Programs In Bangladesh Research Articles

Evaluation of good governance in a participatory forestry program: A case study in Madhupur Sal forests of Bangladesh

Participatory forestry programs in Bangladesh have been implemented since 1980’s to ensure forest conservation along with empowerment of local people, who depend on forest resources. Despite the establishment of legal and institutional frameworks for devolving a meaningful authority to local people, participatory forestry in Bangladesh has been facing many governance challenges. Therefore local people involvement in forest governance needs to be evaluated. A quantitative and qualitative research method has been applied to investigate a forest governance framework for evaluating the efficacy of participatory forestry in Bangladesh. Field data were collected by semi-structured interview of 120 local forest participants using scoring of qualitative data on a point scale (1–5).The study was based on the proposed modified framework for evaluation of good governance in terms of participation, transparency and efficiency. Analysis of data revealed that participation in benefit sharing received the highest score (3.90), while the lowest in the management committee meeting (2.12). Transparency in decision-making process received the lowest score (2.42). Similarly efficiency in handling tree farming fund (TFF) has the lowest score (2.35). In overall governance level, participation received the highest score (3.12), while transparency received the lowest (2.72). Findings indicate that poor governance still exists in participatory forestry program because of low level of participation and lack of transparency in handling tree farming fund (TFF). Therefore pragmatic approaches like strengthening monitoring mechanism, providing incentives for rule compliances need to be adopted to harness the benefit of good governance of a participatory forestry program. The findings of this study would be useful to forest policy-makers, development official and local forest practitioners in formulating effective policies for participatory forest management programs in Bangladesh and other developing countries. Our finding has also an implication on forest governance discourse in participatory forest management regimes.

Bt Eggplant Project in Bangladesh: History, Present Status, and Future Direction.

The purpose of this article is to provide information on the history, accomplishments, and future direction of the Bt brinjal (eggplant) program in Bangladesh, formerly under the Agricultural Biotechnology Support Project II, now the South Asia Eggplant Improvement Partnership (SAEIP). The India-based Maharashtra Hybrid Seed Company (Mahyco) developed an eggplant expressing Cry1Ac (EE-1) for control of the eggplant fruit and shoot borer (EFSB). In a partnership among Mahyco, USAID, Sathguru Management Consultants and Cornell University EE-1 was provided to the Bangladesh Agricultural Research Institute (BARI) who bred it into local varieties. After regulatory approval, four varieties were distributed to 20 farmers who harvested Bt brinjal in 2014. Adoption in subsequent years has increased rapidly so that, in 2018, 27,012 farmers used this technology. This article provides background information on the process leading up to current adoption levels, the level of control of EFSB achieved and the economic benefits of Bt brinjal. Efforts on stewardship, farmer training and communication are discussed. In order to ensure the long-term future of the partnership, we discuss the need to enhance involvement of the private sector in the production and stewardship of Bt eggplant. Bt brinjal is the first genetically engineered crop to be commercially released in Bangladesh, and other GE crops are in the pipeline. Hence, success of the Bt brinjal partnership is likely to affect the future of other GE crops in Bangladesh, as well as other parts of the world where biotechnology is needed for food security and environmental safety.

Clients' Experience and Satisfaction of Utilizing Healthcare Services in a Community Based Health Insurance Program in Bangladesh.

Background: Community-based health insurance is recognized as a promising tool for health system improvement for low-income people that improves the health status of enrolees and enhances productivity and labor supply. The experience and opinion of the clients who utilized health services through the insurance scheme are important for improving healthcare services, shaping health policies and providing feedback on the quality, availability, and responsiveness of healthcare services. However, studies focusing on clients’ satisfaction provided by the health insurance scheme are still limited globally. Objective: To address this knowledge gap, this current study attempted to measure the degree of clients’ satisfaction towards healthcare services and insurance scheme, based on their experience of health care which will serve the future reference point to implement potential quality improvement initiatives of community-based health insurance program. Methods: A cross-sectional household survey was conducted within the catchment area of a community-based health insurance pilot program named Labor Association for Social Protection (LASP) during April–June 2014 to compare the evaluation of healthcare services provided by LASP scheme. In the descriptive analyses, the characteristics of the study participants were presented regarding frequency and the percentages with 95% confidence interval. Spearman correlation analysis was conducted between the satisfaction score of each indicator and overall satisfaction score; multivariate linear regression analysis was used to identify the factors associated with overall health scheme satisfaction. Results: The overall satisfaction mean score was 4.17 ± 0.04 (95% CI: 4.08–4.26) out of 5.00. The most satisfied domains were related to the diagnostic services (4.46 ± 0.98), explanation about the prescribed medicine (4.23 ± 0.81), the surrounding environment of healthcare facility (4.21 ± 0.70) and the behavior of health personnel toward clients (4.18 ± 0.73). Conclusions: Our study observed that the overall satisfaction level towards health services is quite favorable, but satisfaction scores can still be improved. These findings could contribute towards developing and designing the healthcare services packages of community-based health scheme which is in line with the health care financing strategy of Bangladesh as well as the recommendation of the World Health Organization for developing social health insurance as part of path to Universal Health Coverage.

Empirical Understanding of Social Protection Programmes in Southwest Coastal Areas of Bangladesh: A Postmodern Perspective

Abstract Social protection programmes in Bangladesh aimed at reducing the vulnerability of the poor has become exceptionally challenging because of high exposure to weak institutional governance, and frequent natural disasters. As a matter of fact, both the coverage and the types of social protection programmes have been expanded to support the extremely poor households in Bangladesh over the last decade. However, the boundaries between ‘protection approach’ associated with risk reduction and ‘promotion approach’ regarded as the pathways to raise incomes and employment opportunities of the poor have remained understated in policy discourse. This paper addresses how an Interpretivist methodology can be used in exploring the current complexities of social protection programmes in extremely poor households with reference to disaster-affected areas in southwest coastal Bangladesh, giving a particular attention to the interpretation of the beneficiaries as well as service providers. This paper employs an interpretative framework for collecting qualitative data because of its ability to make sense of the complex situations of social protection programmes by generating multicontextual information provided by the beneficiaries of social protection programmes. During the initial fieldwork of the research, the research participants pointed out that there exist strong prevalence and dominance of local politics considered as ‘underlying issues’ in the delivering process of social protection programmes, which is further associated with power-relation between the rich and poor class of the society. However, the current policy discourses of social protection programmes have overlooked those highly pertinent phenomena both in local and national context. This paper argues that the aspects of availability, accessibility and utilisation of social protection programmes is not straightforward as each aspect is further associated with social relations and complex social understanding. An interpretive methodology along with illustrative data collection and analysis techniques can become effective to explore those complex societal understanding related with social protection programmes. Finally, within the adopted interpretive framework, the integrated view related with availability, accessibility and utilisation aspects of social protection programmes need to be addressed while creating a sense of meaning and understanding of overall situation of social protection programmes.

Empirical Understanding of Social Protection Programmes in Southwest Coastal Areas of Bangladesh: A Postmodern Perspective

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Hepatitis B Surface Antigen Seroprevalence among Prevaccine and Vaccine Era Children in Bangladesh.

.Bangladesh introduced hepatitis B vaccine in a phased manner during 2003–2005 into the routine childhood vaccination schedule. This study was designed to evaluate the impact of the introduction of hepatitis B vaccine in Bangladesh by comparing hepatitis B surface antigen (HBsAg) prevalence among children born before and after vaccine introduction and to estimate the risk of vertical transmission of chronic hepatitis B virus (HBV) infection from mother to infant. We also evaluated the field sensitivity and specificity of an HBsAg point-of-care test strip. We selected a nationally representative sample of 2,100 prevaccine era and 2,100 vaccine era children. We collected a 5-mL blood sample from each child. One drop of blood was used to perform rapid HBsAg testing. If a child had a positive HBsAg test result with the rapid test, a blood sample was collected from the mother of the HBsAg-positive child and from the mothers of two subsequently enrolled HBsAg-negative children. All samples were tested for serologic markers of HBV infection using standard enzyme-linked immunosorbent assay. One (0.05%) child in the vaccine era group and 27 (1.2%; 95% confidence interval [CI]: 0.8–1.7%) children in the prevaccine era group were HBsAg positive. Mothers of HBsAg-positive children were more likely to be HBsAg positive than mothers of HBsAg-negative children (odds ratios = 4.7; 95% CI: 1.0–21.7%). Sensitivity of the HBsAg rapid test was 91.2% (95% CI: 76.6–98.1%) and specificity was 100% (95% CI: 99.9–100%). The study results suggest that even without a birth dose, the hepatitis B vaccine program in Bangladesh was highly effective in preventing chronic HBV infection among children.

Micro politics of Social Safety Net Programmes: The case of the Food‐For‐Work Programme in Bangladesh

AbstractA number of studies have established that politics has a role in shaping and implementing Social Safety Net Programmes (SSNPs) and, conversely, SSNPs also influence national or local politics. This study qualitatively analyzes the micro level political discourses of the Food‐For‐Work programme, one of the top 10 SSNPs in Bangladesh, using the concepts of access, institutions and agency under livelihood framework. The analysis of the findings reveals that the programme is not effective in terms of the stated objectives of reducing poverty, but rather serves the interest of political elites. Beneficiary access to the projects depends on categorical membership, ability to participate and gender, which lead the programme to be reduced to subsidized infrastructure projects.

A case for climate justice education: American youth connecting to intragenerational climate injustice in Bangladesh

In this paper, I present evidence for framing climate change education around social justice. More specifically, I provide empirical support for framing climate change education around intragenerational climate justice, and argue that this frame can influence youth in industrialized, wealthy nations to become mobilized, climate-engaged individuals. To do so, I apply critical qualitative analysis to narratives from American youth who participated in a global climate change education program in Bangladesh. My findings include the importance of contextualizing climate justice, framing climate change around humans, implicating ourselves in the problem and recognizing our own obligations in mitigation, seeing climate change as real and tangible, being in a place impacted by climate change, feeling solidarity with those impacted, and recognizing social injustice and power disparities within climate change impacts. Based on these findings, I recommend an approach that provides context, nuance, and personal connection to an otherwise abstract global problem.

Correlates of attempting to quit smoking among adults in Bangladesh

BackgroundQuit attempts are very essential in population-based smoking cessation. Little is known about the correlates of making a quit attempt of smoking in Bangladesh. We aimed to examine correlates of making a quit attempt of smoking among adults in Bangladesh. MethodsWe used data from the 2009 Global Adult Tobacco Survey, Bangladesh. A total of 2217 adult current smokers (2141 males and 76 females) aged 15 years and older who participated in the survey were included. We compared socio-demographic, behavioral, motivational, knowledge and attitudes towards smoking, quitting methods utilized, use of social media to quit smoking, and environmental characteristics of current smokers who made an attempt to quit with those who made no quit attempt during the previous 12 months of the survey. We applied multivariable logistic regression models for analyzing the data. ResultsAmong the 2217 current smokers, 1058 (47.72%) made attempt to quit. We found respondents who smoked their first cigarette within 6 to 30 min of waking up were more likely to make an attempt to quit than those who smoked their first cigarette within 5 min of waking. Moreover, among daily current smokers who smoked 10–19 manufactured cigarettes per day were less likely to make a quit attempt. We also found intention to quit smoking, smoking rules inside the home, and exposure to anti-smoking advertisements as significant correlates of making a quit attempt of smoking among adults in Bangladesh. ConclusionsPolicymakers should consider our findings when implementing tobacco control programs in Bangladesh.

Examining women's physical mobility and microfinance participation in Bangladesh: Results from a nationally representative sample

Using data from the 2011 Bangladesh Demographic and Health Survey, this study examined the association between physical mobility of women and their participation in microfinance, an anti-poverty empowerment program in Bangladesh. Physical mobility was operationalized by a two-item measure that assessed whether women can and if they do go out alone to seek health care. Chi squared tests and propensity score matching techniques were used to examine the association between physical mobility and microfinance participation. Results revealed that women who reported to have physical mobility were 12 percentage points more likely to participate in microfinance compared to a matched group of women who reported to not have physical mobility. In conclusion, the findings indicate that social welfare programs are successful to the extent that norms and institutions support those programs. Furthermore, it highlights the contradiction between the proliferations of empowerment programs and patriarchal social, cultural, and infrastructural barriers that prevent women from accessing such programs.

Importance of coverage and quality for impact of nutrition interventions delivered through an existing health programme in Bangladesh.

Understanding implementation of interventions is critical to illuminate if, how, and why the interventions achieve impact. Alive & Thrive integrated a nutrition intervention into an existing maternal, neonatal, and child health (MNCH) programme in Bangladesh, documenting improvements in women's micronutrient supplement intake and dietary diversity. Here, we examined how well the nutrition intervention was implemented and which elements of implementation explained intervention impact. Survey data were collected in 2015 and 2016 from frontline health workers (FLW) and households in areas randomized to nutrition‐focused MNCH (intensified interpersonal counselling, community mobilization, distribution of free micronutrient supplements, and weight‐gain monitoring) or standard MNCH (antenatal care with standard nutrition counselling). Seven intervention elements were measured: time commitment, training quality, knowledge, coverage, counselling quality, supervision, and incentives. Multiple regression was used to derive difference‐in‐differences (DID) estimates. Using village‐level endline data, path analysis was used to determine which elements most explained intervention impacts. FLWs in both areas were highly committed and well supervised. Coverage was high (>90%) for counselling, supplement provision, and weight‐gain monitoring. Improvements were significantly greater for nutrition‐focused MNCH, versus standard MNCH, for training quality (DID: 2.42 points of 10), knowledge (DID: 1.20 points), delivery coverage (DID: 4.16 points), and counselling quality (DID: 1.60 points). Impact was substantially explained by coverage and delivery quality. In conclusion, integration nutrition intervention into the MNCH programme was feasible and well‐implemented. Although differences in coverage and counselling quality most explained impacts, all intervention elements—particularly FLW training and performance—were likely important to achieving impact.

Reduction of tobacco consumption in a rural area with a community based tobacco control program in Bangladesh

Reduction of tobacco consumption in a rural area with a community based tobacco control program in Bangladesh

Does Workfare Work Well? The Case of the Employment Generation Program for the Poorest in Bangladesh

Evidence on the effectiveness of workfare as an anti-poverty program in developing countries is weak compared with the relatively well-established role of public works during economic crisis as a social safety net. This paper contributes to evidence building by examining the impact of a large-scale workfare program in Bangladesh, the Employment Generation Program for the Poorest. Taking advantage of the program's distinguishable feature of direct wage transfer to a person's bank account, the paper uses accessibility to local banks as an instrumental variable to identify the program's impacts on rural social assistance beneficiaries. Based on locality-by-time fixed effects models over two rounds of locality panel data, the analysis finds that the Employment Generation Program for the Poorest has contributed to increasing overall household consumption and reducing outstanding loans. In particular, expenditures on quality food and health care have significantly increased, which likely helps individuals continue to engage in income-generating activities in the labor market. However, the implementation costs and poor quality of public assets built through work projects could potentially undermine the program's efficiency. Moreover, further evidence is required on the impacts of work experience through workfare on subsequent labor market outcomes and the value of public assets, to assess the program's effectiveness compared with administratively simpler alternative instruments such as unconditional cash transfers.

Machine Learning Based Prediction of Non-communicable Diseases to Improving Intervention Program in Bangladesh

Background: The prevalence of noncommunicable diseases (NCDs) is increasing throughout the world, including in developing countries. An NCD prevention program using information communication technology was implemented for 2 years in Bangladesh. Health checkup data were collected from 16,741 study subjects. However, the effectiveness of the utilized prevention strategy has not yet been evaluated, and some subjects with a risk of NCD have gone undetected. Objective: This study aimed to improve intervention strategies by analyzing collected data and proposing a costeffective personalized predictive model to identify subjects predicted to be at future risk of NCD. Methods: We selected 2,110 subjects who participated in both years of the program and used a machine learning algorithm, gradient boosting decision tree, to build models that would identify subjects who were at risk of future high blood pressure, blood sugar or body mass index (BMI). We used area under the curve (AUC) of receiver operating characteristic curves and cumulative accuracy profile (CAP) curves to evaluate the performance of our models. Results: Models showed fairly good performance: the BMI model (AUC=0.910) yielded the greatest AUC whereas the BS model (AUC=0.730) yielded the lowest. CAP curves indicated that the BMI model could correctly identify 98.0% of at-risk subjects at only 50% of the total time cost. Conclusions: Our models represent powerful tools with which to improve the effect of health intervention programs and the effectiveness at which they are performed with limited medical resources.

Barriers to Labor Migration for the Rural Poor: Experimental Evidence from a Vocational Training Program in Bangladesh

Vocational training programs aimed at rapidly growing sectors have the potential to reduce skill gaps as well as improve income and employment possibilities. Such programs have often been unsuccessful because they are not driven by industry demand and market linkages. Also, they do not tackle other barriers faced by trainees, such as savings and credit constraints and the uncertainty of migration. We introduced a training plus'' program for the apparel sector jobs offered to the poor, rural households in northern Bangladesh, where we relaxed some of these constraints in a rigorous Randomized Control Trial (RCT) setting. Analyzing the program uptake demonstrated an interesting heterogeneity, where gender-specific social barriers, as well as risk and time preferences, play influential roles. Data from the follow-up surveys--six and eighteen months after the intervention -- showed a statistically significant, persistent, and a large effect of the training program on employment when combined with an apprenticeship [on-the-job training (OJT)] or stipend component. We also found substantial income and remittance impacts, especially during the time of a seasonal shock, as well as a reduction in income poverty, both for the stipend and OJT groups. However, the rural household estimates -- twelve months after the intervention--showed no impact on consumption poverty in the origin households.

Improving Access to Delivery Care and Reducing the Equity Gap Through Voucher Program in Bangladesh: Evidence From Difference-in-Differences Analysis.

To test a statistically significant change in delivery by medically trained providers following introduction of a demand-side financing voucher, a population-based quasi-experimental study was undertaken, with 3,300 mothers in 2010 and 3,334 mothers at follow-up in 2012 in government-implemented voucher program and control areas. Results found that voucher program was significantly associated with increased public health facility use (difference-in-differences (DID) 13.9) and significantly increased delivery complication management care (DID 13.2) at facility although a null effect was found in facility-based delivery increase. A subset analysis of the five well-functioning facilities showed that facility deliveries increased DID 5.3 percentage points. Quintile-based analysis of all facilities showed that facility delivery increased more than threefold in lower quintile households comparing to twofold in control sites. The program needs better targeting to the beneficiaries, ensuring available gynecologist-anesthetist pair and midwives, effective monitoring, and timely fund reimbursements to facilities.

Education, Marriage, and Fertility: Long-Term Evidence from a Female Stipend Program in Bangladesh

In 1994, Bangladesh introduced the Female Secondary School Stipend Program that made secondary education free for rural girls. This paper examines the long-term effects of the stipend program on education, marriage, fertility, and labor market outcomes of women. We find that the stipend increased years of education for eligible girls by 14%–25%. These girls were more likely to get married later and have fewer children. They also had more autonomy in making decisions about household purchases, health care, and visiting relatives. They were more likely to work in the formal sector than the agricultural or informal sector. Eligible women were likely to marry more educated husbands who had better occupations and were closer in age to their own. Their children’s health outcomes also improved. These results imply that school-based stipend programs can increase female empowerment through positive effects on schooling and marriage market outcomes over the long term.

Online Parent Training: A Pilot Programme for Children with Autism and Neurodevelopmental Disabilities in Bangladesh

Purpose: This study aimed to assess the implementation of an online parent training programme in Bangladesh, designed to enhance parental knowledge of autism and neurodevelopmental disorders and related interventions. In addition, study participants were expected to become “Master Trainers” with the intention of training other parents in their local communities. Method: This survey study assessed parental knowledge and programme effectiveness, such as potential online learning barriers, cultural sensitivities, and general course content feedback after each unit. Results: The programme had an 81% completion rate (with parents completing all but one unit) with an average programme knowledge score of 86%. Parents felt that the course content was moderately difficult, the length of the units was appropriate, and the units were culturally sensitive. They requested more detailed lessons, specific case studies, and adaptation of the curriculum for older children. Conclusion: The pilot programme merits the next phase of development, which includes local adaptation and translation. However, the findings are limited by the small sample size.

The effect of female education on marital matches and child health in Bangladesh

This paper examines the effects of female education on marriage outcomes by exploiting the exogenous variation generated by the Female Secondary School Stipend Program in Bangladesh, which made secondary education free for rural girls. Our findings show that an additional year of female education leads to an increase in 0.72 years of husband’s education and that better educated women pair with spouses who have better occupations and are closer in age to their own, suggesting assortative mating. Those educated women appear to experience greater autonomy in making decisions on receiving their own health care and visiting their family. Furthermore, educated women have lower fertility and use more maternal health care, and their children have better health outcomes than those of less-educated women. Overall, our results suggest that the marriage market is one of the channels through which women’s education affects their life outcomes.

A 'Do-It-Yourself' Approach to International Nursing Education.

: After helping to establish and lead a bachelor of science in nursing program in Bangladesh, one nurse offers observations on developing similar volunteer projects. He discusses the need for social entrepreneurs to conduct research before committing to a project and the possibility that they might have to rely heavily on their own resources. Being an "audacious optimist" is also a must.