AMK (Abhoynagar, Mirsarai and Kamlapur) HDSS BANGLADESH
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1 AMK (Abhoynagar, Mirsarai and Kamlapur) HDSS BANGLADESH Brief Description The AMK HDSS has presently three active field sites, Abhoynagar, Mirsarai and Kamalapur. Abhoynagar, which includes its former comparison area Keshobpur, has a quarterly surveyed population of about thirty-four thousand. It is located in Khulna division in the southwest of Bangladesh, between Jessore and Khulna cities - about 30 kms away each. This division is the first in Bangladesh to reach the below replacement level fertility. Mirsarai is situated in southeast Bangladesh in the Chittagong Division on the Dhaka-Chittagong highway, about 60 kms north of the latter city and has around forty thousand quarterly surveyed persons. Many workers migrate abroad, mainly to the Gulf States. Kamalapur is a part of Dhaka city, located between the main railway station and a bus terminal, where surveillance for certain diseases and vaccine trials are already taking place. The area has presently about 200,000 inhabitants and is enumerated every two years. From 2008 a part of this population is visited every three months for recording health and demographic events. -1-
2 Population Pyramid: AMK Site 2010 Abhoynagar Mirsarai Kamalapur Demographic Rates in Two Rural Sites Abhoynagar, 2010 Mirsarai, 2010 Crude Birth Rate (CBR) per 1000 population per 1000 population Total Fertility Rate (TFR) 2.08 per woman 2.16 per woman Crude Death Rate (CDR) 5.84 per 1000 population 5.87 per 1000 population Neonatal Mortality per 1000 live births per 1000 live births Post-neonatal Mortality 3.06 per 1000 live births per 1000 live births Infant Mortality 47.47per 1000 live births per 1000 live births Child Mortality (1-4 years) 1.17 per 1000 children aged 1-4 years 2.75 per 1000 children aged 1-4 years Under Five Mortality per 1000 live births per 1000 live births Rate of Natural Increase per 1000 population per 1000 population Objectives The AMK HDSS was originally set up for operations research. Apart from the routine surveillance, the rural sites are presently used for health systems research, while the urban site is more targeted at diseases surveillance and vaccine trials. Migration and urbanization research will also take place in the urban site. The objective of the surveillance is to provide reliable background data needed to translate the results of the research into better and more equitable health care for everyone, but especially in Bangladesh. -2-
3 Priority Research Areas The priority research areas are health systems, specifically in the areas of family planning, infant, child, adolescent and maternal health, and health equity, as well as infectious diseases like dengue, tuberculosis, rotavirus and other diarrhoeal diseases. Maternity Care service Analysis of the place of delivery information shows an increase in institution based deliveries from 5% in 2000 to 21% in 2009 in Abhoynagar. The respective figures for Misarai are 10% and 23%. Analysis by asset quintile of the women shows higher levels of institution based deliveries for women belonging to the less poor and least poor quintiles compared to women in the poorest and poorer quintiles in either area. Abhoynagar Mirsarai Home delivery Institution est er Middle L ess Least Home delivery Institution est er Middle L ess Least Figure 1: Home-based and institution-based deliveries by asset quintiles, 2009 Funders International Centre for Diarrhoeal Disease Research, Bangladesh Donors providing unrestricted support to the Centre's research efforts: Australian Agency for International Development Government of the People s Republic of Bangladesh Canadian International Development Agency Embassy of the Kingdom of the Netherlands Swedish International Development Cooperation Agency Swiss Agency for Development and Cooperation Department for International Development, UK Collaborators International Vaccine Institute (IVI) Centers for Disease Control (CDC) INDEPTH Network -3-
4 Key Publications 1. Koehlmoos P.T, Uddin Md. J, Ashraf A, Rashid Mashida. Homeless in Dhaka: Violence, Sexual Harassment, and Drug-abuse. Journal of Health Population Nutrition 2009 Aug 27(4); ;ISSN Uddin MJ, Koehlmoos TL, Ashraf A, Khan AI, Saha NC, Hossain M. Health needs and health-care-seeking behaviour of street-dwellers in Dhaka, Bangladesh. Health Policy Plan 2009 Jun 17. [Epub ahead of print] 3. Uddin MJ, Larson C, Oliveras E, Khan AI, Quaiyum A, Saha N. Child Immunization Coverage in Rural Hard-to-reach Haor areas of Bangladesh: Possible Alternate Strategies. Asia Pacific Journal of Public Health, January 2009; 21 (1): Uddin MJ and Choudhury AM. Reproductive Health Awareness among Adolescent Girls in Rural Bangladesh. Asia Pacific Journal of Public Health, April 2008; 20(2): Uddin MJ. Knowledge and Perceptions of Rural Adolescent Girls of Bangladeshi on STD and HIV/AIDS. South Asian Anthropologist, September 2008, 8(2): Uddin MJ and Choudhury AM. Menstrual Practices and Reproductive Health Problems among Adolescent Girls in Rural Bangladesh. South Asian Journal of Population and Health, July 2008, 1(2): Gazi R, Khan Sharful I, Haseen F, Sarma H, Islam M.A, Wirtz A.L, Rahman M. Young clients of hotel-based sex workers in Bangladesh: Vulnerability to HIV, Risk perceptions and expressed needs for interventions. International Journal of Sexual Health, 21: , Quaiyum M.A, Gazi R, Khan A.I, Uddin J, Islam M, Ahmed F, Saha N.C. Programmatic aspects of dropouts in child vaccination in Bangladesh: findings from a prospective study. Asia Pacific Journal of Public Health (In press) Koehlmoos P.T, Gazi R, Hossain S, Zaman K. Effect of social franchising on access to and quality of health services in low and middle-income countries. Cochrane Database System Review 21;(1):CD007136, Gazi R, Pervin S, Kabir H. Risk behaviour network and vulnerability to HIV infection of migrant female sex workers in Teknaf, Bangladesh. Pakistan Journal of women s studies (special issue on women working beyond borders; 16(1&2); 55-70, Gazi R, Mercer A, Wansom T, Kabir H, Saha N.C, and Azim T. An assessment of vulnerability to HIV infection of boatmen in Teknaf, Bangladesh. BioMed Central Journal, Conflict and Health, 2:5,
5 Data entry clerks at work at AMK Health and Demographic Surveillance System -5-
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