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Studying impact of the Covid-19 on essential health and nutrition services

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Adiba Khaled

The Covid-19 pandemic may have had an indirect effect on essential health and nutrition services (EHNS) in Bangladesh, in terms of provision, coverage, utilisation and care-seeking behaviour; particularly for reproductive, maternal, neonatal, child and adolescent health (RMNCAH), tuberculosis (TB), and non-communicable diseases (NCD). 

Through this study, we seek to understand the indirect effects of the Covid-19 on EHNS in Bangladesh. There will be specific focus on RMNCAH, together with TB and NCD for provision, coverage, utilisation and care-seeking. Research methods include the review of published and unpublished reports and secondary data analysis, and qualitative primary data collection covering both supply and demand side assessments.

The objective is to propose relevant recommendations arising from the analysis, e.g. options for the demand-side adoption of key measures and supply-side responses and initiatives that could be relevant for the government in EHNS and RMNCAH policy making. We will also support dissemination of findings and recommendations to selective audience from the ministry, World Bank and other development partners.

Our approach

We propose to better understand these impacts through:

  1. review of published and unpublished reports and secondary data analysis; and
  2. primary data collection covering both supply and demand side assessments.

Data collection tools include in-depth interviews, key informant interviews and focus group discussions with service providers, service managers, service recipients, and community people.

To understand the supply side effects, our team would conduct in-depth interviews with different types of service providers like government health and family planning fieldworkers, facility-based workers, facility managers in addition to informal sector service providers and health workers in private/non-government health facilities. For conducting focus group discussions, Health Assistants, EPI technologists, Family Welfare Assistant, Family Welfare Visitor, Brac’s Shebika (DOTS providers) will be approached. To assess the demand side effects, fo will be conducted with pregnant women, recent mothers, mothers of under-five, and patients with TB, diabetes, hypertension and COPD at village, union, upazila, district and Dhaka North City Corporation levels along with interviews of community leaders.

At the national level, findings from key informant interviews with senior government officials from directorate general of health and family planning services, Bangladesh chemists and druggist association, private clinic and diagnostic centre’s owner’s association, prominent health personalities, academics and development partners is also a core part of the research methods.

The study will focus on Dhaka division, Narayanganj district, given that there has been a higher number of confirmed Covid-19 cases than elsewhere. Each remaining level of administrative unit has been selected randomly from this district (Rupganj upazila, Bhalaboo union) along with ward-4 (Mirpur) of Dhaka North City Corporation. As a result, both urban and rural settings will be covered.