Research Reports (2009): Health Studies, Vol - XLI
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Item Possession and usage of insecticidal bed nets among the people of Uganda: is BRAC Uganda Health Programme pursuing a pro-poor path?(BRAC Research and Evaluation Division (RED), 2009) Ahmed, Syed Masud; Zerihun, AbebualThe use of insecticidal bed nets is found to be an effective public health tool for control of malaria, especially for under-five children and pregnant women. BRAC, an indigenous Bangladeshi non-governmental development organization, started working in the East African state of Uganda in June 2006. As part of its efforts to improve the health and well-being of its participants, BRAC Uganda has been distributing long lasting insecticide-treated bed nets (LLIN) at a subsidized price through health volunteers since February 2008. This study was conducted in March-April 2009 to examine how equitable the programme had been in consistence with BRAC Uganda's pro-poor policy.Item Factors influencing utilization of Manoshi delivery centers in urban slums of Dhaka(BRAC Research and Evaluation Division (RED), 2009-12) Rashid, Sarawat; Hashima-e-Nasreen; Akter, MahmudaBRAC introduced Manoshi - a community-based maternal, neonatal and child health initiative in urban slums of Bangladesh in 2007. Community delivery centers were established to provide appropriate management of delivery and essential newborn care along with referral facilities. A population and facility-based exploratory qualitative study, conducted during November 2007 to January 2008, aimed to identify factors affecting the use of delivery centers. Data were collected through in-depth interviews, focus group discussions, exit interviews, informal discussion with different service providers and non-participant observations. Findings suggest that slum residents preferred delivery centers because of free service, delivery attended by trained birth attendants, and management of complications through referral linkages. Preference of home delivery and essential newborn care were identified as an important factor that hindered the use of delivery centers though delivery at the centers was safer than the delivery at home. Other reasons for not using the delivery centers were preference for family birth attendants, facing no problem at home, and objection from mothers-in-law. The delivery-centre related factors, namely, absence of medical doctors, non availability of drugs and injections and fear for surgery were also found to be factors resisting use of delivery centers. Provision for salary or other incentives for health providers, quality performance, training of health providers on effective management of complications and good client-provider interaction may influence better use of delivery centers and play a significant role to continue Manoshi in urban slums without BRAC support.Item Exploring reasons of variation in target achievement in sanitary latrine construction under school sanitation programme of BRAC WASH(BRAC Research and Evaluation Division (RED), 2009-06) Arif, Tahmid; Ahmed, ShamimSince 2007 BRAC's Water, Sanitation and Hygiene (WASH) programme has been promoting construction of sanitary latrines with water source and waste management provision at the girls' secondary educational institutes in 150 sub·districts across Bangladesh. In all cases BRAC offered partial financial support for constructing sanitary latrines and rest of the cost was managed by the school authority. Three educational institutes from each union in a sub·district were considered for this intervention. Each educational institute received Tk. 35,000 from BRAC for procuring construction materials. However, it was observed that target achievement in constructing sanitary latrine was not equal in all the regions. For instance, in the south target achievement was lower compared to the north. Although, it was assumed that in the south achievement would be higher compared to the north as socioeconomic status of the south is better compared to the north. This study explored the reasons of different levels of target achievement in constructing sanitary latrine for girls' in those two regions. A qualitative study was done in Bogra, Thakurgaon, Khulna and Jessore districts. The first two districts were selected from the north and the rest two districts from the south. Each sub·district represented one district. From each sub·district five unions were selected for this study. Data were collected through focus group discussions, in-depth interviews and observations from WASH staff, school teachers, school management committee (SMC) members and guardians. Findings show that financial support of BRAC played a vital role in attracting majority of the institutions to construct the sanitary latrine. However, for some of the institutions particularly for those in the south, the amount of money allocated by BRAC was not attractive. It also shows that unanticipated price hike of construction materials, natural disasters such as cyclone and flood, political affiliatjon, unwillingness of some of the SMC members and school authorities, negotiation-related issues, school selection criteria and misconception about BRAC were some other major constraints against achieving the target in the south. Whereas in the north, necessity and design ofthe latrine, donation from the community people, self interest of teachers; SMC members and guardians, role of village WASH committee, role of female teachers, reputation of BRAC and support from the union parishad chairmen helped in achieving the target.Item Prevention and treatment of malaria in endemic areas of Bangladesh: how are the NGO partners doing?(BRAC Research and Evaluation Division (RED), 2009-06) Ahmed, Syed Masud; Hossain, Shamim