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Publications

Filtering by Tag: M Hafizur Rahman

What Do They Do? Interactions Between Village Doctors and Medical Representatives in Chakaria, Bangladesh

Future Health Systems

Hafizur Rahman, M, Agarwal, S, Tuddenham, S, Iqbal, M, Bhuiya, A, and Peters, DH (2014) What do they do? Interactions between village doctors and medical representatives in Chakaria, Bangladesh International Health doi:10.1093/inthealth/ihu077

Informally trained village doctors supply the majority of health care services to the rural poor in many developing countries. This study describes the demographic and socioeconomic differences between medical representatives, hired by pharmaceutical companies to provide their products to health providers, and village doctors in rural Bangladesh, and explores the nature of their interactions. The research team used focus group discussions, in-depth interviews, and a quantitative survey to understand practice perceptions. They found that medical representatives have a higher average per capita monthly expenditure compared to village doctors, and that the former are better educated with 98% having bachelor's degrees whereas 84% of village doctors have twelfth grade education or less. Medical representatives are the principal information source about new medications for the village doctors. Furthermore, incentives offered by medical representatives and credit availability might influence the prescription practices of village doctors. Findings suggests that improvements in the quality of health care delivered to the rural poor in informal provider-based health markets require stricter regulations and educational initiatives for providers and medical representatives.

Can community health workers increase coverage of reproductive health services?

Future Health Systems

Health services were severely affected during the many years of instability and conflict in Afghanistan. In recent years, substantial increases in the coverage of reproductive health services have been achieved, yet absolute levels of coverage remain very low, especially in rural areas. One strategy for increasing use of reproductive health services is deploying community health workers (CHWs) to promote the use of services within the community and at health facilities. Results show that presence of a female CHW in the community is associated with higher use of modern contraception, antenatal care services and skilled birth attendants but presence of a male CHW is not. Community-level random effects were also significant.
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Exploring new health markets: experiences from informal providers of transport for maternal health services in Eastern Uganda

Future Health Systems

Although a number of intermediate transport initiatives have been used in some developing countries, available evidence reveals a dearth of local knowledge on the effect of these rural informal transport mechanisms on access to maternal health care services, the cost of implementing such schemes and their scalability. This paper, attempts to provide insights into the functioning of the informal transport markets in facilitating access to maternal health care. It also demonstrates the role that higher institutions of learning can play in designing projects that can increase the utilization of maternal health services.
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Increasing access to institutional deliveries using demand and supply side incentives: early results from a quasi-experimental study

Future Health Systems

eographical inaccessibility, lack of transport, and financial burdens are some of the demand side constraints to maternal health services in Uganda, while supply side problems include poor quality services related to unmotivated health workers and inadequate supplies. Most public health interventions in Uganda have addressed only selected supply side issues, and universities have focused their efforts on providing maternal services at tertiary hospitals. To demonstrate how reforms at Makerere University College of Health Sciences (MakCHS) can lead to making systemic changes that can improve maternal health services, a demand and supply side strategy was developed by working with local communities and national stakeholders.
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Medical Representatives in rural Bangladesh: Who are They and What Is Their Role in the Drug Market?

Future Health Systems

M Hafizur Rahman from Johns Hopkins Bloomberg School of Public Health looks at the role of medical representatives in Chakaria, Bangladesh. He focuses on their link with informal providers of health services in rural areas. The presentation was given on 11 July 2011 at the 8th World Congress on Health Economics (iHEA).
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WP15 - Nutritional Status of Children in India: Household Socio-Economic Condition as the Contextual Determinant

Future Health Systems

Despite recent achievement in economic progress in India, the fruit of development has failed to secure a better nutritional status among all children of the country. Growing evidence suggest there exists a socioeconomic gradient of childhood malnutrition in India. The present paper is an attempt to measure the extent of socio-economic inequality in chronic childhood malnutrition across major states of India and to realize the role of household socio-economic status (SES) as the contextual determinant of nutritional status of children.
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Changes in utilization of health services among poor and rural residents in Uganda: are reforms benefitting the poor?

Future Health Systems

Uganda implemented health sector reforms to make services more accessible to the population. An assessment of the likely impact of these reforms is important for informing policy. This paper describes the changes in utilization of health services that occurred among the poor and those in rural areas between 2002/3 and 2005/6 and associated factors.
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Care seeking for postpartum morbidities in Murshidabad, rural India

Future Health Systems

spite the high prevalence of postpartum morbidity and the danger of maternal mortality, women in low-resource settings such as rural India frequently fail to seek care from formal health providers. Understanding the factors that influence care-seeking behavior for postpartum health problems in India is vital to setting program priorities and designing appropriate interventions. Our study sought to elucidate these factors in the rural district of Murshidabad, India.
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Nutritional status of children in India: household socio-economic condition as the contextual determinant

Future Health Systems

The present paper is an attempt to measure the extent of socio-economic inequality in chronic childhood malnutrition across major states of India and to realize the role of household socio-economic status (SES) as the contextual determinant of nutritional status of children.
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Does service accessibility reduce socio-economic differentials in maternity care seeking? Evidence from rural Bangladesh

Future Health Systems

The specific objectives of this research are to examine the socioeconomic differentials of maternity care seeking, and to determine whether accessibility of health services reduces the socioeconomic differentials in maternity care seeking.
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Poverty and Access to Health Care in Developing Countries

Future Health Systems

Poverty contributes to ill health among the poor and to impeded development among poor children. Conversely, It begins with chapters addressing specific diseases associated with poverty, such as tuberculosis, malaria, HIV/AIDS, lymphatic filariasis, hookworm, and measles, along with public health issues in the developing world. Other chapters address poverty and maternal health, health disparities, and human nutrition. Effects of health care services, education, and housing on human development are also addressed, as are the social, economic, engineering, and technology determinants of human development.
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Health markets and future health systems: innovation for equity

Future Health Systems

If health services are to benefit the poor, it is essential to gain a detailed understanding of such markets that can both inform attitudes towards them and guide innovations that attempt to engage with them to improve health outcomes.
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