1. Maternal and Child Health Project: BCDF signed a project with National Center for Child Health and Development (NCCHD), a National Research and Development Agency supervised by the Ministry of Health, Labour and Welfare of Japan. This 3 years project will be implemented in Lohagora of Narail and Araihazar of Narayanganj districts in Bangladesh. About 3,000 mothers will be the participants for this research project. ($35,000 for 3 years)
2. WHO funded project on Infectious Diseases: Vice-President of BCDF, Dr. Mosiur Rahman’s project is selected for the Joint TDR/World Health Organization South-East Asia Region Small Grants Scheme. The project goal is to strengthen local health systems. The title of the project is “A multi-component intervention to reduce infectious disease and improve hygiene and well-being among primary school children in Bangladesh: a randomized controlled trial”.
3. Tobacco research project with Yonsei University, Korea: BCDF completed data collection among adolescent those who are working in tobacco factories in Bangladesh for further information on their health social issues.
Title: Health assessment of children working in tobacco processing industry: A scenario from a developing country. ($5,000)
Although child labor is not accepted but enforced by social norms and economic realities, child labors are very common in Bangladesh. Many families rely on the income generated by their children for survival, so child labor is often highly valued . Additionally, employers often prefer to employ children because they can pay cheaper and considered to be more compliant and obedient than adults. From agriculture to industry child labor is one of major part of workforce in the whole country. Total 7.4 million children are working in the different sectors in Bangladesh . Around 1.3 million children are engaged with hazardous work where 75,000 workers are employed in 195 bidi (kind of smoking stick) factories of Bangladesh . Tobacco production and processing is one of the biggest spaces in Bangladesh where many children are working and this is defined as hazardous work. This type of work is impacting on their mental and physical health and making impediment on their growth. By working in the tobacco factories, children are affecting major health problem related to tobacco.
Methodology: This cross-sectional study will be conducted in northern part of Bangladesh where a lot of tobacco factories are located. Data will be collected into three steps. Physical assessment data will be collected from children by the physicians, key informant interview will be conducted with the child labor, recruiter and the key people engage with this factories. A semi-structured questioner will be used to collect the data from the participants.
1. UNICEF, Child labor in Bangladesh, Updated June 2010
2. International Labour Organization (ILO), Baseline Survey on Child Domestic Labour in Bangladesh, 2006
3. Bangladesh Bureau of Statistics, Report on National Child Labour Survey, 2002-2003
Study area and participants: This study will be conducted in Rangpur and Thakurgaon district which are consider as most tobacco production and procession zone. Initially the planning is to conduct physical assessment for 200 children who are working for tobacco processing in the tobacco industries. Total 30 key informant interviews will be conduct where 20 will be within child labor and 10 will be key stakeholders related to this sector including recruiter, NGO personnel, experts, government officials, etc.
Utilization of the Results: This study will provide information of prevalence of tobacco related disease and the socio-demographic information of the child labor who engage with the tobacco processing in Bidi factories. The outcomes will help to take healthy initiatives for child workers and will support to develop a comprehensive national child policy in Bangladesh.
Ethical Implication: Child workers are not registered and to not wish to expose themselves socially as worker in the tobacco/Bidi factory, for this reason, the ethical approach to interviewing this population is challenges. We will follow all rules and regulation of Institute of Biological Science, University of Rajshahi, Bangladesh.
4. Project title: Development of a mHealth-based package targeting women at reproductive age for NCDs prevention
The Period of the Project: August 01 2018 ~ March 31 2019 ($20,000)
Project plan: In the proposed research, we plan (1) to develop a comprehensive package of community-based intervention to prevent NCDs targeting women at reproductive age (15-49 years old) and (2) to implement a pilot study for preparing large-scale trials for the impact evaluation in the near future. The field study will be conducted in two Upazilas Dhamrai (from Dhaka District in Dhaka division) and Lohagora (from Narail District in Khulna division) in Bangladesh during July 2018 to March 2019, by Bridge of Community Development Foundation (BCDF), a Non-Government Organization (NGO) registered by the Government of Bangladesh. Dhamrai has 16 Unions and Lohagora has 12 Unions (the smallest administrative unit in rural Bangladesh). The rural population in Dhamrai and Lohagora is 306,704 and 215,902, respectively. In these two study sites a cluster randomized controlled trials (RCT) is ongoing to assess the effectiveness of an enhanced program of maternal and child health (MCH) handbook by mobile platform on maternal and neonatal health outcomes, with a total of 3,000 pregnant women and their families to participate in. The mobile platform has made an active linkage between community people and health workers, mobilizing pregnant women to utilize continuum of care and to learn about how to promote health for themselves, their children and families. The current project indicates the usefulness of the mobile platform and the network to improve health literacy of the community people. In Bangladesh, the coverage of mobile phone is universal in rural area, while that of modern communication tools, such as smart phone and ipad, is relevantly low. Therefore, the established mobile platform will be applied in the intervention package in the proposed project.
Development of the intervention among target women at reproductive age who have given a birth during the past one year, in particularly those detected or suspected to have GDM during pregnancy, as they are more likely to expose to the high risk of metabolic symptoms and diabetes in later stage of their life. Based on the evidence proved by previous empirical studies, we assume that the improved life style and health behaviors may reduce the risk to develop NCDs in later life. By referring evidence synthesized by integrated methodologies such as systematic review, meta-analysis and health technology assessment, as well as the counselling interventions to help women who experienced GDM, hypertension, and depression during pregnancy in improving their health behaviors to prevent adverse outcomes conducted in Japan and Thailand by our research team members, a comprehensive intervention package covering relevant daily events such as diet, sleep and physical activities and monitoring related biometric indicators will be developed for accepting for rural Bangladesh. We will try best the cultural fit of the package and develop by the expert in the country. The influence of socio-cultural factors on the life style will be considered to facilitate the implementation and incorporation of the designed intervention in the local health system and society. For example, a guide on nutrition and eating will fit the dietary customs in Bangladesh by involvement of local nutrient and make it acceptable in community people. Then based on theories of behavior economics, a user friendly version of mobile messages will prepare to guide health behaviors covering diet (especially reducing consumption of salt, sugar and oil), sleep and physical activities in daily life at specific gestational ages (first trimester, second trimester and third trimester), postnatal periods (6 weeks, 3 months, 1 years after child birth), as well as for life course. Major indicators of the expected outcomes are detection rate of gestational diabetes and hypertension, knowledge, attitude and practice of health behaviors, and improved anthropometric indicators after the implementation of the developed intervention.
For achieving the proposed goals, the research team will consist of multidisciplinary expertise, including epidemiology and international health (Mori, Gai) and clinical practices for GDM and gestational hypertension (Kawasaki, Tippawan). By close collaboration with BCDF, experts (Syed) in social medicine and nutrition in Bangladesh will also actively join and contribute to the field study.
The pilot study will be then implemented in the two study sites in order to test and modify the developed intervention package based on the feasibility and the validity of the study tools. Ethical approval will be obtained from a local university in Bangladesh as well as NCCHD, Japan. A total of 600 participants in the target population living in Lohagora and Dhamrai, who have given a birth during the past one year, will be recruited from the participants in our ongoing RCT. The study tools including reading materials to disseminate knowledge such as mobile short messages and bulletins, a set of questionnaire and measurement of blood pressure and glucose, will be tested in the participants. Besides, in each village of the Upazila, we will organize five health education sessions with focus group discussions on life course prevention of NCDs for community people, involving the target population of the proposed study areas, their families and for the community health workers. Their understanding and opinions on the designed intervention will be examined by the experts. The study will be monitored regularly by the monitoring team members, who will visit once a month and observe data collection and FGDs in the field. In addition, we will provide refresh training to the field staffs for smooth operation of the project. Data will be checked and coded by the experienced coder. The cleaned quantitative and qualitative data will be input and analyzed using Stata 14.0 and Nvivo 10.0, respectively.
Bridge of Community Development Foundation (BCDF) is a not-for-profit organization established under Act XXI of 1860, Govt. of Bangladesh.
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