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Life Science / 13 crazy statistics about how people use smartphones
« on: February 12, 2019, 02:52:10 PM »
If it seems like almost everyone has a smartphone these days, you’re not far from the truth. More and more people are carrying around tiny computers more powerful than the lunar module that landed on the moon in their pockets, and they’re doing more with them than ever before.
As healthcare goes mobile, it’s important to know as much as possible about your target audience if you want your marketing to be effective. These stats showing how people use their smartphones could have a big impact on how you shape your marketing message for 2016.
1. Nearly two thirds of Americans own smartphones (Pew)
The crazy part of this stat isn’t that 64 percent of U.S. adults own smartphones—it’s that almost twice as many own smartphones as did just four years ago (35 percent in 2011). The industry is changing and it’s changing fast—who can say where it’ll be in another four years?
2. 46 percent of smartphone owners “couldn’t live without” their smartphone (Pew)
3. 36 percent of smartphone owners would choose their phone over their TV (Google)
With a world of knowledge just a tap away, smartphones are quite literally life changing—and nearly half of smartphone users say that they couldn’t live without all that information at their fingertips. A majority of those people would even choose their smartphones over other sources of entertainment.
4. 87 percent of millennials say their smartphone never leaves their side (Zogby)
5. 80 percent of millennials say their smartphone is the first thing they reach for when they wake up (Zogby)
6. 78 percent of millennials use their smartphones more than two hours every day (Zogby)
Millennials and their smartphones are practically joined at the hip. I am the 80 percent; l reach for my smartphone every morning to shut off the alarm and more often than not find myself scrolling through my Twitter timeline. This demographic is only going to get more mobile—if you want to reach millennials, your mobile marketing has to be top notch.
7. 51 percent of cell phone users 55 and older own smartphones (Nielsen)
It’s not just millennials, though; as of 2014, more than half of cell phone owners over 55 years old use smartphones as well. (There’s even a Jitterbug smartphone.) That means you’re not limiting your marketing to a younger audience when you adopt a mobile-friend mindset.
8. 7 percent of Americans are entirely smartphone-dependent (Pew)
10 percent of smartphone owners don’t have high speed Internet access at home, while 15 percent have limited options for Internet access. The overlap between those two groups—approximately 22 million Americans—represents another group who go online only with their smartphones. That figure grows to 15 percent among young adults, 13 percent among Latinos, and 12 percent among African Americans. Depending on the demographics of the region your hospital serves, neglecting mobile marketing could mean neglecting a significant percentage of your audience.
9. 60 percent of millennials believe everything will be done on mobile devices in five years (Zogby)
Millennials make up the largest smartphone-dependent population, and that number will only grow as younger users favor mobile devices over desktop and laptop computers. By adopting a mobile-first mindset now, your hospital can avoid playing catch-up in a few years.
10. 64 percent of smartphone owners use their phone to look up health information (Pew)
11. 94 percent of smartphone owners look for local information (Google)
People are looking online for answers to their health questions, and hospitals are uniquely equipped to provide them. You need to anticipate your community’s needs and share relevant information online where they’ll find it. That means posting to social media and optimizing for search. Optimizing for local search is vital, too—your name, address, and phone number need to be correct and consistent so prospective patients can contact your hospital or find directions to it.
12. More smartphone owners use their phone for watching videos than playing music (Pew)
13. Vertical video viewing is on the rise (KPCB)
Smartphones may be descendants of the iPod, but they do so much more than make phone calls and play music. People love watching videos on mobile—75 percent of users aged 18–29 said they watched a video on the phone compared to 64 percent who listened to music—and there’s now a growing trend of vertical video viewing. Popularized by Snapchat, portrait video ads see completion rates as many as 9 times higher than landscape ads and could be a good fit for a mobile ad campaign regardless of platform.


Every body gets angry at times. But one in five Americans has an anger management problem. A person’s anger may make them melt down in front of others and yell, scream, hit out or abuse others. This type of outburst is destructive anger at its most potent. It hurts you and it hurts others, in physical, emotional and social ways. If you have trouble restraining yourself from angry outbursts, you need to retrain yourself on how to handle challenging situations. This is the best way forward to a calmer life. Following the yo will get a concrete guideline how to control anger in right moment

Health education / Health education strategies
« on: August 26, 2018, 10:29:43 AM »
 Health Education

Health education is one strategy for implementing health promotion and disease prevention programs. Health education provides learning experiences on health topics. Health education strategies are tailored for their target population. Health education presents information to target populations on particular health topics, including the health benefits/threats they face, and provides tools to build capacity and support behavior change in an appropriate setting.

Examples of health education activities include:


Characteristics of health education strategies include:

  1.  Participation of the target population.
  2. Completion of a community needs assessment to identify community capacity, resources, priorities, and needs.
  3.  Planned learning activities that increase participants' knowledge and skills.
  4. Implementation of programs with integrated, well-planned curricula and materials that take place in a setting convenient for  participants.
  5. Presentation of information with audiovisual and computer based supports such as slides and projectors, videos, books, CDs, posters, pictures, websites, or software programs.
  6. Ensuring proficiency of program staff, through training, to maintain fidelity to the program model.


When wrestling with the attitude-behaviour gap and grappling with the emotional and often-irrational nature of the human animal (aka any of your business's stakeholders), you’ll need all the help you can get. Whether you’re crafting a communications strategy to encourage positive behaviour change or facilitating a process to unleash new ideas and breakthrough innovation on a project, thankfully, digital media is facilitating the rapid sharing and diffusion of smart, practical ways to create change.

Over time, I’ve come across a range of online tools, usually free, that provide useful frameworks or helpful stimulus for shaping change and driving innovation. Here I’ll share some of the tools I’ve found most useful, and I invite you to use the comment functionality below to share your favorites with other readers.
Communication tools that also influence behaviour

I’ve found insights from the worlds of behavioural psychology and user experience (UX) design particularly useful. Here are some of the best:

Design with Intent Toolkit

Find 101 approaches to influencing behaviour through design, organised into eight lenses such as the ‘interaction lens’ or the ‘ludic lens.’ Even better, they’re completely free to download.

Wheel of Persuasion

This tool offers a wide range of scientific insights into the psychology of conversion grouped into five dimensions. While it’s focused on online UX design, the thinking can equally be applied to encouraging more sustainable behaviour; for example, the principle of ‘equivalence framing’ is presented in terms of persuading online purchases but can equally be applied to persuading people to make more sustainable purchases. 46 insights are openly available on the website, but you need an access code to view the full tool.

The Hooked Model

A four-stage approach to creating products and services that form habits. More detail of the thinking behind this trigger-action-reward-investment approach can be found in this Slideshare deck or by reading the book.

Mental Notes Cards

50 cards, each featuring an insight into human behaviour and how to translate this into better web design. The principles can easily be adapted to tackling the challenges of promoting sustainable consumption – for example an approach such as ‘chunking’ (grouping information into familiar manageable units) works as well for explaining a complex sustainability concept as for helping someone navigate a website. Out of print currently, but worth getting when available again – in the meantime, check out the bookshelf that inspired them.


Please find the whole report of CDC,USA for the guideline to the reducing the risk of vulnerable community population

Authors:  Md. Imdadul HaqueEmail author, A. B. M. Alauddin Chowdhury, Md. Shahjahan and Md. Golam Dostogir Harun

Published in BMC Complementary and Alternative Medicine



Traditional healing practice is an important and integral part of healthcare systems in almost all countries of the world. Very few studies have addressed the holistic scenario of traditional healing practices in Bangladesh, although these serve around 80% of the ailing people. This study explored distinctive forms of traditional healing practices in rural Bangladesh.

During July to October 2007, the study team conducted 64 unstructured interviews, and 18 key informant interviews with traditional healers and patients from Bhabanipur and Jobra, two adjacent villages in Chittagong district, Bangladesh. The study also used participatory observations of traditional healing activities in the treatment centers.

Majority of the community members, especially people of low socioeconomic status, first approached the traditional healers with their medical problems. Only after failure of such treatment did they move to qualified physicians for modern treatment. Interestingly, if this failed, they returned to the traditional healers. This study identified both religious and non-religious healing practices. The key religious healing practices reportedly included Kalami, Bhandai, and Spiritual Healing, whereas the non-religious healing practices included Sorcery, Kabiraji, and Home Medicine. Both patients and healers practiced self-medication at home with their indigenous knowledge. Kabiraji was widely practiced based on informal use of local medicinal plants in rural areas. Healers in both Kalami and Bhandari practices resorted to religious rituals, and usually used verses of holy books in healing, which required a firm belief of patients for the treatment to be effective. Sorcerers deliberately used their so-called supernatural power not only to treat a patient but also to cause harm to others upon secret request. The spiritual healing reportedly diagnosed and cured the health problems through communication with sacred spirits. Although the fee for diagnosis was small, spiritual healing required different types of treatment instruments, which made the treatment implicitly expensive.

Traditional healing was widely practiced as the means of primary healthcare in rural areas of Bangladesh, especially among the people with low socioeconomic status. The extent of services showed no decline with the advancement of modern medical sciences; rather it has increased with the passage of time.

The whole paper can be available at :

Yes, if we want to prevent tobacco consummations, burden of diseases, disability or death for tobacco consumption, first of all we have to completely ban the tobacco farming. How no individual, institution, laws, policies or government is working or talking vigorously to stop farming tobacco farming??? Governments around the world always propagated against the tobacco using, but taking huge taxes from the tobacco companies and maintain good relationship with them?

So, how we can get over the situation???

 It is of great concern that, in practice, mental health promotion is frequently overlooked in health promotion programmes although the WHO definitions of health and the Ottawa Charter describe mental health as an integral part of health. It is suggested that more attention be given to addressing the determinants of mental health in terms of protective and risk factors for both physical and mental conditions, particularly in developing countries. Examples of evidence-based mental health programmes operating in widely diverse settings are presented to demonstrate that well designed interventions can contribute to the well-being of populations. It is advocated that particular attention be given to the intersectorial cooperation needed for this work.

Source: Please go through the whole paper following the link-


A slowly progressive airway disease that causes the gradual loss of lung function. COPD is an umbrella term that includes chronic bronchitis, chronic obstructive bronchitis, emphysema, and combinations of these diseases. The symptoms of COPD include chronic cough and sputum (a mixture of saliva and mucus) production and severe shortness of breath. As the disease progresses, people increasingly lose their ability to breathe. COPD is the fourth leading cause of death in the United States. The most common risk factor for COPD by far is cigarette smoking.

A number of studies have suggested that COPD is a risk factor for Type 2 diabetes. A study published in Diabetes Care in 2004 followed over 100,000 female nurses enrolled in the Nurses’ Health Study from 1988 to 1996. They were periodically surveyed about whether they had been diagnosed with emphysema, chronic bronchitis, asthma, or diabetes. Those with COPD were nearly twice as likely to develop Type 2 diabetes as those without COPD. (Women with asthma, however, were no more likely to develop diabetes than those who didn’t have asthma). Although the study was carried out in women, the researchers saw no reason not to believe the same association would apply to men.

The researchers suggested that inflammation and oxidative stress may explain this association: Increasingly, inflammation is thought to play a major role in causing Type 2 diabetes, and some of the same inflammatory markers that are increased in diabetes are increased in COPD. Both conditions have also been linked to a phenomenon called oxidative stress, in which highly energized compounds called reactive oxygen species, which react strongly with other molecules, damage tissue. In the case of COPD, oxidative stress injures the airway and promotes inflammation in the lungs, and oxidative stress has been implicated as an underlying cause of the insulin resistance seen in Type 2 diabetes.

COPD cannot be cured, so prevention is key. The most important step for preventing COPD—or stopping or slowing its progression—is avoiding smoking.


Ebola Virus / How Do You Get Ebola?
« on: August 25, 2018, 04:12:18 PM »
Ebola isn’t as contagious as more common viruses like colds, influenza, or measles. It spreads to people by contact with the skin or bodily fluids of an infected animal, like a monkey, chimp, or fruit bat. Then it moves from person to person the same way. Those who care for a sick person or bury someone who has died from the disease often get it.Other ways to get Ebola include touching contaminated needles or surfaces.

You can’t get Ebola from air, water, or food. A person who has Ebola but has no symptoms can’t spread the disease, either.

What Are the Symptoms of Ebola?

Ebola is a rare but deadly virus that causes fever, body aches, and diarrhea, and sometimes bleeding inside and outside the body.

As the virus spreads through the body, it damages the immune system and organs. Ultimately, it causes levels of blood-clotting cells to drop. This leads to severe, uncontrollable bleeding.

The disease was known as Ebola hemorrhagic fever but is now referred to as Ebola virus. It kills up to 90% of people who are infected.Ebola is a deadly disease caused by a virus. There are five strains, and four of them can make people sick. After entering the body, it kills cells, making some of them explode. It wrecks the immune system, causes heavy bleeding inside the body, and damages almost every organ.

The virus is scary, but it’s also rare. You can get it only from direct contact with an infected person’s body fluids.

What Are the Symptoms of Ebola?

Early on, Ebola can feel like the flu or other illnesses. Symptoms show up 2 to 21 days after infection and usually include:

    High fever
    Joint and muscle aches
    Sore throat
    Stomach pain
    Lack of appetite

As the disease gets worse, it causes bleeding inside the body, as well as from the eyes, ears, and nose. Some people will vomit or cough up blood, have bloody diarrhea, and get a rash.

How Is Ebola Diagnosed?

Sometimes it's hard to tell if a person has Ebola from the symptoms alone. Doctors may test to rule out other diseases like cholera or malaria.

Tests of blood and tissues also can diagnose Ebola.

If you have Ebola, you’ll be isolated from the public immediately to prevent the spread.
How Is Ebola Treated?

There’s no cure for Ebola, though researchers are working on it. Treatment includes an experimental serum that destroys infected cells.

Doctors manage the symptoms of Ebola with:

    Fluids and electrolytes
    Blood pressure medication
    Blood transfusions
    Treatment for other infections


Since   early   2006,   highly   pathogenic   avian   influenza H5N1 has been clocking up air miles at an alarming rate. It  has  spread  quickly  to  Europe,  the  middle  east,  India,  and Africa following no apparent pattern, and underlining how  little  scientists  know  about  the  virus  ecology  and  where  it  will  strike  next.  There  is  now  growing  concern  that  the  whirlwind  spread  of  avian  flu  in  some  parts  of  the world is not entirely governed by nature, but by the human activities of commerce and trade. Since mid-2005, the Food and Agriculture Organisation  (FAO) and WHO have given wide prominence to the theory that  migratory  birds  are  carrying  the  H5N1  virus  and  infecting   poultry   flocks   in   areas   that   lie   along   their migratory  route.  Indeed,  this  is  probably  how  the  virus  reached  Europe.  Unusually  cold  weather  in  the  wetlands  near  the  Black  Sea,  where  the  disease  is  now  entrenched,  drove  migrating  birds,  notably  swans,  much  further  west  than usual. But despite extensive testing of wild birds for the disease, scientists have only rarely identified  live  birds  carrying  bird  flu  in  a  highly  pathogenic  form,  suggesting 
these    birds    are    not    efficient    vectors    of    the    virus. 

Furthermore,  the  geographic  spread  of  the  disease  does  not  correlate  with  migratory  routes  and  seasons.  The  pattern  of  outbreaks  follows  major  road  and  rail  routes,  not flyways.  Far more likely to be perpetuating the spread of the virus is the movement of poultry, poultry products, or infected material from poultry farms—eg, animal feed and manure. But  this  mode  of  transmission  has  been  down-played  by  international agencies, who admit that migratory birds are an easy target since nobody is to blame. However, GRAIN, an   international,   non-governmental   organisation   that   promotes   the   sustainable   management   and   use   of   agricultural biodiversity, recently launched a critical report titled Fowl  play:  the  poultry  industry’s  central  role  in  the  bird  flu  crisis.GRAIN points a finger  at  the  transnational  poultry  industry  as  fuelling  the  epidemic.  Over  the  years,  large 
concentrations    of    (presumably    stressed)    birds    have    facilitated an increased affinity of the virus to chickens and
other domestic poultry, with an increase in pathogenicity. Since the 1980s, the intensification of chicken production in  eastern  Asia  has  gained  momentum,  changing  the  whole dynamic of avian influenza  viruses  in  the  southern China epicentre, which has had far-reaching consequences for the rest of the world.


chikungunya / Rural people in Bangladesh also at risk of chikungunya
« on: August 25, 2018, 05:45:09 AM »

Although chikungunya outbreak is limited in Dhaka city this year, people in rural areas are at risk of the disease as studies showed presence of aedes mosquitoes.

Senior Scientific Officer of Institute of Epidemiology, Disease Control and Research (IEDCR) Dr SM Alamgir told the news agency, "Two species of mosquito -- aedes aegypti and aedes albopictus -- cause chikungunya diseases. Presence of aedes albopictus mosquito in rural areas is very high compared to urban areas.

The virus is transmitted from human to human by the bites of aedes mosquitoes, he said, adding, "Suspected chikungunya patients should visit nearby health complexes and hospitals to prevent outbreak of the disease."

Dr Alamgir said, "People living in rural areas and Dhaka city should be aware of chikungunya disease... First case of chikungunya disease in the country was reported in Poba upazila of Rajshahi in 2008."

"We also found some chikungunya cases in rural areas after its first outbreak in Bangladesh. So, rural areas are also venerable for the disease," he added.

He said though IEDCR is getting three to five samples for chikungunya case every day against 25 to 30 cases, it does not indicate that outbreak of the disease is decreasing as a huge number of people left Dhaka during Eid-ul-Fitr.

"We are apparently thinking that outbreak of the disease has decreased a little bit but we have to wait for next few days to confirm the real scenario of the disease," he said.

"Alongside eliminating the breeding sources of mosquito, people should be educated on the diseases as there is no special treatment of the diseases."

Director of Epidemiology, Disease Control and Research (IEDCR) Prof Meerjady Sabrina Flora said, "We got 1,930 chikungunya suspected cases till June 21 this year."

She suggested destroying all potential mosquito breeding sources as the outbreak of chikungunya disease in the capital has increased sharply this year.

Dr Flora said a massive awareness campaign is needed to destroy the breeding sources of mosquito for stopping outbreak of chikungunya disease.

Health experts said chikungunya affected people should drink much water and take full rest. There is no need of any laboratory test as the diseases could be recognized easily by observing some common symptoms.

At a press conference held recently, Director General of Directorate General of Health Services (DGHS) Prof Abul Kalam Azad said, "Chikungunya is not serious like other mosquito-borne diseases. After a particular time, patients get recovery without receiving any special medical treatment."

Chikungunya infected patients should not be admitted to hospitals and even they do not need to go to hospitals for any test to diagnose the disease, he added.

Chikungunya is a viral disease which is transmitted to humans by infected mosquitoes. Health experts said symptoms of the disease appear between four and seven days after a person is bitten by an infected mosquito.

Chikungunya is characterized by an abrupt onset of high fever frequently accompanied by joint pain. Other common signs and symptoms of the disease include muscle pain, headache, nausea, fatigue and rash, they said, adding, the joint pain is often very debilitating, but usually lasts for a few days or may be prolonged to weeks.
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cancer / Breast cancer death rate high in Bangladesh: Says WHO study
« on: August 25, 2018, 05:38:18 AM »
Sixteen percent of the total cancer affected women in the country are victim to breast cancer, says a World Health Organisation (WHO) study.
WHO also ranked Bangladesh 2nd in terms of mortality rate of women in the country from breast cancer.
Dr Lutfar Rahman, project director of Dhaka Ahsania Mission, referred to the study while speaking at the inaugural session of the month-long International Breast Cancer Awareness Programme organised by Ahsania's cancer hospital in the city yesterday.
Cancer specialist Prof Mahbubul Alam said around three-fourth of women aged over 50 in the country are affected with breast cancer.
Unmarried women are at high risk of breast cancer, but it can be cured completely if detected at early stage, said National Prof Dr MR Khan.
Surgical oncologist Prof Haron-or-Rashid suggested women to marry after 20 and adopt first baby before 30 to avoid breast cancer.
Ahsania Mission Cancer Detection Centre and Hospital Director Brig Gen (retd) Syed Fazle Rahim presided over the function.
Jurist barrister Rafiq-ul-Haque, lawmaker MA Jabbar, artiste Parveen Mushtari, and the hospital adviser Mohammad Ali, among others, were present there.
As a part of the awareness programme, the hospital has set to provide free counselling on breast cancer from 9:00am to 2:00pm during the whole October beginning yesterday at the hospital.
People can also contact at 01718594682 and 01712103689 for any information relating to breast cancer.


Further disease outbreaks are likely if the refugees’ living conditions don’t improve.

Diphtheria, a disease long forgotten in most parts of the world thanks to increasing rates of vaccination, is re-emerging in Bangladesh, where more than 655,000 Rohingya have sought refuge since 25 August, following increased violence in Myanmar. As of 21 December, Médecins Sans Frontières (MSF) has seen more than 2,000 suspected cases in its health facilities and the number is rising daily. The majority of patients are between five and 14 years old.

“I was very surprised when I got that first call from the doctor at the clinic telling me that he had a suspected case of diphtheria,” says Crystal Crystal VanLeeuwen, MSF emergency medical coordinator for Bangladesh.

“‘Diphtheria?’ I asked, ‘Are you sure?’ When working in a refugee setting you always have your eyes open for infectious, vaccine-preventable diseases such as tetanus, measles and polio, but diphtheria was not something that was on my radar.”

Diphtheria is a contagious bacterial infection that often causes the buildup of sticky grey-white membrane in the throat or nose. The infection is known to cause airway obstruction and damage to the heart and nervous system. The fatality rate increases without the diphtheria antitoxin (DAT). With global shortages of DAT and the limited quantity that arrived in Bangladesh just over a week ago, the likelihood of a public health emergency looms, threatening a population that has fled the threat of violence and is now faced with another: the outbreak of disease.

If patients don’t receive DAT early on in the progression of their illness, the toxin continues to circulate in the body. This can cause damage to the nervous, cardiac and renal systems weeks after the initial recovery period.

“The first suspected case we identified was a woman around 30 years old,” explains VanLeeuwen. “She came to our health facility in early November and we treated her with antibiotics. She left the clinic, only to return to us over five weeks later. Then she had numbness in her arms, could barely stand or walk and had difficulty swallowing. It is too late to give her DAT at this stage.”

As of today, there are only less than 5,000 vials of DAT globally. “There is not enough of the medication to treat all of the people in front of you who need it and we are forced to make extremely difficult decisions,” says VanLeeuwen. “It becomes an ethical and equity question.”

The emergence and the spread of diphtheria show how vulnerable Rohingya refugees are. The majority of them are not vaccinated against any diseases, as they had very limited access to routine healthcare, including vaccinations, back in Myanmar. Diphtheria is transmitted by droplets and spreads easily in the refugee settlements where people live in overcrowded conditions, with shelters squeezed up against each other and sometimes families with up to 10 people living in one very small space.

MSF has responded to the rapid spread of diphtheria by converting one of its mother and child inpatient facilities in Balukhali makeshift settlement, and the inpatient facility near Moynarghona – which was only days away from opening – into a diphtheria treatment centre.

Alongside this, MSF has set up a treatment centre in Rubber Garden, which was previously a transit centre for new arrivals. The total bed capacity will grow to 415 beds by 25 December. To prevent the further spread of the disease, our teams are also doing tracing and treatment of people who might have come in contact with the disease in the community. As soon as a case is identified, a team visits the family, gives them antibiotics and searches the area for additional cases for referral and treatment.

To contain the spread of the diseases, the most important measure is to ensure vaccination coverage in the shortest possible time. The Ministry of Health and Family Welfare, with the support of other entities, has just started a mass vaccination campaign, which MSF has been supporting by setting up fixed points in our health posts.

But the challenges remain.

An unvaccinated person gains immunity after a minimum of two vaccines, administered four weeks apart. This is a population that knows little or nothing about the benefit of vaccines. Less than a month ago, the Rohingya already participated in a mass measles vaccination campaign. Many do not understand why they need another vaccine. Communication with the population is key to ensuring good vaccination coverage. MSF is also trying to ensure all newly arrived refugees are vaccinated before they are relocated into the camps. But given the time required to complete the course of vaccination, and in the absence of a place where they can be temporally sheltered, it’s a big challenge. As a medical humanitarian organisation, we also face a dilemma.

“Even before the diphtheria, there was a severe lack of inpatient bed capacity. Now we have had to convert those scarcely available beds into dedicated treatment and isolation areas for diphtheria patients only,” says Crystal VanLeeuwen.

“The women and children who previously had access to the facility no longer have this as an option. This is also creating a strain on the space and staffing available in non-diphtheria inpatient facilities that have taken on these patients. The teams have been adapting to the rapidly changing situation but we all face new challenges each day.”

“These diphtheria cases come on top of an ongoing outbreak of measles and the huge load of general and emergency health needs of this many people,” says Pavlos Kolovos, MSF head of mission for Bangladesh.

“They are already vulnerable, coming with almost no vaccination coverage. Now they are living in an extremely densely populated camp, with poor water and hygiene conditions. Until those problems are addressed and improved, we will continue to face further disease outbreaks and not just of diphtheria.”


Despite progress in primary health care (PHC) since the Alma Ata Declaration in 1978, challenges to the provision
of primary health care in Bangladesh still remain. Although the Government takes lead responsibility for national policy, planning and decision making for all health care and is – through the Ministry of Health and Family Welfare (MoHFW) – the major health service provider, a PHC structure is still non-existent in urban areas. The health system is pluralistic and weak in terms of cross-sectoral operation. Government PHC services are administered in rural areas through the ‘Upazila health complex’, which consists of three tiers: at sub-district level (the Upazila level), the union level, and the ward or community level. These three lower tiers of the health system are intended to reach Bangladesh’s estimated 105 million people living in rural areas, and provide an upward referral system towards more specialised treatment.

Every Upazila complex is required to provide the same suite of services, with their budget allocation based on patient bed numbers in their health facilities, rather than local needs at the community level, including usage and geographical particularities. In reality, there
are uncertainties about how functional community clinics actually are in offering these services, particularly in light of limited staffing and expertise, drug availability, and significant evidence of low usage.


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