CUEH Highlights

Urban Health Symposium
The Centre for Urban Equity and Health (CUEH), with several partner organisations, held a two day national urban health symposium titled ‘Urban Health Symposium: Taking Action for Healthy Cities in Bangladesh’ in Dhaka on 22-23 November 2013. The pioneering symposium brought together over 500 people including 75 national and international leaders who helped set the agenda for priority action areas on urban health and the way forward in tackling these emerging urban issues.

The consensus of the symposium was that healthy, inclusive cities in Bangladesh require multidisciplinary action and committed collaboration. Lessons from other nations grappling with urbanisation, as well as from Bangladesh, illuminated the path forward. Bangladesh is well placed to take a healthy cities agenda forward, under the assumption that a positive policy environment is supported by a return to relative political stability. Innovations are already taking place which can be harvested and the negative implications of unplanned urbanisation are being recognised nationally.

International conference and presentations:

Participation in the Health Systems in Asia Conference in Singapore:

Members of the team (Prof. Alayne Adams, Prof. Sabina Faiz Rashid and Dr. Nadira Sultana kakoly) presented findings from the UPPR case study at the conference and Dr. Nadira Sultana kakolyreceived the best poster award.

Participation in the thirdGlobal Symposium on Health Systems Research in South Africa

Three members from CUEH, Dean Professor Sabina Faiz Rashid, Co-Director Professor Alayne Adams, and Dr Nadira Sultana Kakoly participated in the thirdGlobal Symposium on Health Systems Research in South Africa from 30 September- 3 October 2014 in Cape Town, South Africa. The participants took active part in the oral presentation of the research findings from the centreas well as developingmany networking opportunities for future work.

Participation in ICUH 2015 in Dhaka

Members from CUEH, Dean Sabina Faiz Rashid, Co-Director Professor Alayne Adams were part of theorganising committee for the Urban Health Conference 2015 held in Dhaka in 2015. Research findings from the centrewerepresented at the conference by Dr Nadira Sultana Kakoly, Dr. Sabina Faiz Rashid, Dr. Alayne Adams, Mr. Tapas Mazumdar from JPGSPH.

Understanding demand and provision of eye care services among slum-dwellers in Dhaka, Bangladesh

Overview
Studies on access to eye care services in developing countries show that lack of awareness, availability, accessibility and affordability of services constitute major barriers in seeking treatment. This can result in low uptake of eye care services which represents a challenge for the elimination of avoidable blindness. Evidence exists that even when services are available, they are underused by potential beneficiaries. It is therefore important to identify the reasons for the low uptake of services and to implement appropriate strategies to address these issues. Delay in seeking eye care services is an important cause of avoidable blindness, especially in cases where early detection and treatment would have prevented the patient from becoming blind.

The overall aim of this research is to better understand the demand for and provision of eye care services in urban slum-dwelling communities in Dhaka by answering the following questions:
• What types of facility are offering eye care services in the targeted areas? What are their characteristics?
• What is the willingness-to-pay for refractive error services (spectacles)? What are the implications in terms of pricing and sustainability for eye care providers targeting slum-dwellers?
• What is the community attitude and practice around eye care? What are the main reasons for consultations? Where do patients go and why? What is the perceived advantage of each type of facility?
• What are the main barriers to accessing eye care services in poor urban communities? Do eye care facilities targeting slum-dwelling communities deliver effective services to the poor?

Activities
Based on the study’s objectives, several different research approaches were adopted to answer the research questions as summarised in the table below:
• Geographic information system (GIS) mapping and facility assessment
• Household surveys
• Qualitative interviews: focus group discussions (FGD) and in-depth interviews (IDI)
• Patient exit interviews (from eye care facilities)
• Patient exit interviews (from optic shop)

Partners/donor

Donor:
Sightsavers
Standard Charted Bank’s ‘Seeing is Believing’ programme
Partners:
Sightsavers
HNPP, BRAC

Prevalence of Eye Illnesses in Low-income Urban Communities in Dhaka, Bangladesh

Overview
Visual impairment is a major health concern across the world, especially in developing countries. In Bangladesh, around 650,000 people aged 30 years and above are suffering from visual impairment. Many factors hinder the ability to seek health care for eye illnesses including lack of awareness about eye diseases and eye care facilities; socioeconomic, cultural or psychological barriers, ignorance, etc. In order to improve the eye health situation in Bangladesh, eye care services must reach remote areas and be included in primary health care services. BRAC has been working with the government to improve the situation of eye care service through the Vision Bangladesh Project.

Most studies in both global and Bangladesh contexts have primarily focused on visual impairment. There was no study which investigated prevalence of all types of eye illnesses in Bangladesh, regardless of visual impairment. This study was conducted to estimate the community-based prevalence of any kind of eye illnesses in slum dwellers, one of the most vulnerable and poor communities. The outcome of this study will not only help in the formulation of the policy, but also support the designing of community-based programmes to address the eye care needs of vulnerable populations.

Activities
This study was conducted in two stages; the first stage was conducted in collaboration with BRAC’s Health, Nutrition and Population Programme (HNPP). A survey was conducted among participants aged 18 years and above from 1,320 randomly selected households from three slums in Dhaka (Shabujbag, Mirpur and Mohammadpur). Demographic and economic information of the participants as well as the families were taken in the survey. All interviewed participants were invited for free eye examinations at three selected eye care facilities.
During the second stage, willing survey participants underwent free eye examination at the three eye care facilities (Ad-din Women’s Medical College and Hospital, Bangladesh National Society for Blinds Dhaka Eye Hospital and Voluntary Association for Rural Development Eye Hospital).

Partners/donor

Donor: Health Nutrition and Population Programme, BRAC