- A mHealth intervention (mTB-Tobacco) for smoking cessation in people with tuberculosis: a two-stage adaptive design, randomized trial (Quit 4 TB Trial)
Quit 4 TB Trial project aims to assess in people with TB who smoke daily and check the effectiveness and cost effectiveness of mTB-Tobacco in achieving continuous abstinence for at least six months and also assess the effectiveness and cost effectiveness of mTB-Tobacco in enhancing TB treatment adherence and improving clinical outcomes. We will conduct a multi-center, cluster randomized, controlled trial consisting of four phases. Phase 1 involves consultation with Patients and Public Involvement (PPI) group about the study processes. PPI members will also review and provide feedback on the participant facing materials. Phase 2 is the pilot study. In Phase 3 (superiority trial), which will last for 12 months (6 months recruitments and 6 months follow ups), we will compare mTB-Tobacco (intervention A) with usual care (control). In Phase 4 (non-inferiority trial), which will last for another 12 months (6 months recruitment and 6 months follow ups), we will compare mTB-Tobacco (intervention A) with face-to-face behavioral support (intervention B). The primary endpoint will be biochemically verified continuous abstinence at 6 months post randomization. Abstinence is defined as self-report of not having used more than 5 cigarettes, bidis, water pipe sessions since the quit date, verified biochemically by a breath carbon monoxide (CO) reading of less than 10 ppm at month 6. Secondary outcomes will include Point abstinence, defined as a self-report of not using tobacco in the previous 7 days, assessed at week 9 and month 6, Adherence to TB Treatment, TB Programme outcomes, Cured, Completed treatment, Treatment failure, Defaulted, Died and Relapse cases.
- Assessing the effectiveness of using Public-Private Partnerships to improve family planning services in Bangladesh
Under this study, a public-private partnership (PPP) was developed to help private medical practitioners (PMPs) implement a referral strategy between themselves and family planning centres. We assessed whether the PPP model was effective in increasing the use of long-acting reversible contraceptive methods (LARCMs) and acceptable to both public and private healthcare providers.
Our findings revealed the PPP model is acceptable. The uptake of LARCMs increased with the use of a systematic referral system, as well as when the PMPs were in regular contact with and/or had their clinics either in or near the health centres that provided the family planning services. PMPs were more likely to refer patients to family planning centres if they were sure that their incentives would be properly disbursed. Additionally, it was apparent pharmacists and paramedics play an important role for motivating patients towards particular family planning methods. Communication between the PMPS and family planning centres is important to ensure continuous referral of patients for family planning services.
A policy brief was published based on the findings from the study which is available online.
- ASTRA – Addressing Smokeless Tobacco and Building Research Capacity in South Asia
ASTRA is a world-class, international and interdisciplinary group, aiming to reduce the substantial burden of disease caused by smokeless tobacco. Smokeless tobacco is responsible for thousands of deaths per year, but has so far been neglected in policy and research.
ASTRA’s international teams will carry out policy research and develop interventions to address the problems caused by smokeless tobacco use in South Asia. Our focus is on Bangladesh, India and Pakistan, where 80% of the world’s 300 million smokeless tobacco users live, and where the most harmful types of smokeless tobacco are favoured.
ASTRA is a three-year programme, with a budget of £2M, funded by the National Institute for Health Research, UK (NIHR).
- Children Learning About Second-hand Smoke (CLASS-II)
Children Learning About Second-hand Smoke (CLASS-II) was a two-arm pilot cluster randomised controlled trial funded by the Medical Research Council, UK. The project primarily aimed to establish the effectiveness of a school-based intervention, ‘Smoke Free Homes’ , in reducing exposure of school children to second hand smoke. Its effect on frequency and severity of respiratory illness, healthcare contacts, school absenteeism, smoking uptake and their lung function, quality of life and school performance were also studied.
CLASS II found that a school-based intervention has the potential to reduce children’s exposure to second-hand smoke. The trial provides key information to conduct a future definitive trial in this area of public health, which despite its importance has so far received little attention.
- Children Learning About Second-hand Smoking (CLASS-III)
Second-hand smoke (SHS) exposure costs 800,000 lives a year. Children in developing countries are worst affected as smoke-free laws are only partially implemented, and private homes and cars remain a key source of SHS exposure.
Children Learning About Second-hand Smoking (CLASS-III) is an ongoing project of ARK Foundation in collaboration with University of York. It is a multinational cRCT, through which we aim to assess the effectiveness and cost-effectiveness of a school-based Smoke-Free Intervention (SFI) in reducing children’s exposure to SHS and the frequency and severity of respiratory symptoms.The project started in the year 2010, to research the effects of secondhand smoke on children. Currently this research is in its third phase which explains the project name (CLASS-III).
We will conduct a two-arm cluster randomised controlled-trial in Dhakai. We will recruit and randomise 34 schools (1360 children), half of the schools will be allocated to the intervention arm receiving SFI and the other half usual education. A change in salivary cotinine -a highly sensitive and specific biomarker of SHS exposure- is the primary outcome which will be measured at month 3. Secondary outcomes include frequency and severity of respiratory symptoms, healthcare contacts, school absenteeism, smoking uptake and quality of life. An economic and process evaluation will also be conducted. The investigators’ expertise and track record within the field is complemented by their extensive links with schools and with policy makers of the country.
Full Title: Children Learning About Second-hand Smoking (CLASS-III)
Funder: Medical Research Council
Duration: March, 2022 – January, 2024
Host Institution: University of York, UK
For more details: To know more about CLASS III please visit:
- Community Dialogues in Bangladesh
Community Dialogues in Bangladesh aims to develop and test a “community dialogue” approach for preventing and controlling antibiotic resistance in Bangladesh. It is funded by the Economic and Social Research Council, UK. The project has five objectives: to conduct research to inform the content of and processes for delivering community dialogues; to adapt the community dialogues approach to the setting; to pilot-test the approach in the catchment areas of five community clinics; to evaluate the feasibility of the pilot intervention in terms of the number of people it reaches, the extent to which it is delivered as intended, and whether or not is it acceptable to a range of stakeholders; and to engage with key stakeholders, such as policy makers, district health officials, community clinic staff and communities to ensure that the intervention is appropriate.
- Community Solutions To Antimicrobial Resistance- COSTAR
Antimicrobial resistance (AMR) is a major threat to global health, food sustainability and security, and socio-economic development. It is estimated that AMR infections cause approximately 700,000human deaths each year globally, a figure that is set to rise to 10 million by 2050 if no action is taken.
COSTAR will build upon these successful foundations by combining the PV and CDA
approaches into a single intervention in each setting. COSTAR will use PV as a mechanism of generating knowledge to support the further development of CDA resources in each setting. Project teams will then use these resources to implement the CDA, and will assess its effectiveness for improving knowledge, attitudes, and practices in relation to AMR. In both Nepal and Bangladesh, COSTAR will use PV and rapid ethnographic studies to understand the One Health context of antimicrobial resistance in each country. These learnings will support the development of contextually specific materials to support the training of CDA facilitators. CDAs will then be delivered in each country.
In Bangladesh, CDAs will be implemented across the catchment areas of 25 community clinics,each of which has an approximate population of 6000. The approach will be evaluated through a cluster-randomised control trial (RCT). COSTAR will also assess the scaleup cost and cost-effectiveness of the CDA, the extent to which it is equitable, gender sensitive and participatory, and its potential to be scaled up.
Full title: Engaging communities to address antimicrobial resistance: Identifying
contextualized and sustainable community-led solutions in low resource settings.
Funder: UKRI (UK Research and Innovation) GCRF collective fund
Duration: January 1st 2021 – December 31st 2023
Host Institution: University of Leeds (UK)
Partners: HERD International (Nepal), ARK Foundation (Bangladesh), Chittagong Veterinary University (Bangladesh), Malaria Consortium, University of Liverpool, University of Western Australia.
Implementation settings: Nepal and Bangladesh
Website: COSTAR : https://ce4amr.leeds.ac.uk/costar/
- Community-Led Responsive and Effective Urban Health Systems (CHORUS)
CHORUS is a Research Programme Consortium that brings together health researchers from Africa, South Asia and the UK. CHORUS works with communities, health professionals and city level decision makers to develop and test ways to improve the health of the poorest urban residents. As rapid and uncontrolled urbanisation continues across low- and middle-income countries, health systems are struggling to keep up, and the needs of poor urban communities are often not met. This is especially true for those experiencing exclusion due to intersections with gender, caste, ethnicity, religion and disability. The CHORUS vision is to address these challenges and help build resilience in urban health systems. Our demand-led approach will work with poor communities to understand their health needs and design and evaluate interventions that will drive the improvement of the urban health system. We will work closely with urban policymakers and providers to ensure that any intervention developed is consistent with policy objectives and is feasible and sustainable. Our response will be divided into a number of research pillars and cross cutting themes.
CHORUS is funded by UK aid from the British people, however, the views expressed do not necessarily reflect the UK government’s official policies.
- Delivering a contextualized package of care for child development (0 - 12 months) and maternal mental health in the Rohingya refugee camps in Bangladesh
Background of the study:
The early childhood period is the basis for later success in life. It is the time when a child’s brain develops at a rapid rate creating plenty of opportunities for children’s learning and development. A child can have a good start in life when he/she grows up in a nurturing and stimulating environment that meets his/her essential needs such as nutrition, health, and safety, as well as the psychological, social, spiritual, and intellectual needs. This also means that the child has a greater chance of reaching his/her full potential later in life. Therefore, it is important to address children’s needs holistically because the absence of one or more essential needs can lead to negative developmental outcomes for children. Each and every child has a right to early
childhood development (ECD). The United Nations Convention on the Rights of the Child Article 6 (Article 6, UNICEF) highlights that the child has “a right to live…and develop healthy” and that every child has “the right to a standard of living that is good enough to meet their physical and mental needs” (Article 27, UNICEF).
Many of Bangladesh’s 61 million children suffer from malnutrition and lack appropriate
stimulation and early learning opportunities. About two fifths of the country’s children younger than five years old have stunted growth and about a fifth of newborns have low birth weights. In addition, about half the two-year-olds in Bangladesh are well below international height standards and about a third are severely underweight.
As of February 2018, the United Nations estimates that almost 1 million Rohingya refugees have fled Burma’s violent campaign of ethnic cleansing (4). Almost universally, they’ve moved into refugee settlements in Cox’s Bazar, Bangladesh.
This has caused a strain to Bangladesh, which has sheltered a remarkable number of people in just six months, leading to desperately cramped conditions in the camps. Air pollution in Ukhia and Teknaf has increased because of smoke from firewood burned by refugees and exhaust from thousands of trucks, jeeps, and cars bringing people and goods into the camps.
The refugees have changed the demographics of Bangladesh’s Ukhia and Teknaf areas, where Rohingya now outnumber locals 2 to 1.Of the approximately 900,000 Rohingya, 73 percent are living in new spontaneous settlements, 13 percent in makeshift settlements, 9 percent among host communities, and 5 percent in formal refugee camps.
More than 48,000 Rohingya infants are expected to be born in Bangladesh this year and would be exposed to different diseases and malnutrition since birth that might cause untimely death by five, warns Save the Children. According to the Needs and Population Monitoring Report, approximately 4.9 percent or 42,516 women of the total Rohingya population in Bangladesh (867,673) are pregnant. It is estimated that 15 percent of them will suffer miscarriage, meaning there will be an estimated 4,015 live births per month or 48,184 live births in 2018, Save the Children says. Children make up approximately 58 percent of the 655,000 Rohingyas, who fled violence in Rakhine of Myanmar to Bangladesh since late August last year. “We’re expecting about
130 live births per day in 2018. Most babies will likely be born at home in basic tents, in part because of the shortage of quality, 24-hour health facilities able to handle and manage basic emergency obstetrics, as well as challenges accessing healthcare,” said Rachael Cummings, the aid group’s health advisor in Cox’s Bazar.
Comprehensive early childhood care provides a strong foundation for good health, growth, and success in education, according to global evidence. Education is important for early learning and to prepare children for a better interactive youth years. It motivates and prepares children to attend primary school, provides parents with information about new approaches to education and prepares them to support their children’s growing experience.
The aim of the study is to develop an contextualize and evaluate an intervention for communitybased child development and maternal depression care in refugee camps.
Materials and Methods:
The intervention materials (i.e. provider training and mother counseling) will be contextualized and evaluated for delivering similar care in Bangladesh refugee setting. A cluster randomized trial, process evaluation and costing study will help knowing its effectiveness and feasibility in refugee setting. This adaptation, through a locally constituted technical working group, will take into account the technical, social, economic, and management support considerations for delivering child development and mental health care in a refugee camp setting.
We propose to evaluate the effectiveness (rather than efficacy) of a contextualized intervention, under potentially replicable circumstances in the refugee setting. A cluster randomized trial will have a total of 696 mother-child pairs in 22 clusters, randomly divided into equal number of intervention and control clusters. The mother-child pairs will get registered in the trial when the newborn child is less than 6 weeks old; and will be followed up, on quarterly basis, till the child gets one year old i.e. when the outcome measurements for child development and maternal mental health will be done.
We will also evaluate the feasibility of delivering child development and maternal mental health care, through community based care providers, in the refugee setting. The feasibility assessment will have a process-evaluation component to learn about the provider and consumer experiences of the intervention; and a costing study to assess the financial implications of replicating the intervention.
The clinic-based counseling intervention covering child stimulation, nutrition, and maternal mental health was delivered mainly by clinic assistant to mothers at ≤6 weeks, 3, 6, and 9 months of the child’s age. At 12 months of child age; each mother-child pair will be assessed for: the primary outcome, delays in the five development domains (ASQ-3 scores), and secondary outcomes, prevalence of stunting and maternal depression (PHQ-9 score). The outcome assessors will be blinded to the cluster-arm allocation. Outcome analyses will be calculated on cluster-level.
All children less than 6 weeks of age will be screened for eligibility, based on agreed
inclusion/exclusion criteria. The mother of each eligible child will be informed about the ECD care trial; and asked for consent to participate. Those who consent will get recruited in the trial, while those who refuse will receive the same care but their data will not be included in the trial. The ECD care will be delivered, at respective homes, by trained refugee women from the same camp. The care package will include mainly: a) child brain development and nutrition counseling; and b) mother depression assessment and care. At the end, home-based measurement of the outcomes will be arranged/ conducted for all registered children and their mothers. The outcome
measurement (when child gets 12 month old) will include: a) child brain development with ASQ-3; b) child physical growth i.e. weight and length; and c) mother depression with PHQ-9. These measurements will require 30-45 minutes for each mother-child pair. The quantitative data (ASQ-3 and PHQ-9) will be supplemented by semi-structured interviews with mothers, community care providers, and project staff. The quantitative and qualitative data collected on participating mothers and children will be kept confidential. This will include measures such as safe storage and restricted access to data; and using codes to identify mothers and children; and report statistics and
responses without identifying any individual. The intervention is expected to have beneficial health effect on children and mothers, without adding any potential risk to their health and wellbeing.
Potential benefit of the study:
This study will contextualize and potentially scale up implementation products available to deliver community-based child development and maternal mental health care in refugee camps. This will provide evidence of intervention effectiveness and feasibility for its possible scaling in refugee camps. This possibly may get considered for an integrated delivery of child development and mental health care at public primary health care facilities.
- Developing a psycho-social support (PSS) intervention for people with multi-drug resistant tuberculosis (MDR-TB) and com-morbid depression in Bangladesh: a feasibility study
This study aims to develop an acceptable and feasible psycho-social support (PSS) package that will be ready to embed within the existing National TB Control Programme (NTP) service delivery system in Bangladesh.
The existing service delivery system does not include any screening for mental health problems among MDR TB patients, or psycho-social counselling for the MDR TB patients.
We aim to develop an acceptable and feasible PSS package to embed within the existing NTP service delivery system. Our specific objectives are to assess the existing MDR-TB services, exploring the facilitators and barriers in the current service provision for mental health support; assess the prevalence of depression among MDR-TB patients using the depression module of the Public Health questionnaire (PHQ-9); validate PHQ-9 in the Bangladesh context; identify whether depression is associated with cure rate; and develop tools, materials and guideline for a PSS packagethat is applicable to the Bangladesh MDR-TB programme context.
- Evaluation of Tobacco Dependence Measures of Smokeless Tobacco (ST) Users in Bangladesh
Evaluation of Tobacco Dependence Measures of Smokeless Tobacco (ST) users in Bangladesh was a study supported by the University of York, UK. .
It was an 18-month project that aimed to evaluate psychometric properties of the Oklahoma Scale of Smokeless Tobacco Dependence among Bangladeshi smokeless tobacco users, and to identify underlying constructs and processes that explains dependence among smokeless tobacco users.
- Improving primary health care using community clinics in rural Bangladesh
Improving primary health care using community clinics in rural Bangladesh is a project that aimed to improve the quality of care of children in community clinics through an intervention and evaluation study.
The intervention contributed to a change in national policy and practice, with approximately 14,000 community health care providers nationwide given the job aid and trained.
Part of the findings from this project have been disseminated at a conference in Vancouver on November, 2016.
A research article and a policy brief on this study are published and available online.
- Improving the diagnosis and treatment of cardiovascular disease, diabetes and related conditions through primary health care in Bangladesh
This project aimed to develop and evaluate a service delivery model for the delivery of quality care to patients of cardiovascular diseases (CVDs) and diabetes at the Upazila Health Complexes and other primary health care (PHC) facilities.
Specific objectives included: establishing a systematic screening and care process to enhance early diagnosis of CVD and diabetes in selected PHC facilities; improving treatment and follow-up of CVD and diabetes through enabled primary care arrangements; developing and adapting case management guidelines, tools and training modules; building capacity of doctors, nurses and paramedics at the selected PHC facilities for early diagnosis and effective treatment of CVD and diabetes; and testing and evaluating guidelines and tools for further scale up.
- Integrating depression care in tuberculosis and hepatitis services in South Asia (IMPACT CCD)
The overall long-term aim of this research programme is to improve health outcomes and quality of life for people with depression and tuberculosis in South Asia. This study is aimed carring out the preliminary work for a future trial to evaluate depression care integrated with tuberculosis services. The specific objectives are:
- To understand the facilitators and barriers to detecting and treating depression in tuberculosis
- To develop, using codesign, culture- and context-appropriate approaches to case finding and treatment for depression integrated with tuberculosis care (including pathways and materials) that can be delivered by non -mental health specialists- the ‘TB-D’ intervention.
- To test the feasibility of case finding for depression in tuberculosis services (in terms of coverage and acceptability to patients and healthcare staff).
- To develop a protocol for a randomised controlled trial to evaluate the ‘TB-D’ intervention.
- Intervention for Mothers in Pregnancy to Reduce Exposure to Second-hand Smoking (IMPRESS)
Intervention for Mothers in Pregnancy to Reduce Exposure to Secondhand Smoking (IMPRESS) is a study that aimed to culturally adapt, and then evaluate, the effectiveness of evidence-based strategies to reduce second-hand smoking within homes in the peri-urban area of Bangladesh. It also aimed to determine the costs versus benefits of implementing such an intervention.A paper has been published based on qualitative findings from the first phase of the study carried out in India and Bangladesh.
A pilot trial of a multi-component intervention is being conducted as part of the project.
- Investigating mental and physical health comorbidity, Survey in people with severe mental illness in South Asia (IMPACT SMI)
The IMPACT SMI study is financially supported by National Institute of Health Research (NIHR).The IMPACT consortium comprises four UK Universities and four partner organizations from Bangladesh, India and Pakistan. Coordinated by the University of York, IMPACT’s UK partners include the. Our South Asian partners include Rawalpindi Medical University, Pakistan, Institute of Psychiatry, RMU, Pakistan, ARK Foundation, Bangladesh, National Institute of Mental Health, Bangladesh, National Institute of Mental Health and Neuroscience (NIMHANS), India. We are supported by key stakeholders, including the World Health Organization (WHO). The governance, activities and progress of IMPACT are overseen by an International Advisory Board (IAB), comprising members from the George Washington University, USA, Kings College London, Duke NUS Graduate Medical School, Singapore, Conventry and Warwickshire Partnership NHS Trust, UK, ESK and Weer Valleys NHS Foundation Trust, and Bangladesh’s National Heart Foundation Hospital and Research Institute.
Objectives: Determine the prevalence of physical disorders and lifestyle health-risk behaviours in people with SMI in South Asia.
- Muslim Communities Learning About Second-Hand Smoke (MCLASS-II)
Muslim Communities Learning About Second-hand Smoke (MCLASS-II) in Bangladesh is an effectiveness-implementation hybrid study funded by the Medical Research Council, UK. Its overall aim is to reduce the burden of disease due to second-hand smoke in low- and middle-income countries by discovering innovative community-based approaches to behaviour change. It will assess the feasibility and acceptability of introducing an intervention using imams as a change agent, thereby helping policy makers adapt tobacco cessation strategies to the local context. The findings will help researchers conduct a randomised controlled trial to assess the effectiveness of the intervention in reducing exposure to second-hand smoke at home.
- National Situation Analysis on Policy and Programmes Promoting Physical Activity in Bangladesh
The main objective of this World Health Organization (WHO) funded project was to identify the barriers and facilitators of physical activities to reach Global Action Plan on the prevention of NCDs in Bangladesh. The situation analysis also attempted to provide an overall view of the current scenario regarding the presence of physical activity as a standalone action area or as a part of other policies, frameworks or guidelines in the country.
The study was completed by following qualitative research methods. The qualitative data collection tools included desk reviews, key informant interviews (KII), group consultative meetings, and validation workshops. At first, KIIs were conducted to get the initial information and topics for further probing. A series of KIIs and several small group consultative meetings were conducted in the first phase of data collection. After that, a comprehensive examination of all the policies, strategic frameworks, action plans, reports, laws, and legislation pertinent to the promotion of physical activity in Bangladesh was carried out through the desk review method. After gathering and evaluating the relevant information, all the data were combined analysed and then synthesized.
The study found that physical activity as a means of promoting physical fitness, a healthy and fit lifestyle, and overall good health has not gotten the necessary importance in Bangladesh as it should have. While there is a lack of awareness among the people about its significance and usefulness, there is also a lack of national initiatives to remedy that. There is no policy or guideline in the country that specifically promotes physical activity. Though it has come up as part of various other policies and strategies, it did not receive enough emphasis in national plans and programmes.
Creating responsive health systems: improving the use of feedback from service users in quality assurance and human resource management in Bangladesh.
is a project that aims to assist policymakers in designing a comprehensive health-systems intervention to make Bangladesh’s health system more responsive. It will do so through assessing the current system of collecting, and responding to, feedback from health service users at sub-district (Upazila) level; and designing a comprehensive health systems intervention to improve utilisation of user feedback in health service quality assurance and human resource management processes at Upazila level. It is a multi-disciplinary and mixed-method health systems research study, using Realist Evaluation.
- Strengthening midwifery in Bangladesh – Lessons learnt
Project Summary: The Foreign, Commonwealth and Development Office (FCDO) of the UK government has invested in the ‘Strengthening Midwifery in Bangladesh’ program to establish midwifery education. The FCDO is also providing technical assistance to the Government of Bangladesh through UNFPA. The government has demonstrated commitment to midwifery services by creating 2996 midwife posts. Currently, there are 1149 midwives working in 421 upazillas and 1312 sub centers, with 55 institutes offering a 3-year diploma course in midwifery studies.
FCDO commissioned ARK Foundation to conduct a study with the aim of investigating the role of licensed midwives in improving maternal and newborn healthcare services in Bangladesh. The study also aimed to generate insights on the effectiveness of midwifery services and their long-term impact on maternal health. Furthermore, the study aimed to provide suggestions for the future direction of the midwifery program, including identifying scale-up options, opportunities, and challenges by involving and linking private and NGO sectors for training more midwives.
The study employed a mixed-methods design, including desk review, interviews, focus group discussions, case studies, and observation. Data was collected from three purposively selected upazilas in three districts. Key findings highlighted the positive impact of midwives in delivering core services such as antenatal care, postnatal care, deliveries, family planning, and newborn care. The study emphasized the need to scale up service delivery by midwives, strengthen health systems, and enhance midwifery education for program sustainability and quality.
Duration: From December’21 to June’22.
Funding organization: The Foreign, Commonwealth and Development Office (FCDO), UK
- Surveys for Urban Equity (SUE)
For public health services to respond to the growing burden of NCDs among the urban poor, the proper measurement of disease prevalence, risk factors and behaviours is a crucial first step. In low- and middle-income countries (LMICs), household surveys – such as the Demographic and Health Surveys (DHS) programme and the World Health Organization’s Stepwise Approach to Surveillance (STEPS) – provide vital data sources to inform national health sector planning in over 90 LMIC countries. However, the way these surveys are currently designed and presented undermines their use by decision-makers to monitor inter- and intra-urban health and plan interventions, and particularly to respond to the health needs of the poorest. The under-representation of the urban poor in these surveys means that health issues they experience are masked by the better health outcomes among the urban wealthy. This provides an overly rosy picture of urban health.
Our GCRF Foundation Award aims to address these problems by testing novel survey sampling and mapping approaches, piloting questionnaires on mental health and injuries, exploring the nature and definitions of urban poverty and households and working closely with urban-health decision-makers to find the best ways to present and use the data we collect.
- TB & Tobacco
The TB and Tobacco project aims to investigate ways in which interventions designed to encourage people to stop smoking can be integrated into tuberculosis (TB) control programmes. Its ultimate goal is to improve the health and longevity of patients suffering from TB, as well as decreasing the number of people who suffer from tobacco-related diseases.
- The Bangladesh Asthma Hajj Study
The Hajj is a massive pilgrimage that occurs once a year, involving two to three million individuals from more than 180 countries. Every year, around 120,000 pilgrims from Bangladesh perform the Hajj. One of the top causes of hospitalisation during the Hajj is acute asthma and its complications. One in five pilgrims with previously diagnosed asthma will present with an unscheduled attendance or hospitalisation during the Hajj.
All Hajj pilgrims attend a medical examination about three to four months before the pilgrimage at various centres located nationwide. This offers an opportunity to intervene, with proper assessment and management.
Aim and impact
Building on an initial study in Malaysia, this project is being undertaken in collaboration with the ARK Foundation in Bangladesh. This study will focus on the current pre-Hajj medical check-up services and their management process in Bangladesh, and whether they provide an opportunity to manage the risk of asthma issues among Hajj pilgrims. Limited research has been done on this issue in Bangladesh, and context-specific research is required to understand the public health challenges associated with Hajj and the existing barriers and opportunities in integrating any intervention.
This research was funded by the National Institute for Health Research (NIHR) Global Health Research Unit on Respiratory Health (RESPIRE) using UK aid from the UK Government to support global health research. The views expressed are those of the author(s) and not necessarily those of the NIHR or the UK Department of Health and Social Care.
- The Impact of the Covid-19 Pandemic on People with Severe Mental Illness and on Mental Health Service Provision in South Asia (Global Efforts on COVID-19) (IMPASS GECO)
The IMPACT consortium comprises four UK Universities and four partner organizations from Bangladesh, India and Pakistan. Coordinated by the University of York, IMPACT’s UK partners include the London School of Economics and Political Science, UK, University of Keele, UK, University of Dundee, UK, University of York/ Hull York Medical School, UK. Our South Asian partners include Rawalpindi Medical University, Pakistan, Institute of Psychiatry, RMU, Pakistan, ARK Foundation, Bangladesh, National Institute of Mental Health, Bangladesh, National Institute of Mental Health and Neuroscience (NIMHANS), India. The study is financially supported by Medical Research Council (MRC-UKRI). We are supported by key stakeholders, including the World Health Organization (WHO). The governance, activities and progress of IMPACT are overseen by an International Advisory Board (IAB), comprising members from the George Washington University, USA, Kings College London, Duke NUS Graduate Medical School, Singapore, Coventry and Warwickshire Partnership
General Objectives: Investigate impact of the pandemic and its response on people with SMI and on mental health care in Bangladesh.
- Explore receipt and response of SMI patients to advice about preventing spread of Covid-19
- Understand pandemic’s impact on SMI patient’s well-being, health, health risk behaviours, quality of life; access to/receipt of mental & physical healthcare; housing and food security, domestic violence, employment and income
- Explore impacts on mental health care
- Inform strategies to mitigate the impact of the pandemic on people with SMI and healthcare services.
- Tobacco Control Capacity Programme
The Tobacco Control Capacity Programme is a £3.4 million programme of training and research funded by Research Councils UK as part of the Global Challenges Research Fund. The overall aim of the programme is to improve research capacity in low- and middle-income countries (LMICs) to conduct high-quality studies that will generate evidence on how to reduce morbidity and mortality caused by tobacco use and to advance key development priorities. The programme has been funded until the end of 2021.
- Understanding and Addressing the Shrinking Civic Space in Bangladesh: A mixed method study
The aim of this research is to strengthen civil society in Bangladesh by addressing the challenges faced by civil society organizations (CSOs) and promoting an enabling environment for their work. The project is funded by the Dutch Ministry of Foreign Affairs (MFA) under the Learning for Strengthening Civil Society (L-SCS) program. The research will be conducted in partnership with the ARK Foundation in Bangladesh.
The research project has three phases: research co-creation, research implementation, and research finalization. The research questions to be addressed include understanding the factors that impact civic space, exploring coping strategies of CSOs, and identifying strategies to reverse the shrinking civic space trend.
To shape effective practices of CSOs, generate new knowledge, and provide input into wider community engagements, the research will be carried out using a participatory approach, involving CSOs in the research process. The research findings will be used to inform policy advocacy, enhance coordination between CSOs and the government, and bring about positive changes in legislation and behavior.
Overall, the research project aims to contribute to the growth and effectiveness of civil society in Bangladesh by addressing the challenges faced by CSOs and promoting an inclusive and collaborative society.
Duration: From January 2023 to June 2025.
Funding organization: The Dutch Ministry of Foreign Affairs (MFA)
Partner and host organization: Mannion Denniels
Other country partners: Burundi, Uganda, Sudan, Egypt, Lebanon, Niger
- Urban Anchal
Urban Anchal is a study looking at sustainable day-care for 1-4 year olds in disadvantaged urban communities in Dhaka, Bangladesh
It aims to address the lack of safe, stimulating and health-promoting environments for adequate early childhood development (ECD). Urban slums provide a challenging environment for child health. With slum-dwelling women working long hours and limited availability of extended family, slum communities face a childcare vacuum, undermining children’s healthy ECD. Adverse experiences and exposures increase the risk of poor health, social and cognitive outcomes during childhood and later in life.
Our study assesses the feasibility of providing day-care centres for young children in Dhaka. This present a holistic solution, allowing women to work whilst knowing their children are safe and provided with ECD opportunities. Our partners, Centre for Injury Prevention and Research, have extensive experience delivering and evaluating childcare in rural Bangladesh. Their model achieved significant impacts on all-cause mortality and injuries.
This project is funded from the UK Medical Research Council’s Public Health Intervention Development Fund and is of 1.5 years duration.
- A mHealth intervention (mTB-Tobacco) for smoking cessation in people with tuberculosis: a two-stage adaptive design, randomized trial (Quit 4 TB Trial)