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Community health workers for noncommunicable diseases prevention and control in Bangladesh:a qualitative study

Global Health Research and Policy 2021年第1期6卷 497-506页

作者： lal rawal Shamim Jubayer Sohel R.Choudhury Sheikh Mohammed Shariful Islam Abu S.Abdullah School of Health Medical and Applied SciencesCentral Queensland UniversitySydney Campus400 Kent StreetSydneyNSWAustralia Physical Activity Research Group Appleton InstituteCentral Queensland UniversityAdelaideSAAustralia Translational Health Research Institute(THRI) Western Sydney UniversitySydneyAustralia National Heart Foundation Hospital and Research Institute Mirpur 2Dhaka 1216Bangladesh Institute for Physical Activity and Nutrition Deakin UniversityMelbourneAustralia Global Health Research Center Duke Kunshan University8 Duke AvenueKunshan 215347People’s Republic of China Duke Global Health Institute Duke UniversityDurhamNCUSA Boston University School of Medicine Boston Medical CenterBostonMAUSA

Background:The increasing burden of Non-Communicable Diseases(NCDs)in Bangladesh underscores the importance of strengthening primary health care *** this study,we examined the barriers and facilitators to engaging Community Health Workers(CHWs)for NCDs prevention and control in ***:We used multipronged approaches,including *** analyses using a literature review,key personnel and stakeholders’consultative meetings,and exploratory studies.A grounded theory approach was used for qualitative data collection from health facilities across three districts in *** conducted in-depth interviews with CHWs(Health Inspector;Community Health Care Provider;Health Assistant and Health Supervisor)(n=4);key informant interviews with central level health policymakers/managers(n=15)and focus group discussions with CHWs(4 FGDs;total n=29).Participants in a stakeholder consultative meeting included members from the government(n=4),non-government organisations(n=2),private sector(n=1)and universities(n=2).Coding of the qualitative data and identification of themes from the transcripts were carried out and thematic approach was used for data ***:The CHWs in Bangladesh deliver a wide range of public health *** also provide several NCDs specific services,including screening,provisional diagnosis,and health education and counselling for common NCDs,dispensing basic medications,and referral to relevant health *** services are being delivered from the sub-district health facility,community clinics and urban health *** participants identified key challenges and barriers,which include lack of NCD specific guidelines,inadequate training,excessive workload,inadequate systems-level support,and lack of logistics supplies and ***,the facilitating factors to engaging CHWs included government commitment and program priority,development of NCD related policies and strategies,establishment of NCD corners,community su

关键词： Community health workers Non-communicable diseases Health policy Health systems Challenges and barriers

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Depression and health-related quality of life of patients with type 2 diabetes attending tertiary level hospitals in Dhaka,Bangladesh

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Global Health Research and Policy 2023年第1期8卷 91-104页

作者： Manish K.Namdeo Sarita Verma Rajat Das Gupta Rubana Islam Shaila Nazneen lal B.rawal Independent Scholar and Alumni JPGSPHBRAC UniversityBangladeshChhindwaraIndia Tata Institute of Social Sciences MumbaiIndia University of South Carolina ColumbiaSCUSA International Initiative for Impact Evaluation(3Ie) ColumbiaSCUSA University of Texas at El Paso El PasoTXUSA Central Queensland University Sydney CampusSydneyAustralia.

Introduction Type 2 diabetes mellitus(T2DM)and depression are closely *** with T2DM are at increased risk of developing depression and vice versa.T2DM and depression comorbid conditions adversely affect Health-Related Quality of Life(HRQOL)and management of *** this study,we assessed depression and HRQOL among patients with T2DM in Dhaka,*** A cross-sectional study was conducted in two tertiary-level hospitals in Dhaka,*** were collected from 318 patients with T2DM.A set of standard tools,PHQ-9(for assessing depression)and EuroQol-5D-5L(for assessing the HRQOL),were *** analyses,including Chi-square and Fisher’s exact tests,Wilcoxon(Mann-Whitney),and Spearman’s correlation coefficient tests,were performed using SPSS(v.20).Results The majority of the patients(58%)were females,with a mean age(standard deviation)of 52±10 years,and 74%of patients lived in urban *** prevalence of depression was 62%(PHQ-9 score≥5).Over three-quarters(76%)reported problems in the anxiety/depression dimension of EQ-5D,followed by pain/discomfort(74%),mobility(40%),self-care(36%),and usual activities(33%).The depression and T2DM comorbid condition were associated with all the five dimensions of EQ-5D(χ^(2)statistics with df=1 was 52.33,51.13,52.67,21.61,7.92 for mobility,self-care,usual activities,pain/discomfort,and anxiety/depression dimensions respectively,p-<0.01).The mean EQ-5D index(0.53 vs.0.75)and the mean EQ-5D VAS(65 vs.76)both showed lower values in T2DM patients with depression compared to T2DM patients without depression(Wilcoxon test,p-<0.001).Conclusions We conclude that the majority of the patients with T2DM had comorbid conditions,and the HRQOL was negatively affected by comorbid depression in T2DM *** suggests the importance of timely screening,diagnosis,treatment,and follow-up of comorbid depression in T2DM patients to improve overall health and QOL.

关键词： Depression HRQOL Comorbidity Bangladesh Type 2 diabetes

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Health problems and utilization of health services among Forcibly Displaced Myanmar Nationals in Bangladesh

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Global Health Research and Policy 2021年第1期6卷 97-109页

作者： lal B.rawal Kie Kanda Tuhin Biswas MdImtiaz Tanim Padam Kanta Dahal Md.Rajibul Islam Tarique Md.Nurul Huda Tahmina Begum Berhe W.Sahle Andre M.N.Renzaho Iqbal Anwar School of Health Medical and Applied Sciences Collage of Science and Sus-tainabilityCentral Queensland UniversitySydney CampusSydneyAustralia Physical Activity Research Group Appleton InstituteCentral Queensland UniversityWayvilleAustralia Translational Health Research Institute Western Sydney UniversitySydneyAustralia School of Nursing and Midwifery Western Sydney UniversitySydneyAustralia The University of Queensland BrisbaneAustralia mPower Social Enterprises Ltd. DhakaBangladesh Health Intervention and Technology Assessment Program(HITAP) Non-thaburiThailand Infectious Diseases Division icddrbDhakaBangladesh Health Systems and Population Division icddrbDhakaBangladesh School of Nursing and Midwifery Deakin UniversityGeelongVICAustralia Centre for Quality and Patient Safety Research(QPS) Alfred Health PartnershipMel-bourneVICAustralia Melbourne School of Population and Global Health University of MelbourneMelbourneVICAustralia School of Medicine Western Sydney UniversitySydneyAustralia

Background:Access to and utilization of health services have remained major challenges for people living in low-and middle-income countries,especially for those living in impaired public health environment such as refugee camps and temporary *** study presents health problems and utilization of health services among Forcibly Displaced Myanmar Nationals(FDMNs)living in the southern part of ***:A mixed-method(quantitative and qualitative)approach was *** 999 household surveys were conducted among the FDMNs living in makeshift/temporary settlements and host *** used a grounded theory approach involving in-depth interviews(IDIs),focus group discussions(FGDs),and key informant interviews(KIIs)including 24 IDIs,10 FGDs,and 9 *** quantitative data were analysed with ***:The common health problems among the women were pregnancy and childbirth-related complications and violence against *** the children,fever,diarrhoea,common cold and malaria were frequently observed health *** general health,HIV/AIDS,insecurity,discrimination,and lack of employment opportunity were common problems for ***,61.2%women received two or more antenatal care(ANC)visits during their last pregnancy,while 28.9%did not receive any ANC *** majority of the last births took place at home(85.2%)assisted by traditional birth attendants(78.9%),a third(29.3%)of whom suffered pregnancy-and childbirth-related *** clinics run by the non-governmental organizations(NGOs)(76.9%)and private health facilities(86.0%)were the most accessible places for seeking healthcare for the FDMNs living in the makeshift *** participants heard about HIV/AIDS.78.0%of them were unaware about the means of HIV transmission,and family planning methods were poorly used(45.2%).Conclusions:Overall,the health of FDMNs living in the southern part of Bangladesh is poor and they have inadequate access to and utilization o

关键词： Rohingya refugees Bangladesh Family planning HIV/AIDS Health services

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