Browsing by Author "George, Joby"
Now showing 1 - 3 of 3
Results Per Page
Sort Options
Item Caregiver acceptability of the guidelines for managing young infants with possible serious bacterial infections (PSBI) in primary care facilities in rural Bangladesh(PLOS, 2020-04-14) Applegate, Jennifer A.; Ahmed, Salahuddin; Harrison, Meagan; Callaghan-Koru, Jennifer; Mousumi, Mahfuza; Begum, Nazma; Moin, Mamun Ibne; Joarder, Taufique; Ahmed, Sabbir; George, Joby; Mitra, Dipak K.; Ahmed, ASM Nawshad Uddin; Shahidullah, Mohammod; Baqui, Abdullah H.Many infants with possible serious bacterial infections (PSBI) do not receive inpatient treatment because hospital care may not be affordable, accessible, or acceptable for families. In 2015, WHO issued guidelines for managing PSBI in young infants (0–59 days) with simpler antibiotic regimens when hospital care is not feasible. Bangladesh adopted WHO’s guidelines for implementation in outpatient primary health centers. We report results of an implementation research study that assessed caregiver acceptability of the guidelines in three rural sub-districts of Bangladesh during early implementation (October 2015-August 2016).Item Implementation outcomes of the national scale up of chlorhexidine cord cleansing in Bangladesh’s public health system(Journal of Global Health, 2019) Callaghan-Koru, Jennifer A; Khan, Marufa; Islam, Munia; Sowe, Ardy; Islam, Jahurul; Billah, Sk Masum; Mannan, Imteaz Ibne; George, Joby; The Bangladesh Chlorhexidine Scale Up Study GroupBackground Chlorhexidine (CHX) cleansing of the umbilical cord stump is an evidence-based intervention that reduces newborn infections and is recommended for high-mortality settings. Bangladesh is one of the first countries to adopt and scale up CHX nationally. This study evaluates the implementation outcomes for the CHX scale up in Bangladesh and identifies and describes key milestones and processes for the scale up. Methods We adapted the RE-AIM framework for this study, incorporating the WHO/ExpandNet model of Scale Up. Adoption and incorporation milestones were assessed through program documents and interviews with national stakeholders (n = 25). Provider training records served as a measure of reach. Implementation was assessed through a survey of readiness to provide CHX at public facilities (n = 4479) and routine data on the proportion of all live births at public facilities (n = 813 607) that received CHX from December 2016 to November 2017. Six rounds of a rolling household survey with recently-delivered women in four districts (n = 6000 to 8000 per round) measured the effectiveness and maintenance of the scale up in increasing population-level coverage of CHX in those districts. Results More than 80 000 providers, supervisors, and managers across all 64 districts received a half-day training on CHX and essential newborn care between July 2015 and September 2016. Seventy-four percent of facilities had at least 70% of maternal and newborn health providers with CHX training, while only 46% had CHX in stock on the day of the assessment. The provision of CHX to newborns delivered at facilities steadily increased from 15 059 newborns (24%) in December 2016 to 71 704 (72%) in November 2017. In the final household survey of four districts, 33% of newborns were reported to receive CHX, and babies delivered at public facilities had 5.04 times greater odds (95% CI = 4.45, 5.72) of receiving CHX than those delivered at home. Conclusions The scale up of CHX in Bangladesh achieved sustained national implementation in public health facilities. Institutionalization barriers, such as changes to supply logistics systems, had to be addressed before expansion was achieved. For greater public health impact, implementation must reach deliveries that take place at home and in the private sector.Item Provider performance and facility readiness for managing infections in young infants in primary care facilities in rural Bangladesh(PLOS, 2020-04-22) Applegate, Jennifer A.; Ahmed, Salahuddin; Harrison, Meagan; Callaghan-Koru, Jennifer; Mousumi, Mahfuza; Begum, Nazma; Moin, Mamun Ibne; Joarder, Taufique; Ahmed, Sabbir; George, Joby; Mitra, Dipak K.; Ahmed, ASM Nawshad Uddin; Shahidullah, Mohammod; Baqui, Abdullah H.Neonatal infections remain a leading cause of newborn deaths globally. In 2015, WHO issued guidelines for managing possible serious bacterial infection (PSBI) in young infants (0–59 days) using simplified antibiotic regimens when compliance with hospital referral is not feasible. Bangladesh was one of the first countries to adopt WHO’s guidelines for implementation. We report results of an implementation research study that assessed facility readiness and provider performance in three rural sub-districts of Bangladesh during August 2015-August 2016.