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In a recent paper, A call for evidence-based reforms in nursing in Bangladesh, Akter and colleagues recommended several ways to strengthen the contributions of nurses. For example, pathways to enable nurses to become Nurse Practitioners could improve health-care access in rural settings. They also recommend recruiting more individuals with nursing education background to key administrative positions across clinical environments and in the Ministry of Health. They conclude, “An evidence-based reform that involves nurses in all professional decision-making processes around healthcare would result in a supportive environment that empowers nurses in Bangladesh, ultimately yielding better quality patient care.”

 
 
 

IUBAT nursing students with visiting faculty volunteers
IUBAT nursing students with visiting faculty volunteers

In a recent article in Foreign Affairs, Nicholas Eberstadt writes, “In the foreseeable future, many poorer countries will have to contend with the needs of an aged society even though their workers are far less productive than those in wealthier countries. Consider Bangladesh: a poor country today that will be an elderly society tomorrow, with over 13 percent of its 2050 population projected to be seniors. The backbone of the Bangladeshi labor force in 2050 will be today’s youth. But standardized tests show that five in six members of this group fail to meet even the very lowest international skill standards deemed necessary for participation in a modern economy: the overwhelming majority of this rising cohort cannot ‘read and answer basic questions’ or ‘add, subtract, and round whole numbers and decimals.’

 

We have written frequently about BHP efforts to tackle this problem, including our delivery of free pre-school and primary education in a rural village; advocacy for meaningful, national-level student assessments, and BHP Director John Richards’ book on education in South Asia. As a tiny organization, however, BHP has only limited impact. We are hopeful that the education reform group now making recommendations to the interim government in Bangladesh will be able to achieve more substantial change.

 
 
 

This opening sentence by Nicholas Kristof in the New York Times introduces the topic of obstetric fistula, which affects over one million women worldwide: “Typically impoverished women in poor countries where home births are the norm, who couldn’t get to a doctor in time … [suffer from] childbirth injuries that can be as damaging psychologically as physically. Prevention will come about by improving emergency obstetric services, a path that will also reduce deaths in childbirth.” Kristof recommends supporting the Fistula Foundation, which has financed over 100,000 fistula repairs in more than 30 countries, at an average cost per surgery of just $619 USD.





Dr. Nazmul Huda is a frequent collaborator with Bangladesh Health Project. He has taught in the IUBAT Nursing program and he spear-headed development of the IUBAT MPH program. In 2019, while he was country director for a program to reduce fistula, Nazmul along with BHP director Prof. John Richards and other experts wrote about high rates of C-section in Bangladesh and Pakistan (see below). In the right circumstances, C-section is vital; as a profitable short-cut it can be another source of childbirth injury.  Huda et al conclude, “Reducing caesarean rates requires government to strengthen health human resource development…. [However, due to] generally inadequate support for vaginal delivery either in facilities or in homes, families will increasingly choose a facility delivery, usually a caesarean, usually in a private clinic.” Unfortunately, as Huda et al predicted five years ago, c-section rates in Bangladesh have continued to rise.


Human resource development, especially in health professions, is the mission of BHP, enacted through most of our projects. Presently, the role of male family-members in childbirth planning is the research topic of IUBAT nursing faculty member, Mohammed Ali. Ali is now enrolled in studies at University of Oxford with support from our donors. BHP directors have mentored several IUBAT College of Nursing graduates. If you are interested in providing mentoring or financial support please contact us.

 
 
 

STRENGTHENING POPULATION HEALTH IN BANGLADESH

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