Development knowledge and experience - from Bangladesh to Afhanistan and beyond

Chowdhury, A Mushtaque R; Alam, M. Aminul; Ahmed, Jalaluddin

doi:10.2471/blt.05.028332

Cited by 20 publications

(10 citation statements)

References 3 publications

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“…The injection safety practices indicators were also comparatively better in Dhaka. This may be due to the fact that there had been a few previous interventions implemented to reduce misuse and promote safe injection practices in the selected UHCs of Dhaka [ 12 , 13 ]. The authors of the study with the funding support from the WHO/SIGN project implemented MTP intervention in 2004/2005 in 4 UHCs (these 4 UGCs were also included in our current study) of Dhaka.…”

Section: Discussionmentioning

confidence: 99%

“…A recent intervention study using monitoring-training-planning (MTP) strategy (an intervention which combines managerial, educational and regulatory strategies)[ 4 ] showed that the intervention has reduced the use injections in some health complexes in Bangladesh [ 13 ]. The intervention results are only indicative rather than confirmatory owing to lack of proper expertise, trained personnel, funding and sound methodology; and a small sample size in limited study areas.…”

Section: Introductionmentioning

confidence: 99%

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A comprehensive situation assessment of injection practices in primary health care hospitals in Bangladesh

et al. 2011

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BackgroundUnderstanding injection practices is crucial for evidence-based development of intervention initiatives. This study explored the extent of injection use and injection safety practices in primary care hospitals in Bangladesh.MethodsThe study employed both quantitative and qualitative research methods. The methods used were - a retrospective audit of prescriptions (n = 4320), focus group discussions (six with 43 participants), in-depth interviews (n = 38) with a range service providers, and systematic observation of the activities of injection providers (n = 120), waste handlers (n = 48) and hospital facilities (n = 24). Quantitative and qualitative data were assessed with statistical and thematic analysis, respectively, and then combined.ResultsAs many as 78% of our study sample (n = 4230) received an injection. The most commonly prescribed injections (n = 3354) including antibiotics (78.3%), IV fluids (38.6%), analgesics/pain killers (29.4%), vitamins (26.7%), and anti-histamines (18.5%). Further, 43.7% (n = 1145) of the prescribed antibiotics (n = 2626) were given to treat diarrhea and 42.3% (n = 600) of IV fluids (n = 1295) were used to manage general weakness conditions. Nearly one-third (29.8%; n = 36/120) of injection providers reported needle-stick injuries in the last 6 months with highest incidences in Rajshahi division followed by Dhaka division. Disposal of injection needles, syringes and other materials was not done properly in 83.5% (n = 20/24) of the facilities. Health providers' safety concerns were not addressed properly; only 23% (n = 28/120) of the health providers and 4.2% (n = 2/48) of the waste handlers were fully immunized against Hepatitis B virus. Moreover, 73% (n = 87/120) of the injection providers and 90% (n = 43/48) of the waste handlers were not trained in injection safety practices and infection prevention. Qualitative data further confirmed that both providers and patients preferred injections, believing that they provide quick relief. The doctors' perceived injection use as their prescribing norm that enabled them to prove their professional credibility and to remain popular in a competitive health care market. Additionally, persistent pressure from hospital administration to use up injections before their expiry dates also influenced doctors to prescribe injections regardless of actual indications.ConclusionsAs far as the patients and providers' safety is concerned, this study demonstrated a need for further research exploring the dynamics of injection use and safety in Bangladesh. In a context where a high level of injection use and unsafe practices were reported, immediate prevention initiatives need to be operated through continued intervention efforts and health providers' training in primary care hospitals in Bangladesh.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

A comprehensive situation assessment of injection practices in primary health care hospitals in Bangladesh

et al. 2011

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“…By many accounts, BRAC is the largest NGO in the world. Its vast network of staff provides services to >110 million people in multiple countries 52. Despite being independently operated, BRAC has achieved nationwide program expansion more sustainably and with fewer management challenges than many of the government‐led programs cited above.…”

Section: Community Health Worker Program Scalabilitymentioning

confidence: 99%

“…Female CHVs, or Shasthya Shebikas , also sell health products such as contraceptives, iodized salt, ORS, safe delivery kits, sanitary napkins, and vegetable seeds with the support of microloan provisions from BRAC 11. Several other experimental cost‐recovery approaches are also being implemented at various BRAC sites that help motivate CHVs to provide high‐quality PHC services 52…”

Section: Community Health Worker Program Scalabilitymentioning

confidence: 99%

Community Health Workers in Global Health: Scale and Scalability

Liu

Sullivan

Khan

et al. 2011

Mount Sinai J Medicine

123

131

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Community health worker programs have emerged as one of the most effective strategies to address human resources for health shortages while improving access to and quality of primary healthcare. Many developing countries have succeeded in deploying community health worker programs in recognition of the potential of community health workers to identify, refer, and in many cases treat illnesses at the household level. However, challenges in program design and sustainability are expanded when such programs are expanded at scale, particularly with regard to systems management and integration with primary health facilities. Several nongovernmental organizations provide cases of innovation on management of community health worker programs that could support a sustainable system that is capable of being expanded without being stressed in its functionality nor effectiveness--therefore, providing for stronger scalability. This paper explores community health worker programs that have been deployed at national scale, as well as scalable innovations found in successful nongovernmental organization-run community health worker programs. In exploration of strategies to ensure sustainable community health worker programs at scale, we reconcile scaling constraints and scalable innovations by mapping strengths of nongovernmental organizations' community health worker programs to the challenges faced by programs currently deployed at national scale.

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“…43 Across the world, regardless of the type of microfinance model used, loan repayment rates above 95% are common. [59][60][61][62] Below, we describe some of the models found in the literature.…”

Section: Methodsmentioning

confidence: 99%

Microfinance: A General Overview and Implications for Impoverished Individuals Living with HIV/AIDS

Caldas¹,

Arteaga²,

Muñoz³

et al. 2010

Journal of Health Care for the Poor and Underserved

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Microfinance among people living with HIV/AIDS (PLWHA) faces some opposition and remains understudied. This literature review examines microfinance's evolution and impact on a variety of social and health indicators and its emerging implementation as a primary prevention tool for HIV and economic intervention for PLWHA. There is an abundance of literature supporting the apparent utility of microfinance. However, our understanding of the subject remains clouded by the heterogeneity and methodological limitations of existing impact studies, and access limitations to microfinance curbs our understanding of microfinance for this population. Existing literature suggests PLWHA could attain economic stability from microfinance and achieve successful repayment rates in some settings. The precarious socioeconomic and health issues of PLWHA pose unique challenges to minimizing loan default risk. Carefully-designed clinical studies are needed to assess whether PLWHA can be as successful with microfinance as healthy individuals.

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Development knowledge and experience - from Bangladesh to Afhanistan and beyond

Cited by 20 publications

References 3 publications

A comprehensive situation assessment of injection practices in primary health care hospitals in Bangladesh

A comprehensive situation assessment of injection practices in primary health care hospitals in Bangladesh

Community Health Workers in Global Health: Scale and Scalability

Microfinance: A General Overview and Implications for Impoverished Individuals Living with HIV/AIDS

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