The FHS-India team has been engaged in research on the human health status in the Indian Sundarbans since 2009 and came up with a comprehensive report in 2010. A more in-depth report on the health of children of the Indian Sundarbans was published in 2013 in the name of Sundarbans Health Watch. In this present endeavor we have reflected on the pathways of climate change impacts on the health of the Sundarbans’ children. This report is based on a mixed method study conducted in Sagar, one of the six most vulnerable blocks out of the nineteen administrative blocks of the Sundarbans. This study has made an attempt to find out the present condition of different aspects of child health under climate crisis, to identify the gaps in service delivery and possible ways out on the basis of scientific evidence.Read More
Filtering by Category: Childhood health
Ethiopia successfully achieved Millennium Development Goal 4 of reducing under five mortality by more than two-thirds between 1990 and 2015. Adoption of the health extension programme, and implementation of the integrated management of neonatal and childhood illnesses (IMNCI) and the integrated community case management (iCCM) models of care, contributed to this achievement. However, child mortality remains high at 67 per 1,000 live births.Read More
Where girls are less likely to be fully vaccinated than boys: Evidence from a rural area in Bangladesh
Hanifi SM, Ravn H, Aaby P and Bhuiya A (2018) Where girls are less likely to be fully vaccinated than boys: Evidence from a rural area in Bangladesh, Vaccine, 36(23):3323-30, DOI: 10.1016/j.vaccine.2018.04.059
Immunization is one of the most successful and effective health intervention to reduce vaccine preventable diseases for children. Recently, Bangladesh has made huge progress in immunization coverage. In this study, we compared the recent immunization coverage between boys and girls in a rural area of Bangladesh.Read More
A community-based cluster randomised controlled trial in rural Bangladesh to evaluate the impact of the use of iron-folic acid supplements early in pregnancy on the risk of neonatal mortality
Huda TM, Rahman MM, Raihana S, Islam S, Tahsina T, Alam A, Agho K, Rasheed S, Hayes A, Karim MA and Rahman QS (2018) A community-based cluster randomised controlled trial in rural Bangladesh to evaluate the impact of the use of iron-folic acid supplements early in pregnancy on the risk of neonatal mortality: the Shonjibon trial, BMC Public Health, 18(1):816, DOI: 10.1186/s12889-018-5713-1
Iron-deficiency is the most common nutritional deficiency globally. Due to the high iron requirements for pregnancy, it is highly prevalent and severe in pregnant women. There is strong evidence that maternal iron deficiency anaemia increases the risk of adverse perinatal outcomes. However, most of the evidence is from observational epidemiological studies except for a very few randomised controlled trials. IFA supplements have also been found to reduce the preterm delivery rate and neonatal mortality attributable to prematurity and birth asphyxia. These results combined indicate that IFA supplements in populations of iron-deficient pregnant women could lead to a decrease in the number of neonatal deaths mediated by reduced rates of preterm delivery. In this paper, we describe the protocol of a community-based cluster randomised controlled trial that aims to evaluate the impact of maternal antenatal IFA supplements on perinatal outcomes.Read More
The FHS India team have produced a new film titled Children of an Uncertain Climate, based on an FHS study titled ‘Decoding Child Health Impact under Climate Crisis.’ This short film identifies the pathways by which Climate Change is impacting the child health in Indian Sundarbans – a climatically vulnerable setting.Read More
The Sundarbans, the mangrove forest delta shared both by India and Bangladesh, is among the worst hit regions of climate change in the world. Even though food insecurities due to climate change are felt across the region, the distribution of vulnerabilities is largely uneven depending upon existing climatic and social intersections.
Within the context of socio-cultural and political dynamics, and rapid globalization, efforts to respond to, mitigate, or adapt to climate change needs to address issues of equity and social justice, posing both challenges and opportunities.Read More
Hanifi SMA, Das S, and Rahman M (2018) Bangladeshi neonates miss the potential benefits of early BCG vaccination, International Journal of Epidemiology, Volume 47, Issue 1, Pp 348–349, DOI: 10.1093/ije/dyx223
Bangladesh is a high-TB-burden country. It is recommended, for TB-endemic areas, that BCG be given to neonates at the first possible opportunity of their life. Several observational studies and lately a few randomized trials show that BCG offers ‘heterologous protective effects’ beyond its target disease tuberculosis. A recent review by WHO’s Strategic Advisory Group of Experts on Immunization (SAGE) on non-specific effects of BCG vaccine shows that vaccination at birth reduces neonatal mortality by 48% (18–67%), which is mainly due to the prevention of neonatal sepsis and respiratory infections. In Bangladesh, neonatal mortality is high (28 per 1000 live births) (and accounts for about two-thirds of all under-five deaths), mainly due to infections, birth asphyxia, respiratory infection and prematurity.Read More
Socioeconomic inequalities in under-five mortality in rural Bangladesh: evidence from seven national surveys spreading over 20 years
Chowdhury AH, Hanifi SMA, Mia MN and Bhuiya A (2017) Socioeconomic inequalities in under-five mortality in rural Bangladesh: evidence from seven national surveys spreading over 20 years, International Journal for Equity in Health (2017) 16:197, DOI: 10.1186/s12939-017-0693-9
Socioeconomic inequality in health and mortality remains a disturbing reality across nations including Bangladesh. Inequality drew renewed attention globally. Bangladesh though made impressive progress in health, it makes an interesting case for learning. This paper examined the trends and changing pattern of socioeconomic inequalities in under-five mortality in rural Bangladesh. It also examined whether mother’s education had any effect in reducing socioeconomic inequalities.Read More
Geo-climatically Vulnerable Sundarbans: A social network analysis of mother’s social ties and child care
Ghosh U, Bose S, Bramhachari R (2017) Geo-climatically Vulnerable Sundarbans: A social network analysis of mother’s social ties and child care, International Journal for Population, Development and Reproductive Health, Volume 1, Issue 1, pp. 27 - 41
Present paper explores mother's individual and system level social ties to support in taking care of children in resource scarce setting of the Indian Sundarbans. Climatic uncertainties resulted in male out-migration in search of alternative livelihoods leading towards female-headed households. Women now face triple burden of works – livelihood, household chores and childcare. Hence it is pertinent to know how and to what extent social ties support child care in female headed households in comparison to male headed households.Read More
Opportunities for strengthening infant and young child feeding policies in South Asia: Insights from the SAIFRN policy analysis project
Thow AM, Karn S, Devkota MD, Rasheed S, Roy SK, Suleman Y, Hazir T, Patel A, Gaidhane A, Puri S, Godakandage S, Senarath U and Dibley MJ (2017) Opportunities for strengthening infant and young child feeding policies in South Asia: Insights from the SAIFRN policy analysis project, BMC Public Health, 17(Suppl 2):404 DOI: 10.1186/s12889-017-4336-2
South Asian countries experience some of the highest levels of child undernutrition in the world, strongly linked to poor infant and young child feeding (IYCF) practices. Strong and responsive policy support is essential for effective interventions to improve IYCF. This study aimed to identify opportunities for strengthening the policy environment in the region to better support appropriate infant and young child feeding.Read More
Analysis of stakeholders networks of infant and young child nutrition programmes in Sri Lanka, India, Nepal, Bangladesh and Pakistan
Uddin S, Mahmood H, Senarath U, Zahiruddin Q, Karn S, Rasheed S and Dibley M (2017) Analysis of stakeholders networks of infant and young child nutrition programmes in Sri Lanka, India, Nepal, Bangladesh and Pakistan, BMC Public Health, 17(Suppl 2):405, DOI: 10.1186/s12889-017-4337-1
Effective public policies are needed to support appropriate infant and young child feeding (IYCF) to ensure adequate child growth and development, especially in low and middle income countries. The aim of this study was to: (i) capture stakeholder networks in relation to funding and technical support for IYCF policy across five countries in South Asia (i.e. Sri Lanka, India, Nepal, Bangladesh and Pakistan); and (ii) understand how stakeholder networks differed between countries, and identify common actors and their patterns in network engagement across the region.
Rasheed S, Roy SK, Das S, Chowdhury SN, Iqbal M, Akter SM, Jahan K, Uddin S and Thow AM (2017) Policy content and stakeholder network analysis for infant and young child feeding in Bangladesh, BMC Public Health, 17(Suppl 2):402, DOI: 10.1186/s12889-017-4338-0
Appropriate infant and young child feeding (IYCF) practices are essential for nutrition of infants and young children. Bangladesh has one of the highest levels of malnutrition globally along with sub-optimal IYCF practices. A supportive policy environment is essential to ensure that effective IYCF interventions are scaled up.
The objectives of our study were to assess the support for IYCF in the national policy environment through policy analysis and stakeholder analysis and in so doing identify opportunities to strengthen the policy environment.Read More
Impact of fortified biscuits on micronutrient deficiencies among primary school children in Bangladesh
Adams AM, Ahmed R, Mahbub Latif AHM, Rasheed S, Das SM, Hasib E, Farzana FD, Ferdous F, Ahmed S, Faruque ASG (2017) Impact of fortified biscuits on micronutrient deficiencies among primary school children in Bangladesh, PLOS One, 12(4): e0174673, DOI: 10.1371/journal.pone.0174673
Micronutrient deficiencies can compromise the development potential of school-aged children, and their later health and productivity as adults. School feeding and school-based fortification approaches have been utilized globally to redress nutritional deficiencies in this age group. The authors explored the acceptability and micronutrient impact of a Bangladesh Government supported school-based micronutrient fortification program for children attending rural primary schools in 10 disadvantaged sub-districts.
Expressing collective voices on children’s health: photovoice exploration with mothers of young children from the Indian Sundarbans
Ghosh U, Bose S, Bramhachari R and Mandal S (2016) Expressing collective voices on children’s health: photovoice exploration with mothers of young children from the Indian Sundarbans, BMC Health Services Research, 16:1866, DOI: 10.1186/s12913-016-1866-8
The Indian Sundarbans is marked by inhospitable terrain and frequent climatic shocks which jointly hinder access to health care. Community members, and women in particular, have few means to communicate their concerns to local decision makers. Photovoice is one way in which communities can raise their local health challenges with decision makers. This study unlocks mothers’ voices on the determinants of their children’s health to inform local level decision-making on child health issues in the Indian Sundarbans.Read More
Participatory Action Research (PAR) methodologies can help empower marginalised groups to capture and articulate their experiences and concerns to decision-makers. Future Health Systems (FHS) has worked with women in the Sundarbans of West Bengal to use Photovoice – a PAR method using photographs and narrative – to raise awareness of the challenges the women face to access health care. The initiative has led local policymakers and health workers to prioritise, and take steps to address, the issues.
FHS India Research Brief 9 - Voices from the ground: Photovoice research on children’s health in the Indian Sundarbans
The objective of this brief is to introduce the Photovoice method, highlight how it helped capture the voices of mothers in the Sundarbans, and demonstrate how the method can bridge the gap between communities and local decision-makers.Read More
Effectiveness of a pay-for-performance intervention to improve maternal and child health services in Afghanistan: a cluster-randomized trial
Engineer C, Dale E, Agarwal A, Agarwal A, Alonge O, Edward A, Gupta S, Schuh H, Burnham G, Peters DH (2016) Effectiveness of a pay for performance intervention to improve maternal and child health services in Afghanistan: A cluster-randomized trial, International Journal of Epidemiology, doi: 10.1093/ije/dyv362
A cluster randomized trial of a pay-for-performance (P4P) scheme was implemented in Afghanistan to test whether P4P could improve maternal and child (MCH) services. The authors found that the intervention had minimal effect, possibly due to difficulties communicating with health workers and inattention to demand-side factors. P4P interventions need to consider management and community demand issues.
In health-care settings, stakeholder’s knowledge, attitudes and perspectives influence their perception towards children, including children’s rights and right to health. The knowledge and attitudes generally present a culture of how children’s right are perceived and treated. This study explored the knowledge, attitudes and perspectives of 35 Indian health care stakeholders regarding children’s rights and right to health and their perspectives on realization of the selected domains of rights in reality.Read More
FHS India Research Brief 8: Early Childhood Development in the Sundarbans Neglect in the face of risks and adversity
Risks and adversities during early childhood majorly hamper this neurological development. They are also irreversible with long standing impact on the eventual productivity in life. Given the huge impact that deficits in the early years have in terms of human productivity and sustainable development, early childhood development needs serious attention. This research brief provides formative evidence on the gaps in the care practices needed for Early Childhood Development in the Sundarbans. It will begin by first gauging the status of child development, the gaps and challenges in key practices needed for it and it will conclude with key recommendations.Read More