Background: Community-based programs in rural low-and middle-income country settings are well-pla... more Background: Community-based programs in rural low-and middle-income country settings are well-placed to conduct gender transformative activities that aid program sustainability and catalyse wider social change, such as reducing gender inequities that in turn improve health outcomes. The Anchal program is a drowning prevention intervention for children aged 1-5 years old in rural Bangladesh. It provides community crèche-based supervision delivered by local trained paid-female volunteers. We aimed to identify the impact of the Anchal program on gender norms and behaviours in the community context, and the effects these had on program delivery and men and women’s outcomes. Methods: Qualitative in-depth interviews, focus group discussions and observations were conducted with program beneficiaries and providers. Gender impacts and outcomes were analysed using FHI 360’s Gender Integration Framework. Results: The Anchal program was found to be a gender accommodating program as it catered f...
Background In Bangladesh diarrhoeal disease and respiratory infections contribute significantly t... more Background In Bangladesh diarrhoeal disease and respiratory infections contribute significantly to morbidity and mortality. Handwashing with soap reduces the risk of infection; however, handwashing rates in infrastructure-restricted settings remain low. Handwashing stations – a dedicated, convenient location where both soap and water are available for handwashing – are associated with improved handwashing practices. Our aim was to identify a locally feasible and acceptable handwashing station that enabled frequent handwashing for two subsequent randomized trials testing the health effects of this behaviour. Methods We conducted formative research in the form of household trials of improved practices in urban and rural Bangladesh. Seven candidate handwashing technologies were tested by nine to ten households each during two iterative phases. We conducted interviews with participants during an introductory visit and two to five follow up visits over two to six weeks, depending on the ...
Objectives Community-based health programmes implemented in low-income and middle-income countrie... more Objectives Community-based health programmes implemented in low-income and middle-income countries impact community gender norms and roles and relationships, which in turn affect individuals’ health outcomes. Programmes should measure their effects on gender norms, roles and relationships in the communities in which they operate to respond to unexpected health consequences. We conducted a gender analysis on a drowning reduction programme in rural Bangladesh to identify its impacts on gendered roles and behaviours in the community. Design A mixed-method approach was used. Quantitative programme monitoring data were analysed to assess gender differences in participation and engagement. A qualitative approach using interviews, focus group discussions and observations with purposively selected programme implementing staff and participants aimed at finding explanations for quantitative findings and additional impacts of the programme on gender in the community. The analysis was conducted...
The American Journal of Tropical Medicine and Hygiene, 2021
In low- and middle-income countries (LMICs), hand sanitizer may be a convenient alternative to so... more In low- and middle-income countries (LMICs), hand sanitizer may be a convenient alternative to soap and water to increase hand hygiene practices. We explored perceptions, acceptability, and use of hand sanitizer in rural Bangladesh. We enrolled 120 households from three rural villages. Promoters distributed free alcohol-based hand sanitizer, installed handwashing stations (bucket with tap, stand, basin, and bottle for soapy water), and conducted household visits and community meetings. During Phase 1, promoters recommended handwashing with soap or soapy water, or hand sanitizer after defecation, after cleaning a child’s anus/feces, and before food preparation. In Phase 2, they recommended separate key times for hand sanitizer: before touching a child ≤ 6 months and after returning home. Three to 4 months after each intervention phase, we conducted a survey, in-depth interviews, and group discussions with child caregivers and male household members. After Phase 1, 82/89 (92%) househo...
Background: Community-based health programs implemented in low-and middle-income countries have a... more Background: Community-based health programs implemented in low-and middle-income countries have additional health impacts beyond their targeted outcomes, such as on gender norms, roles and relationships. Programs should measure their effects on gender to respond to any unexpected consequences. Hence, we conducted a gender analysis on a drowning reduction program in rural Bangladesh providing survival swimming classes to children.Methods: A mixed-methods approach was used. Quantitative program monitoring data was analysed to assess gender differences in program participation and engagement. A qualitative approach using interviews, focus group discussions and observations aimed to find explanations for quantitative findings and additional experiences of the program. The analysis was conducted using Family Health International 360’s Gender Integration Framework.Results: Fewer girls participated in the swimming classes than boys due to cultural perceptions on appropriate activities for ...
BackgroundLiving and environmental conditions in rural Bangladesh expose children to drowning. Th... more BackgroundLiving and environmental conditions in rural Bangladesh expose children to drowning. The Anchal programme protects children through crèche-based supervision in an enclosed space run by locally recruited carers. It is unclear under what conditions the programme best operates to maximise protection. We conducted a process evaluation of Anchal to determine enabling factors and challenges to implementation.MethodsQuantitative programme data were analysed to calculate metrics including child participation and fidelity of implementation to defined processes. Qualitative data collection with programme participants and implementers provided insights into barriers and enablers of implementation. Analysis was guided by the UK Medical Research Council’s process evaluation framework.ResultsAnchal operated 400 centres with an average of 22.2 children enrolled, as per target. However, daily attendance averaged lower than the 80% target. Children aged 1–2 years old, who are most at risk ...
The American journal of tropical medicine and hygiene, Feb 26, 2016
We conducted a nonrandomized trial of strategies to promote soapy water for handwashing in rural ... more We conducted a nonrandomized trial of strategies to promote soapy water for handwashing in rural Bangladesh and measured uptake. We enrolled households with children < 3 years for three progressively intensive study arms: promotion of soapy water (N = 120), soapy water promotion plus handwashing stations (N = 103), and soapy water promotion, stations plus detergent refills (N = 90); we also enrolled control households (N = 72). Our handwashing stations included tap-fitted buckets and soapy water bottles. Community promoters visited households and held community meetings to demonstrate soapy water preparation and promote handwashing at key times. Field workers measured uptake 4 months later. In-depth interviews and focus group discussions assessed factors associated with uptake. More households had soapy water at the handwashing place in progressively intensive arms: 18% (promotion), 60% (promotion plus station), and 71% (promotion, station with refills). Compared with the promoti...
The aim of this paper is to find the causes behind poor performance in English subject of the pri... more The aim of this paper is to find the causes behind poor performance in English subject of the primary students of Bangladesh. Data derived from both primary and secondary sources while primary data were collected through in-depth interview and informal discussions from primary school-teachers, students and their parents. Findings revealed that among the four language skills, students were the weakest in writing skill. Respondents opined that English teaching-learning process in classroom was not appropriate and, thus, students got less interest to learn English. A fear in English among the students was also responsible for their poor performance.
Background: Community-based programs in rural low-and middle-income country settings are well-pla... more Background: Community-based programs in rural low-and middle-income country settings are well-placed to conduct gender transformative activities that aid program sustainability and catalyse wider social change, such as reducing gender inequities that in turn improve health outcomes. The Anchal program is a drowning prevention intervention for children aged 1-5 years old in rural Bangladesh. It provides community crèche-based supervision delivered by local trained paid-female volunteers. We aimed to identify the impact of the Anchal program on gender norms and behaviours in the community context, and the effects these had on program delivery and men and women’s outcomes. Methods: Qualitative in-depth interviews, focus group discussions and observations were conducted with program beneficiaries and providers. Gender impacts and outcomes were analysed using FHI 360’s Gender Integration Framework. Results: The Anchal program was found to be a gender accommodating program as it catered f...
Background In Bangladesh diarrhoeal disease and respiratory infections contribute significantly t... more Background In Bangladesh diarrhoeal disease and respiratory infections contribute significantly to morbidity and mortality. Handwashing with soap reduces the risk of infection; however, handwashing rates in infrastructure-restricted settings remain low. Handwashing stations – a dedicated, convenient location where both soap and water are available for handwashing – are associated with improved handwashing practices. Our aim was to identify a locally feasible and acceptable handwashing station that enabled frequent handwashing for two subsequent randomized trials testing the health effects of this behaviour. Methods We conducted formative research in the form of household trials of improved practices in urban and rural Bangladesh. Seven candidate handwashing technologies were tested by nine to ten households each during two iterative phases. We conducted interviews with participants during an introductory visit and two to five follow up visits over two to six weeks, depending on the ...
Objectives Community-based health programmes implemented in low-income and middle-income countrie... more Objectives Community-based health programmes implemented in low-income and middle-income countries impact community gender norms and roles and relationships, which in turn affect individuals’ health outcomes. Programmes should measure their effects on gender norms, roles and relationships in the communities in which they operate to respond to unexpected health consequences. We conducted a gender analysis on a drowning reduction programme in rural Bangladesh to identify its impacts on gendered roles and behaviours in the community. Design A mixed-method approach was used. Quantitative programme monitoring data were analysed to assess gender differences in participation and engagement. A qualitative approach using interviews, focus group discussions and observations with purposively selected programme implementing staff and participants aimed at finding explanations for quantitative findings and additional impacts of the programme on gender in the community. The analysis was conducted...
The American Journal of Tropical Medicine and Hygiene, 2021
In low- and middle-income countries (LMICs), hand sanitizer may be a convenient alternative to so... more In low- and middle-income countries (LMICs), hand sanitizer may be a convenient alternative to soap and water to increase hand hygiene practices. We explored perceptions, acceptability, and use of hand sanitizer in rural Bangladesh. We enrolled 120 households from three rural villages. Promoters distributed free alcohol-based hand sanitizer, installed handwashing stations (bucket with tap, stand, basin, and bottle for soapy water), and conducted household visits and community meetings. During Phase 1, promoters recommended handwashing with soap or soapy water, or hand sanitizer after defecation, after cleaning a child’s anus/feces, and before food preparation. In Phase 2, they recommended separate key times for hand sanitizer: before touching a child ≤ 6 months and after returning home. Three to 4 months after each intervention phase, we conducted a survey, in-depth interviews, and group discussions with child caregivers and male household members. After Phase 1, 82/89 (92%) househo...
Background: Community-based health programs implemented in low-and middle-income countries have a... more Background: Community-based health programs implemented in low-and middle-income countries have additional health impacts beyond their targeted outcomes, such as on gender norms, roles and relationships. Programs should measure their effects on gender to respond to any unexpected consequences. Hence, we conducted a gender analysis on a drowning reduction program in rural Bangladesh providing survival swimming classes to children.Methods: A mixed-methods approach was used. Quantitative program monitoring data was analysed to assess gender differences in program participation and engagement. A qualitative approach using interviews, focus group discussions and observations aimed to find explanations for quantitative findings and additional experiences of the program. The analysis was conducted using Family Health International 360’s Gender Integration Framework.Results: Fewer girls participated in the swimming classes than boys due to cultural perceptions on appropriate activities for ...
BackgroundLiving and environmental conditions in rural Bangladesh expose children to drowning. Th... more BackgroundLiving and environmental conditions in rural Bangladesh expose children to drowning. The Anchal programme protects children through crèche-based supervision in an enclosed space run by locally recruited carers. It is unclear under what conditions the programme best operates to maximise protection. We conducted a process evaluation of Anchal to determine enabling factors and challenges to implementation.MethodsQuantitative programme data were analysed to calculate metrics including child participation and fidelity of implementation to defined processes. Qualitative data collection with programme participants and implementers provided insights into barriers and enablers of implementation. Analysis was guided by the UK Medical Research Council’s process evaluation framework.ResultsAnchal operated 400 centres with an average of 22.2 children enrolled, as per target. However, daily attendance averaged lower than the 80% target. Children aged 1–2 years old, who are most at risk ...
The American journal of tropical medicine and hygiene, Feb 26, 2016
We conducted a nonrandomized trial of strategies to promote soapy water for handwashing in rural ... more We conducted a nonrandomized trial of strategies to promote soapy water for handwashing in rural Bangladesh and measured uptake. We enrolled households with children < 3 years for three progressively intensive study arms: promotion of soapy water (N = 120), soapy water promotion plus handwashing stations (N = 103), and soapy water promotion, stations plus detergent refills (N = 90); we also enrolled control households (N = 72). Our handwashing stations included tap-fitted buckets and soapy water bottles. Community promoters visited households and held community meetings to demonstrate soapy water preparation and promote handwashing at key times. Field workers measured uptake 4 months later. In-depth interviews and focus group discussions assessed factors associated with uptake. More households had soapy water at the handwashing place in progressively intensive arms: 18% (promotion), 60% (promotion plus station), and 71% (promotion, station with refills). Compared with the promoti...
The aim of this paper is to find the causes behind poor performance in English subject of the pri... more The aim of this paper is to find the causes behind poor performance in English subject of the primary students of Bangladesh. Data derived from both primary and secondary sources while primary data were collected through in-depth interview and informal discussions from primary school-teachers, students and their parents. Findings revealed that among the four language skills, students were the weakest in writing skill. Respondents opined that English teaching-learning process in classroom was not appropriate and, thus, students got less interest to learn English. A fear in English among the students was also responsible for their poor performance.
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