Women focused development intervention reduces neonatal mortality in rural Bangladesh: a study of the pathways of influence
Background: There has been a substantial reduction in hazard of childhood death in Bangladesh over the last decade. The reduction was much greater in case of infants whose mothers participated in the development program. However, the pathways through which development interventions influence neon...
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BRAC Research and Evaluation Division (RED)
2019
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| Acesso em linha: | http://hdl.handle.net/10361/13096 |
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10361-130962019-11-24T21:01:07Z Women focused development intervention reduces neonatal mortality in rural Bangladesh: a study of the pathways of influence Hashima-E-Nasreen Bhuiya, Abbas Ahmed, Syed Masud Chowdhury, Mushtaque Women Neonatal mortality Rural Bangladesh Women's development BRAC Bangladesh Fetal death Infants--Mortality Mothers--Mortality Women in development Background: There has been a substantial reduction in hazard of childhood death in Bangladesh over the last decade. The reduction was much greater in case of infants whose mothers participated in the development program. However, the pathways through which development interventions influence neonatal survival remain to be explored. Objective: Study the impact of BRAC's women focused development interventions on neonatal mortality in Matlab. Methods: A case-control study comprising 117 cases (died within 28 days) and 351 controls (live children taken from the nearest door of cases) born during the year 1999- 2000 was employed. Twelve case studies from both cases and controls were done to complement the quantitative data. ICDDR, B surveillance database provided the sampling frame. The risk ratio was estimated to see how BRAC program participation reduces risk of mortality, and stratified analysis was done to see the effects of third variables over the association. Finally, log regression was done to see the net effect of variables on neonatal death. Results: Neonates of BRAC non-members were at 1.9 times increased risk (CL; 1.09- 3.25) of dying compared to neonates of BRAC members. This association works through two intermediate variables including antenatal care and family planning. Mothers' age and fathers' occupation acted as confounders over this association. Physical violence against mothers and psychological stress, pre-maturity and low-birth-weight had respectively 2.2, 1.7, 13 and 2 times increased risk of neonatal death. However, BRAe membership did not have any influence over these factors. When simultaneously accounting for all variables in a multivariate log regression, a dose response association was maintained for antenatal care, family planning, physical violence and pre-maturity. Conclusion: There has been a substantial reduction of neonatal morality among mothers who participated in BRAC intervention. For an effective reduction of these deaths, program planners should think about ways to address all risk factors together rather than antenatal care and family planning alone. Acknowledgements: The financial support of the Ford Foundation and Aga Khan Foundation is acknowledged. 2019-11-24T10:36:57Z 2019-11-24T10:36:57Z 2003-05 Research report Nasreen, H. E., Bhuiya, A., Ahmed, S. M., & chowdhury, M. (2003, May). Women focused development intervention reduces neonatal mortality in rural Bangladesh: a study of the pathways of influence. Research Reports (2003): Health Studies, Vol - XXXV, 61–83. http://hdl.handle.net/10361/13096 en application/pdf BRAC Research and Evaluation Division (RED) |
| institution |
Brac University |
| collection |
Institutional Repository |
| language |
English |
| topic |
Women Neonatal mortality Rural Bangladesh Women's development BRAC Bangladesh Fetal death Infants--Mortality Mothers--Mortality Women in development |
| spellingShingle |
Women Neonatal mortality Rural Bangladesh Women's development BRAC Bangladesh Fetal death Infants--Mortality Mothers--Mortality Women in development Hashima-E-Nasreen Bhuiya, Abbas Ahmed, Syed Masud Chowdhury, Mushtaque Women focused development intervention reduces neonatal mortality in rural Bangladesh: a study of the pathways of influence |
| description |
Background: There has been a substantial reduction in hazard of childhood death in
Bangladesh over the last decade. The reduction was much greater in case of infants
whose mothers participated in the development program. However, the pathways through
which development interventions influence neonatal survival remain to be explored.
Objective: Study the impact of BRAC's women focused development interventions on
neonatal mortality in Matlab.
Methods: A case-control study comprising 117 cases (died within 28 days) and 351
controls (live children taken from the nearest door of cases) born during the year 1999-
2000 was employed. Twelve case studies from both cases and controls were done to
complement the quantitative data. ICDDR, B surveillance database provided the
sampling frame. The risk ratio was estimated to see how BRAC program participation
reduces risk of mortality, and stratified analysis was done to see the effects of third
variables over the association. Finally, log regression was done to see the net effect of
variables on neonatal death.
Results: Neonates of BRAC non-members were at 1.9 times increased risk (CL; 1.09-
3.25) of dying compared to neonates of BRAC members. This association works through
two intermediate variables including antenatal care and family planning. Mothers' age
and fathers' occupation acted as confounders over this association. Physical violence
against mothers and psychological stress, pre-maturity and low-birth-weight had
respectively 2.2, 1.7, 13 and 2 times increased risk of neonatal death. However, BRAe
membership did not have any influence over these factors. When simultaneously
accounting for all variables in a multivariate log regression, a dose response association
was maintained for antenatal care, family planning, physical violence and pre-maturity.
Conclusion: There has been a substantial reduction of neonatal morality among mothers
who participated in BRAC intervention. For an effective reduction of these deaths,
program planners should think about ways to address all risk factors together rather than
antenatal care and family planning alone.
Acknowledgements: The financial support of the Ford Foundation and Aga Khan Foundation is
acknowledged. |
| format |
Research report |
| author |
Hashima-E-Nasreen Bhuiya, Abbas Ahmed, Syed Masud Chowdhury, Mushtaque |
| author_facet |
Hashima-E-Nasreen Bhuiya, Abbas Ahmed, Syed Masud Chowdhury, Mushtaque |
| author_sort |
Hashima-E-Nasreen |
| title |
Women focused development intervention reduces neonatal mortality in rural Bangladesh: a study of the pathways of influence |
| title_short |
Women focused development intervention reduces neonatal mortality in rural Bangladesh: a study of the pathways of influence |
| title_full |
Women focused development intervention reduces neonatal mortality in rural Bangladesh: a study of the pathways of influence |
| title_fullStr |
Women focused development intervention reduces neonatal mortality in rural Bangladesh: a study of the pathways of influence |
| title_full_unstemmed |
Women focused development intervention reduces neonatal mortality in rural Bangladesh: a study of the pathways of influence |
| title_sort |
women focused development intervention reduces neonatal mortality in rural bangladesh: a study of the pathways of influence |
| publisher |
BRAC Research and Evaluation Division (RED) |
| publishDate |
2019 |
| url |
http://hdl.handle.net/10361/13096 |
| work_keys_str_mv |
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| _version_ |
1814308809466707968 |