Bangladesh: a success case in combating childhood diarrhoea

Sk Masum Billah, Shahreen Raihana, Nazia Binte Ali, Afrin Iqbal, Mohammad Masudur Rahman, Abdullah Nurus Salam Khan, Farhana Karim, Mohd Anisul Karim, Aniqa Hassan, Bianca Jackson, Neff Walker, M. Altaf Hossain, Sukumar Sarker, Robert E. Black, Shams El Arifeen

Research output: Contribution to journalArticle

Abstract

Background: Bangladesh had a large reduction in childhood deaths due to diarrhoeal disease in recent decades. This paper explores the preventive, promotive, curative and contextual drivers that helped Bangladesh achieve this exemplary success. Methods: Primary and secondary data collection approaches were used to document trends in reduction of Diarrhoea Specific Mortality Rate (DSMR) between 1980 and 2015, understand what policies and programmes played key roles, and estimate the contribution of specific interventions that were implemented during the period. Data acquisition involved relevant document reviews and in-depth interviews with key stake-holders. A systematic search of literature was undertaken to explore socio-economic, aetiological, behavioural, and nutritional drivers of diarrhoeal disease reduction in Bangladesh. Finally, we used LiST (Lives Saved Tool) to model the contributions of the relevant interventions during three time periods (1980-2015, 1980-2000 and 2000-2015), and to project the number of lives saved in 2030 (compared to 2015) if these interventions were implemented at near universal coverage (90%). Results: The factors which likely had the most impact on DSMR were the coordinated efforts of the Government of Bangladesh (GoB) with non-government organizations (NGOs) and the private sector that enabled swift implementation, at scale, of interventions like oral rehydration solution (ORS) and zinc, promotion of breastfeeding, handwashing and sanitary latrines (WASH), as well as improvements in female education and nutrition. Compared to 1980, we found ORS and reduction in stunting prevalence had the greatest impact on DSMR, saving roughly 70 000 lives combined in 2015. Until 2000, ORS had a higher contribution to DSMR reduction than reduction in stunting prevalence. This proportionate contribution was reversed during 2000-2015. At near universal coverage (90%) of combined direct diarrhoeal disease, nutrition and WASH interventions, we project that an additional 5356 deaths due to diarrhoea could be averted in 2030. Conclusion: Bangladesh's achievement in reduction of DSMR highlights the important role of an enabling policy environment that fostered coordinated efforts of the public and private sectors and NGOs for maximal impact. To maintain this momentum, evidence-based interventions should be scaled up at universal coverage.

Original languageEnglish (US)
Number of pages1
JournalJournal of global health
Volume9
Issue number2
DOIs
StatePublished - Dec 1 2019

Fingerprint

Bangladesh
Diarrhea
Rehydration Solutions
Universal Coverage
Fluid Therapy
Mortality
Growth Disorders
Private Sector
Toilet Facilities
Organizations
Hand Disinfection
Public Sector
Breast Feeding
Zinc
Economics
Interviews
Education

ASJC Scopus subject areas

  • Health Policy
  • Public Health, Environmental and Occupational Health

Cite this

Billah, S. M., Raihana, S., Ali, N. B., Iqbal, A., Rahman, M. M., Khan, A. N. S., ... El Arifeen, S. (2019). Bangladesh: a success case in combating childhood diarrhoea. Journal of global health, 9(2). https://doi.org/10.7189/jogh.09.020803

Bangladesh : a success case in combating childhood diarrhoea. / Billah, Sk Masum; Raihana, Shahreen; Ali, Nazia Binte; Iqbal, Afrin; Rahman, Mohammad Masudur; Khan, Abdullah Nurus Salam; Karim, Farhana; Karim, Mohd Anisul; Hassan, Aniqa; Jackson, Bianca; Walker, Neff; Hossain, M. Altaf; Sarker, Sukumar; Black, Robert E.; El Arifeen, Shams.

In: Journal of global health, Vol. 9, No. 2, 01.12.2019.

Research output: Contribution to journalArticle

Billah, SM, Raihana, S, Ali, NB, Iqbal, A, Rahman, MM, Khan, ANS, Karim, F, Karim, MA, Hassan, A, Jackson, B, Walker, N, Hossain, MA, Sarker, S, Black, RE & El Arifeen, S 2019, 'Bangladesh: a success case in combating childhood diarrhoea', Journal of global health, vol. 9, no. 2. https://doi.org/10.7189/jogh.09.020803
Billah SM, Raihana S, Ali NB, Iqbal A, Rahman MM, Khan ANS et al. Bangladesh: a success case in combating childhood diarrhoea. Journal of global health. 2019 Dec 1;9(2). https://doi.org/10.7189/jogh.09.020803
Billah, Sk Masum ; Raihana, Shahreen ; Ali, Nazia Binte ; Iqbal, Afrin ; Rahman, Mohammad Masudur ; Khan, Abdullah Nurus Salam ; Karim, Farhana ; Karim, Mohd Anisul ; Hassan, Aniqa ; Jackson, Bianca ; Walker, Neff ; Hossain, M. Altaf ; Sarker, Sukumar ; Black, Robert E. ; El Arifeen, Shams. / Bangladesh : a success case in combating childhood diarrhoea. In: Journal of global health. 2019 ; Vol. 9, No. 2.
@article{39757c353af1445a818a8248cad4f37b,
title = "Bangladesh: a success case in combating childhood diarrhoea",
abstract = "Background: Bangladesh had a large reduction in childhood deaths due to diarrhoeal disease in recent decades. This paper explores the preventive, promotive, curative and contextual drivers that helped Bangladesh achieve this exemplary success. Methods: Primary and secondary data collection approaches were used to document trends in reduction of Diarrhoea Specific Mortality Rate (DSMR) between 1980 and 2015, understand what policies and programmes played key roles, and estimate the contribution of specific interventions that were implemented during the period. Data acquisition involved relevant document reviews and in-depth interviews with key stake-holders. A systematic search of literature was undertaken to explore socio-economic, aetiological, behavioural, and nutritional drivers of diarrhoeal disease reduction in Bangladesh. Finally, we used LiST (Lives Saved Tool) to model the contributions of the relevant interventions during three time periods (1980-2015, 1980-2000 and 2000-2015), and to project the number of lives saved in 2030 (compared to 2015) if these interventions were implemented at near universal coverage (90{\%}). Results: The factors which likely had the most impact on DSMR were the coordinated efforts of the Government of Bangladesh (GoB) with non-government organizations (NGOs) and the private sector that enabled swift implementation, at scale, of interventions like oral rehydration solution (ORS) and zinc, promotion of breastfeeding, handwashing and sanitary latrines (WASH), as well as improvements in female education and nutrition. Compared to 1980, we found ORS and reduction in stunting prevalence had the greatest impact on DSMR, saving roughly 70 000 lives combined in 2015. Until 2000, ORS had a higher contribution to DSMR reduction than reduction in stunting prevalence. This proportionate contribution was reversed during 2000-2015. At near universal coverage (90{\%}) of combined direct diarrhoeal disease, nutrition and WASH interventions, we project that an additional 5356 deaths due to diarrhoea could be averted in 2030. Conclusion: Bangladesh's achievement in reduction of DSMR highlights the important role of an enabling policy environment that fostered coordinated efforts of the public and private sectors and NGOs for maximal impact. To maintain this momentum, evidence-based interventions should be scaled up at universal coverage.",
author = "Billah, {Sk Masum} and Shahreen Raihana and Ali, {Nazia Binte} and Afrin Iqbal and Rahman, {Mohammad Masudur} and Khan, {Abdullah Nurus Salam} and Farhana Karim and Karim, {Mohd Anisul} and Aniqa Hassan and Bianca Jackson and Neff Walker and Hossain, {M. Altaf} and Sukumar Sarker and Black, {Robert E.} and {El Arifeen}, Shams",
year = "2019",
month = "12",
day = "1",
doi = "10.7189/jogh.09.020803",
language = "English (US)",
volume = "9",
journal = "Journal of Global Health",
issn = "2047-2978",
publisher = "Edinburgh University Global Health Society",
number = "2",

}

TY - JOUR

T1 - Bangladesh

T2 - a success case in combating childhood diarrhoea

AU - Billah, Sk Masum

AU - Raihana, Shahreen

AU - Ali, Nazia Binte

AU - Iqbal, Afrin

AU - Rahman, Mohammad Masudur

AU - Khan, Abdullah Nurus Salam

AU - Karim, Farhana

AU - Karim, Mohd Anisul

AU - Hassan, Aniqa

AU - Jackson, Bianca

AU - Walker, Neff

AU - Hossain, M. Altaf

AU - Sarker, Sukumar

AU - Black, Robert E.

AU - El Arifeen, Shams

PY - 2019/12/1

Y1 - 2019/12/1

N2 - Background: Bangladesh had a large reduction in childhood deaths due to diarrhoeal disease in recent decades. This paper explores the preventive, promotive, curative and contextual drivers that helped Bangladesh achieve this exemplary success. Methods: Primary and secondary data collection approaches were used to document trends in reduction of Diarrhoea Specific Mortality Rate (DSMR) between 1980 and 2015, understand what policies and programmes played key roles, and estimate the contribution of specific interventions that were implemented during the period. Data acquisition involved relevant document reviews and in-depth interviews with key stake-holders. A systematic search of literature was undertaken to explore socio-economic, aetiological, behavioural, and nutritional drivers of diarrhoeal disease reduction in Bangladesh. Finally, we used LiST (Lives Saved Tool) to model the contributions of the relevant interventions during three time periods (1980-2015, 1980-2000 and 2000-2015), and to project the number of lives saved in 2030 (compared to 2015) if these interventions were implemented at near universal coverage (90%). Results: The factors which likely had the most impact on DSMR were the coordinated efforts of the Government of Bangladesh (GoB) with non-government organizations (NGOs) and the private sector that enabled swift implementation, at scale, of interventions like oral rehydration solution (ORS) and zinc, promotion of breastfeeding, handwashing and sanitary latrines (WASH), as well as improvements in female education and nutrition. Compared to 1980, we found ORS and reduction in stunting prevalence had the greatest impact on DSMR, saving roughly 70 000 lives combined in 2015. Until 2000, ORS had a higher contribution to DSMR reduction than reduction in stunting prevalence. This proportionate contribution was reversed during 2000-2015. At near universal coverage (90%) of combined direct diarrhoeal disease, nutrition and WASH interventions, we project that an additional 5356 deaths due to diarrhoea could be averted in 2030. Conclusion: Bangladesh's achievement in reduction of DSMR highlights the important role of an enabling policy environment that fostered coordinated efforts of the public and private sectors and NGOs for maximal impact. To maintain this momentum, evidence-based interventions should be scaled up at universal coverage.

AB - Background: Bangladesh had a large reduction in childhood deaths due to diarrhoeal disease in recent decades. This paper explores the preventive, promotive, curative and contextual drivers that helped Bangladesh achieve this exemplary success. Methods: Primary and secondary data collection approaches were used to document trends in reduction of Diarrhoea Specific Mortality Rate (DSMR) between 1980 and 2015, understand what policies and programmes played key roles, and estimate the contribution of specific interventions that were implemented during the period. Data acquisition involved relevant document reviews and in-depth interviews with key stake-holders. A systematic search of literature was undertaken to explore socio-economic, aetiological, behavioural, and nutritional drivers of diarrhoeal disease reduction in Bangladesh. Finally, we used LiST (Lives Saved Tool) to model the contributions of the relevant interventions during three time periods (1980-2015, 1980-2000 and 2000-2015), and to project the number of lives saved in 2030 (compared to 2015) if these interventions were implemented at near universal coverage (90%). Results: The factors which likely had the most impact on DSMR were the coordinated efforts of the Government of Bangladesh (GoB) with non-government organizations (NGOs) and the private sector that enabled swift implementation, at scale, of interventions like oral rehydration solution (ORS) and zinc, promotion of breastfeeding, handwashing and sanitary latrines (WASH), as well as improvements in female education and nutrition. Compared to 1980, we found ORS and reduction in stunting prevalence had the greatest impact on DSMR, saving roughly 70 000 lives combined in 2015. Until 2000, ORS had a higher contribution to DSMR reduction than reduction in stunting prevalence. This proportionate contribution was reversed during 2000-2015. At near universal coverage (90%) of combined direct diarrhoeal disease, nutrition and WASH interventions, we project that an additional 5356 deaths due to diarrhoea could be averted in 2030. Conclusion: Bangladesh's achievement in reduction of DSMR highlights the important role of an enabling policy environment that fostered coordinated efforts of the public and private sectors and NGOs for maximal impact. To maintain this momentum, evidence-based interventions should be scaled up at universal coverage.

UR - http://www.scopus.com/inward/record.url?scp=85074389271&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85074389271&partnerID=8YFLogxK

U2 - 10.7189/jogh.09.020803

DO - 10.7189/jogh.09.020803

M3 - Article

C2 - 31673347

AN - SCOPUS:85074389271

VL - 9

JO - Journal of Global Health

JF - Journal of Global Health

SN - 2047-2978

IS - 2

ER -