimates. However, the following sections present the key findings of the study.
Infant feeding practices in rural Bangladesh
(BRAC Research and Evaluation Division (RED), 1997-08) Gazi, Rukhsana; Karim, Fazlul; Ali, Ahmed
This study was part of a longitudinal study on the consequences of low birth weight (LBW) babies which was carried out in three unions of Manikganj district during 1993- 1994. This study aimed to assess the breastfeeding practices among infants and to compare the weaning practices among LBW and normal birth weight infants. A total of 644 infants were registered within 48 hours of birth and they received monthly follow-up visit upto one year of age. Although breastfeeding was universal in the study population, detrimental feeding practices, such as the administration of pre-lacteal foods (75%) and rejection of colostrum (1 1 %) were prevalent among the mothers. There was a delay in initiation of first breastfeeding. Although 77% of the mothers exclusively breastfed their babies at the first month, the prevalence of exclusive breastfeeding decreased to 50% by the third month. The main reason for giving additional foods was that the mothers felt breastmilk was insufficient. A significantly higher proportion of LBW infants received additional feeding than the normal infants. It might be due to the mothers perception that the additional foe
Involving the other half: male perception of BRAC's health program
(BRAC Research and Evaluation Division (RED), 1996-07) Shahaduzzaman; Chowdhury, AMR; Karim, Fazlul
In July 1991, BRAC integrated its diverse health activities into the newly established Women Health and Development Programme (WHDP). But as men play a key role in making decisions in deferent spheres of women's life, health programme managers increasingly recognize the importance of male involvement in women focused health program. This study was therefore done with the objectives, to determine the knowledge, attitude and felt need of the male population of the community regarding BRAC's Women's Health and Development Program. The principal investigator stayed for nearly a month (Jan1996) with a family in a typical village of a WHDP working area to gather information. Informal conversation , key informant interview and observation of health care service delivery was done . The study reveals that , men have a gep.eralized feeling of being neglected by the BRAC's health program. Men have knowledge only about the curative components of the programme though more programmatic input was given to the preventive components. Contradictory attitude was revealed among men regarding BRAC's programme. This was also found that there is lack of regular male contact by the field workers. However. a strong felt need \vas expressed by most men regarding health information and services. In order to ensure male involvement in the program. it was recommended to organize orientation session for field workers on male involvement, to strengthen male torums, to specify male audience, to open male only clinic and to recruit male community health workers.