As well as developing injury prevention programmes the CIPRB conducts world class research. CIPRB collaborates with distinguished researchers, institutions and development organizations to address one of the most under acknowledged public health issues facing the world today.
Our research objectives are to;
- Provide better insight regarding the issues related to injuries
- Provide a better understanding of the magnitude of injuries
- Discover effective prevention techniques and tools
- Assess the impact of different injury prevention interventions
- Contribute to achieving the MDGs through reducing mortality and morbidity and developing realistic and cost-effective solutions
Methods of research
1) Field Laboratory
For new research, programme innovation and related activities the CIPRB utilises its field laboratory situated at Raiganj in the Sirajganj district. The CIPRB constructed the laboratory which has helped developed effective links with local institutions and the community. The laboratory serves a population of 135,000 providing a unique health, demographic and injury surveillance system.
Raiganj has a population of 317,666 and has 9 Unions/Wards, 187 Mauzas/Mahallas, 267 villages and 77,198 households. The total area of Raiganj is 259.74 sq. km (100.28 miles) and a literacy rate of 38.15%.
Since CIPRB’s inception it has conducted injury surveillance (from 2005 to 2010) in five unions namely Dhubil, Ghurka, Brammagachha, Chandaikona and Dhangara at Raiganj upazila of Sirajganj district covering 43,729 households under the Prevention of Child Injuries through Social-intervention and Education (PRECISE) project.
More recently, injury surveillance has continued with the support of the International Drowning Research Centre-Bangladesh (IDRC-B). From 2010, 5 data collectors and 1 supervisor have conducted injury surveillance in a total 31,334 households of 3 unions namely Brammagachha, Chandaikona and Dhangara at Raiganj upazila of Sirajganj district. The surveillance is conducted in every household at 6 month intervals and the information is collected on birth, death, marriage, migration and injury morbidity.
At present CIPRB is conducting research programs on Maternal and Newborn Health Care and on Nutrition.
Notable research activities conducted
Designing and implementing Comprehensive Child Injury Program (PRECISE)
Infrastructure survey on Injuries
Household Risk and Hazards
Feasibility of rural swimming learning centre
Hospital based Child Injury Surveillance
Evaluation of quality assurance scheme in health care
Maternal and Neonatal Health Survey in Netrokona
Financial Empowerment and Violence Against Women
Community Based Postnatal Care Study
Community based rehabilitation of disabilities
Qualitative studies in New Neonatal questions in demographic health survey
Maternal and Peri-natal Death Review (MPDR)
Pilot Implementation of “Quality Improvement System in Maternal and Neonatal Health Services in Two Districts of Bangladesh
Baseline survey training, Life Saving Skills (LSS) for EmOC training and other activities under the project titled Making it Happen 2 (MiH2)
At present the CIPRB is conducting the following research:
- Saving of Lives from Drowning (SoLiD): a child drowning prevention research project
- Bangladesh Anchal and SwimSafe (BASS)
- Situation analysis and effects of small-scale infrastructural measures for traffic calming and protection of vulnerable road users at rural black spots on the N2 highway in Bangladesh
At present, CIPRB is conducting the following researches on nutrition:
1. Assessment on Integrating Infant and Young Child Feeding (IYCF) in MNCH Programs.
2. Survey on the women having under two years children.
3. Research on SHIKHA Intervention in ‘Feed the Future’ Project.
Reproductive and child health research
Bangladesh has made significant progress to reduce maternal mortality in recent years. The Bangladesh Maternal Mortality and Health Care Survey reports that maternal mortality has declined from 322 per 100,000 live births in 2001 to 194 per 100,000 live births in 2010 and that Bangladesh is on track to achieving the Millennium Development Goal 5.
To accelerate this reduction, CIPRB has been operating various programmes through its Centre for Reproductive and Child Health.
– Maternal and Perinatal Death Review (MPDR)
The Maternal and Perinatal Death Review (MPDR) is an evidence based intervention undertaken by the government and initially piloted in Thakurgaon, Bangladesh in 2010. The Director General of Health Services (DGHS) in collaboration with the Director General of Family Planning (DGFP) under UNICEF – CIPRB partnership experienced for the first time a MPDR system within its health system.
MPDR is being implemented through district health and Family Planning units of the health system using field level staff and health care providers. The key activities include death notification (maternal, neonatal and stillbirth) both at community and facility level. The data has been used for death mapping and identifying death dense geographic areas for focused interventions. Verbal autopsies are conducted in all maternal deaths and a representative sample of neonatal deaths and stillbirths. From this the system is able to identify medical and/or social causes for those deaths. The process provides ample scope to the health managers and providers in planning and developing need based strategies and approaches for the reduction of maternal and perinatal deaths.
The experience in Thakurgaon was encouraging and effectively implemented. DGHS, DGFP, UNICEF, UNFPA, WHO, CIPRB and professional experts recognized its successful implementation with visibility and positive outcomes, and it was unanimously recommended for scale up. DFID and UKaid provided necessary funds for the project from 2010 to mid-2012 and the remainder of 2012 was funded by the Canadian CIDA. In October 2013 – September 2015 phase, the Department of Foreign Affairs, Trade and Development (DFATD) Canada extended their financial support to implement the intervention in 10 districts of Bangladesh including Thakurgaon, Jamalpur, Narail, Moulvibazar, Panchagarh, Sirajganj, Bagerhat, Netrokona, Bandarban and Cox’s Bazar districts of Bangladesh.
MPDR is covering a population of approximately 18 million people in 70 sub-districts under ten mentioned districts. The intervention is also covering 70 facilities at Upazila level (Upazila health complex), 10 district hospitals and 11 Maternal and Child Welfare Centers (MCWCs).
Implementation of Making it Happen 2 (MiH2) in Bangladesh
Bangladesh has made significant progress towards MDG 4 and 5. To accelerate reduction of maternal and neonatal mortality, the country needs to enhance access to skilled care during child birth and obstetric and neonatal complications.
The ‘Making It Happen’ programme aims to reduce maternal and newborn mortality and morbidity (MDG4 and MDG5) by increasing the availability and improving the quality of Skilled Birth Attendance (SBA) and Emergency Obstetric and Newborn Care (EmONC). Liverpool Tropical School of Medicine (LSTM), UK and CIPRB are jointly implementing the ‘Making It Happen-Phase 2’ (MiH2) programme (2013-2015) under the policy support and guidance of the Line Director, MNCAH, DGHS and Line Director, MCRAH, DGFP of the government. The Obstetrical Gynaecological Society of Bangladesh (OGSB) is also providing technical assistance. A national Coordination committee chaired by Line Director, MNCAH, DGFP was formed on 20th July 2013 and provides support and supervision.
The programme applied evidence-based training, using proven adult education techniques, together with improved supervision and data management. The LSS-EOC & NC training package was developed by LSTM and Royal College of Obstetricians and Gynaecologists in collaboration with the Department of Making Pregnancy Safer at WHO. The training programme will be implemented in the following hospitals and their referral medical college hospitals.
|Name of intervention districts||Population coverage(x 1000)||Govt. Hospitals at District level||Number of Upazila Health Complex (UHC)||Referral Medical College Hospital (MCH)|
|Panchagar||981||2 (DH, MCWC)||4||Dinajpur & Rangpur|
|Sunamganj||2,443||2 (DH, MCWC)||9||Sylhet|
|Sirajgong||3,072||2 (DH, MCWC)||8||Bogra|
|Borguna||882||2 (DH, MCWC)||4||Barishal|
|Potuakhali||1,517||2 (DH, MCWC)||6||Barishal|
|Bagerhat||1,461||2 (DH, MCWC)||8||Khulna|
The major MiH-2 activities include (i) Baseline survey for mapping HR and EmONC services (ii) Training of HCPs (iii) National capacity building (TOT) (iv) M&E in intervention hospitals (v) Quality of Care (QoC) (vi) Organizing workshop on Confidential Enquiry on Maternal Death.
As part of the programme already implemented a base line survey was undertaken in government hospitals (DH, MCWC, UHCs) of 6 districts and their referral 6 medical college hospitals on 22nd July, 2013. The baseline assessment recorded the current status of those facilities on availability and quality of EOC-NC care/services in addition to human resource mapping in maternal and neonatal health care.
The aim of MiH2 is to reduce maternal and new born mortality and morbidity by ensuring the availability of Emergency Obstetric Care (EOC) and new born care at facility level by skilled health professionals by training at least 80% of all EOC health care providers.
Environment and climate change research
In 2008, CIPRB conducted a research study of the SwimSafe programme to ensure it complies with the social and environmental conditions of Bangladesh and to develop a set of guidelines to improve the implementation and the scaling up of the programme.
The initial findings showed that parents living in rural areas who are literate discouraged their children from swimming, which leaves them with skills comparable to children of poorer families. This disparity is also found among girls when compared to boys whose families are economically better off.
People, irrespective of their socioeconomic position place more emphasis on schooling and textbook based education. They liken swimming training to a game and therefore consider it a low-priority for their children. Besides the other socioeconomic restrictions, there are also environmental hurdles to overcome such as the reduction in the number of available ponds due to fish cultivation. In addition, during summer months there is a lack of water in these existing ponds.
To combat the risks associated with climate change, it is imperative to include lifesaving skills, such as the SwimSafe program, in the primary and secondary education system of Bangladesh. In addition, community and policymakers need to preserve open spaces and water bodies, and carry out campaigns on the importance of such programmes.