Journal of Health, Population, and Nutrition

Permanent URI for this collection

https://imsear.searo.who.int/handle/123456789/8

ISSN: 1606-0997 (Print)

Frequency: Quarterly

Language: English

Published by ICDDR,B: Centre for Health and Population Research

Peer-reviewed open access journal indexed in Index Medicus

Web site: https://www.banglajol.info/index.php/JHPN/



Browse

Browsing Journal of Health, Population, and Nutrition by Author ","

Now showing 1 - 3 of 3
  • Thumbnail Image
    Item
    Operational issues and trends associated with the pilot introduction of zinc for childhood diarrhoea in Bougouni district, Mali.
    (2008-06-09) Winch, Peter J; Gilroy, Kate E; Doumbia, Seydou; Patterson, Amy E; Daou, Zana; Diawara, Adama; Swedberg, Eric; Black, Robert E; Fontaine, Olivier; ,
    Zinc for the treatment of childhood diarrhoea was introduced in a pilot area in southern Mali to prepare for a cluster-randomized effectiveness study and to inform policies on how to best introduce and promote zinc at the community level. Dispersible zinc tablets in 14-tablet blister packs were provided through community health centres and drug kits managed by community health workers (CHWs) in two health zones in Bougouni district, Mali. Village meetings and individual counselling provided by CHWs and head nurses at health centres were the principal channels of communication. A combination of methods were employed to (a) detect problems in communication about the benefits of zinc and its mode of administration; (b) identify and resolve obstacles to implementation of zinc through existing health services; and (c) describe household-level constraints to the adoption of appropriate home-management practices for diarrhoea, including administration of both zinc and oral rehydration solution (ORS). Population-based household surveys with caretakers of children sick in the previous two weeks were carried out before and four months after the introduction of zinc supplementation. Household follow-up visits with children receiving zinc from the health centres and CHWs were conducted on day 3 and 14 after treatment for a subsample of children. A qualitative process evaluation also was conducted to investigate operational issues. Preliminary evidence from this study suggests that the introduction of zinc does not reduce the use of ORS and may reduce inappropriate antibiotic use for childhood diarrhoea. Financial access to treatments, management of concurrent diarrhoea and fever, and high use of unauthorized drug vendors were identified as factors affecting the effectiveness of the intervention in this setting. The introduction of zinc, if not appropriately integrated with other disease-control strategies, has the potential to decrease the appropriate presumptive treatment of childhood malaria in children with diarrhoea and fever in malaria-endemic areas.
  • Thumbnail Image
    Item
    Rickets: an overview and future directions, with special reference to Bangladesh. A summary of the Rickets Convergence Group meeting, Dhaka, 26-27 January 2006.
    (2008-03-22) Craviari, Thierry; Pettifor, John M; Thacher, Tom D; Meisner, Craig; Arnaud, Josiane; Fischer, Philip R; ,
    Rickets has emerged as a public-health problem in Bangladesh during the past two decades, with up to 8% of children clinically affected in some areas. Insufficiency of dietary calcium is thought to be the underlying cause, and treatment with calcium (350-1,000 mg elemental calcium daily) is curative. Despite this apparently simple treatment, little is known about the most appropriate management of bone deformities of affected children, and further studies are needed to determine the details of dosing and duration of calcium therapy, the role of bracing, and specific indications for surgical intervention. Effective preventive measures that can feasibly reach entire communities are needed, and these may differ between various affected regions.
  • Thumbnail Image
    Item
    Trends in use of referral hospital services for care of sick newborns in a community-based intervention in Tangail District, Bangladesh.
    (2006-12-27) Bari, Sanwarul; Mannan, Ishtiaq; Rahman, Mohammed Anisur; Darmstadt, Gary L; Serajil, M Habibur R; Baqui, Abdullah H; El Arifeen, Shams; Rahman, Syed Moshfiqur; Saha, Samir K; Ahmed, A S M Nawshad Uddin; Ahmed, Saifuddin; Santosham, Mathuram; Black, Robert E; Winch, Peter J; ,
    The Projahnmo-II Project in Mirzapur upazila (sub-district), Tangail district, Bangladesh, is promoting care-seeking for sick newborns through health education of families, identification and referral of sick newborns in the community by community health workers (CHWs), and strengthening of neonatal care in Kumudini Hospital, Mirzapur. Data were drawn from records maintained by the CHWs, referral hospital registers, a baseline household survey of recently-delivered women conducted from March to June 2003, and two interim household surveys in January and September 2005. Increases were observed in self-referral of sick newborns for care, compliance after referral by the CHWs, and care-seeking from qualified providers and from the Kumudini Hospital, and decreases were observed in care-seeking from unqualified providers in the intervention arm. An active surveillance for illness by the CHWs in the home, education of families by them on recognition of danger signs and counselling to seek immediate care for serious illness, and improved linkages between the community and the hospital can produce substantial increases in care-seeking for sick newborns.